There has been much policy debate about paying physicians by salary or compensating them for the work that they do. We study a natural experiment in which we observe multiple practices in the same institution, switching to productivity pay at different times. We will study the effect of productivity pay on billing, utilization, and patient outcomes.
(Partner: Harvard University School of Engineering and Applied Science)
This inter-disciplinary project addresses two formidable health care realities: the growing number of patients with chronic conditions who require coordinated care from multiple medical providers, and a growing chasm between the complexity of health information and individuals’ health literacy. To meet these challenges, researchers are developing the following four computational capabilities that would support parents caring for children with medical complexity:
More than 70 percent of U.S. child health care resources are committed to the 5 percent of children with the most complex of medical conditions. Fiscal pressures, reforms to the Medicaid program, and implementation of the Affordable Care Act (ACA) provide opportunities to reduce inefficiencies and to expand access to high-quality subspecialty care for these children.
The Consortium for Healthcare Informatics Research (CHIR) is a multisite project funded by Department of Veterans Affairs Health Services Research and Development (HSR&D). The projects develops methods in natural language processing (NLP) to advance the effective use of unstructured text and other types of electronic health record (EHR) clinical data to improve the health and health care of Veterans.
We measure the degree of supplier-induced demand in newborn treatment, by exploiting changes in reimbursement arising from the introduction in Japan of the partial prospective payment system (PPS). Under the partial PPS, neonatal intensive care unit (NICU) utilization became relatively more profitable than other procedures, since it was excluded from prospective payments. We find that hospitals respond to PPS adoption by increasing NICU utilization and more frequently manipulating infants' reported birth weights -- the latter of which is a measure that determines the infant's maximum allowable length of stay in NICU. This induced demand substantially increases hospitals' reimbursements.
Philippines Conference Room
Previous research suggests that the emotions people value (“ideal affect”) can help explain cultural differences in health care preferences. For example, those valuing excitement tend to prefer physicians who promote excitement and medications that induce feelings of excitement. However, the emotions people want to avoid (“avoided affect”) may be just as influential, particularly among older adults and East Asian Americans who tend to be motivated more by avoiding (versus approaching) certain outcomes.
Background: Cancer is the second leading cause of death in the United States and disproportionately affects elderly patient populations. Many describe poor quality of life and experience, unnecessary suffering, and treatment options with little benefit. Additionally, many elderly patients with cancer also are less likely to receive a full diagnosis or engage in shared-decision making. No studies have evaluated the influence of health coaches and shared-decision making tools on patient and caregiver experiences and receipt of goal concordant care.
