More from these Authors

• Article | New England Journal of Medicine | April 18, 2013

  Leading Clinicians and Clinicians Leading

  Richard Bohmer

  More effective models of care delivery are needed, but their successful implementation depends on effective care teams and good management of local operations (clinical microsystems). Clinicians influence both, and local clinician leaders will have several key tasks.

  Keywords: health care; leadership; Performance;

  Citation:

  Bohmer, Richard. "Leading Clinicians and Clinicians Leading." New England Journal of Medicine 368, no. 16 (April 18, 2013): 1468–1470.

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• Case | HBS Case Collection | 2013 (Revised from original 2002 version)

  Intermountain Health Care

  Richard M.J. Bohmer, Amy C. Edmondson and Laura Feldman

  Intermountain Health Care (IHC), an integrated delivery system based in Utah, has adopted a new strategy for managing health care delivery. The approach focuses management attention not only on the facilities where care takes place but also on physician decision making and the care process itself, with the aim of boosting physician productivity and improving care quality, while saving money. This case explores the challenges facing Brent James, executive director of the Institute for Health Care Delivery Research at IHC, as he implements new structures and systems (including a data warehouse for care outcomes, electronic patient records, computer workstations, clinical data support systems, and protocols for care) designed to support clinical process management across a geographically diverse group of physicians with varying levels of interest and dedication to IHC. Also highlights an innovative strategy for creating and disseminating knowledge at the individual and organizational levels to maintain high standards in care delivery.

  Keywords: Change Management; Cost vs Benefits; Ethnicity Characteristics; Cost Management; Health Care and Treatment; Innovation Strategy; Organizational Structure; Performance Improvement; Problems and Challenges; Adoption; Information Technology; Technology Adoption; Health Industry; Utah;

  Citation:

  Bohmer, Richard M.J., Amy C. Edmondson, and Laura Feldman. "Intermountain Health Care." Harvard Business School Case 603-066, March 2013. (Revised from original October 2002 version.)

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• Article | American Economic Review | 2013

  A Note on Fairness and Redistribution

  Rafael Di Tella and Juan Dubra

  In an influential paper, Alesina and Angeletos (2005)—henceforth, AA—argued that a preference for fairness could lead two identical societies to choose different economic systems. In particular, two equilibria might arise: one with low taxes and a belief that the income-generating process is "fair" because effort is important (an "American" equilibrium) and another with high taxes and the belief that the process is "unfair" because luck prevails. Piketty (1995) had shown that a similar pattern could arise from standard preferences if initial beliefs about the relative importance of effort and luck in generating income differed across the two societies, while Benabou and Tirole (2006) study this issue using more realistic preferences (Buera, Monge-Naranjo, and Primiceri 2011 discuss the evolution of beliefs about economic systems). A key contribution of AA is to obtain these two equilibria from identical societies assuming agents prefer outcomes that are fair, an important modification because fairness considerations seem central in the demand for redistribution, and because in several settings (as in some ultimatum games) such preferences for fairness can lead to large (material) inefficiencies. In this note we report a difficulty we encountered when interpreting the results in AA: we find multiplicity (and demand for redistribution) even if luck plays no role. In other words, there is multiplicity even if the equilibrium tax rate is independent of the signal-to-noise ratio (a quantity that expresses how important effort is, relative to luck, in the determination of income). This conflicts with the notion that the signal-to-noise ratio plays a central role in generating multiplicity with AA preferences for fairness.

  Keywords: fairness; taxes; beliefs;

  Citation:

  Di Tella, Rafael, and Juan Dubra. "A Note on Fairness and Redistribution." American Economic Review 103, no. 1 (2013): 549–553.

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