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- 2021
- Working Paper
The Health Costs of Cost-Sharing
By: Amitabh Chandra, Evan Flack and Ziad Obermeyer
We use the design of Medicare’s prescription drug benefit program to demonstrate three facts about the health consequences of cost-sharing. First, we show that an as-if-random increase of 33.6% in out-of-pocket price (11.0 percentage points (p.p.) change in...
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- 2021
- Working Paper
Status and Mortality: Is There a Whitehall Effect in the United States?
By: Tom Nicholas
Do white collar workers with lower social status in the occupational hierarchy die younger? The influential Whitehall studies of British civil servants identified a strong inverse relationship between employment rank and mortality, but we do not know if this effect...
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- August 2020
- Article
Volunteering and Subsequent Health and Well-Being in Older Adults: An Outcome-Wide Longitudinal Approach
By: Eric Kim, A.V. Whillans, Matt Lee, Ying Chen and Tyler VanderWeele
Background: Growing evidence documents strong associations between volunteering and favorable health and well-being outcomes. However, epidemiological studies have not evaluated whether changes in volunteering are associated with subsequent health and well-being...
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- July 2020
- Article
Healthy Business? Managerial Education and Management in Healthcare
By: Nicholas Bloom, Raffaella Sadun, Renata Lemos and John Van Reenen
We investigate the link between hospital performance and managerial education by collecting a large database of management practices and skills in hospitals across nine countries. We find that hospitals that are closer to universities offering both medical education...
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- 2020
- Working Paper
Spreading the Health: Americans' Estimated and Ideal Distributions of Death and Health(care)
By: Sorapop Kiatpongsan and Michael I. Norton
The 2010 Patient Protection and Affordable Care Act intensified debates over the role of government in the distribution of healthcare. A nationally-representative sample of Americans reported their estimated and ideal distributions of healthcare (unmet need for...
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- 2020
- Working Paper
Working (From Home) During a Crisis: Online Social Contributions by Workers During the Coronavirus Shock
By: Prithwiraj Choudhury, Wesley W. Koo and Xina Li
Prior research has documented that during mortality-related crises workers face psychic costs and are motivated to make social contributions. In addition, management practices that encourage workers to make social contributions during a crisis create value for firms....
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- 2021
- Working Paper
Status and Mortality: Is There a Whitehall Effect in the United States?
By: Tom Nicholas
Do white collar workers with lower social status in the occupational hierarchy die younger? The influential Whitehall studies of British civil servants identified a strong inverse relationship between employment rank and mortality, but we do not know if this effect...
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- January 2, 2020
- Article
Changes in Quality of Care After Hospital Mergers and Acquisitions
By: Nancy Dean Beaulieu, Leemore S. Dafny, B. E. Landon, Jesse Dalton, Ifedayo Kuye and J. Michael McWilliams
Background: The hospital industry has consolidated substantially during the past two decades and at an accelerated pace since 2010. Multiple studies have shown that hospital mergers have led to higher prices for commercially insured patients, but research about effects...
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- January 2020
- Article
The Market Reacts Quickly: Changes in Paclitaxel Vascular Device Purchasing Within the Ascension Healthcare System
By: Peter P. Monteleone, Subhash Banerjee, Priya Kothapalli, Ariel Dora Stern, Daniel Fehder, Ron Ginor, Dominic Vollmar, Edward T. A. Fry and Mark J. Pirwitz
Background. A meta-analysis of trials in endovascular therapy suggested an increased mortality associated with treatment exposure to paclitaxel. Multiple publications and corrections of prior data were performed, and the United States Food and Drug Administration has...
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- November 2019
- Article
A Review of Bundled Payments in Total Joint Replacement
By: Olivia Manickas-Hill, Kevin J. Bozic and Thomas W. Feeley
The Bundled Payments for Care Improvement (BPCI) initiative, developed by the U.S. Center for Medicare & Medicaid Innovation, aims to reduce health care expenditures while maintaining or improving patient outcomes.
Several published reports evaluating the impact... View Details
Several published reports evaluating the impact... View Details
- July 2019
- Article
Evaluation of Economic and Clinical Outcomes Under Centers for Medicare & Medicaid Services Mandatory Bundled Payments for Joint Replacements
By: Derek A. Haas, Xiaoran Zhang, Robert S. Kaplan and Zirui Song
In 2016, the Centers for Medicare & Medicaid Services (CMS) launched its first mandatory bundled payment program, the Comprehensive Care for Joint Replacement (CJR) model, by randomizing metropolitan statistical areas (MSAs) into the payment model. The paper analyzed...
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- 2019
- Working Paper
Throwing the Baby Out with the Drinking Water: Unintended Consequences of Arsenic Mitigation Efforts in Bangladesh
By: Nina Buchmann, Erica Field, Rachel Glennerster and Reshmaan Hussam
The 1994 discovery of arsenic in ground water in Bangladesh prompted a massive public health effort to test all tubewells in the country and convince nearly one-quarter of the population to switch to arsenic-free drinking water sources. According to numerous sources,...
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- August 21, 2018
- Article
Patient–Physician Gender Concordance and Increased Mortality Among Female Heart Attack Patients
By: Brad Greenwood, Seth Carnahan and Laura Huang
We examine patient gender disparities in survival rates following acute myocardial infarctions (i.e., heart attacks) based on the gender of the treating physician. Using a census of heart attack patients admitted to Florida hospitals between 1991 and 2010, we find...
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- November 2017
- Article
A Retrospective Analysis of Hypertension Screening at a Mass Gathering in India: Implications for Non-communicable Disease Control Strategies
By: S. Balsari, P. Vemulapalli, M. Gofine, K. Oswal, R. Merchant, S. Saunik, G. Greenough and T. Khanna
Cardiovascular disease is the leading cause of mortality from noncommunicable diseases (NCD) in India. The government’s National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke seeks to increase capacity building, screening,...
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- 2017
- Working Paper
Healthy Business? Managerial Education and Management in Healthcare
By: Nicholas Bloom, Raffaella Sadun, Renata Lemos and John Van Reenen
We investigate the link between hospital performance and managerial education by collecting a large database of management practices and skills in hospitals across nine countries. We find that hospitals that are closer to universities offering both medical education...
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- December 2015
- Article
Task Shifting in Surgery: Lessons from an Indian Heart Hospital
By: Budhaditya Gupta, Robert S. Huckman and Tarun Khanna
We present a case study that illustrates task shifting, the transfer of activities from senior to junior colleagues, in the context of cardiac surgery at the Narayana Health City Cardiac Hospital (NH) in India. The case discusses the factors driving the adoption of...
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- 2016
- Working Paper
Cohort Turnover and Operational Performance: The July Phenomenon in Teaching Hospitals
By: Hummy Song, Robert S. Huckman and Jason R. Barro
We consider the impact of cohort turnover—the planned simultaneous exit of a large number of experienced employees and a similarly sized entry of new workers—on operational performance in the context of teaching hospitals. Specifically, we examine the impact of the...
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- Article
Time-driven Activity-based Costing of Multivessel Coronary Artery Bypass Grafting across National Boundaries to Identify Improvement Opportunities: Study Protocol
By: F. Erhun, B. Mistry, T. Platcheck, A. Milstein, V.G. Narayanan and R. S. Kaplan
Coronary artery bypass graft (CABG) surgery is a common treatment for coronary artery disease—a disease that affects over 10% of US adults and is a major cause of morbidity and mortality. In 2005, the mean cost for a CABG procedure among Medicare beneficiaries in the...
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- Fall 2014
- Article
Seesaws and Social Security Benefits Indexing
The price indexation of Social Security benefit payments has emerged in recent years as a flashpoint of debate in the United States. I characterize the direct effects that changes in that price index would have on retirees who differ in their initial wealth at...
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- 2013
- Working Paper
Adjusting National Accounting for Health: Is the Business Cycle Countercyclical?
By: Mark Egan, Casey B. Mulligan and Tomas J. Philipson
Many national accounts of economic output and prosperity, such as gross domestic product (GDP) or net domestic product (NDP), offer an incomplete picture by ignoring, for example, the value of leisure, home production, and the value of health. Previous discussed...
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