Theses and Dissertations
Filtering by
- All Subjects: healthcare
- All Subjects: Warehousing Practices
- Creators: Department of Supply Chain Management
Data Sources: I use the Healthcare Cost and Utilization Project’s Nationwide Inpatient Sample (NIS) from 2000 to 2011. The NIS is a 20% sample of all inpatient claims. The Manhattan Institute supplied data on the availability of health savings accounts in each state. State PTR implementation dates were gathered by Hans Christensen, Eric Floyd, and Mark Maffett of University of Chicago’s Booth School of Business by contacting the health department, hospital association, or website controller in each state.
Study Design: The NIS data was collapsed by procedure, hospital, and year providing averages for the dependent variable, Cost, and a host of covariates. Cost is a product of Total Charges within the NIS and the hospital’s Cost to Charge ratio. A new binary variable, PTR, was defined as ‘0’ if the year was strictly less than the disclosure website’s implementation date, ‘1’ for afterwards, and missing for the year of implementation. Then, using multivariate OLS regression with fixed effect modeling, the change in cost from before to after the year of implementation is estimated.
Principal Findings: The analysis estimates the effect of PTR to decrease the average cost per procedure by 7%. Specifications identify within state, within hospital, and within procedure variation, and reports that 78% of the cost decrease is due to within-hospital, within-procedure price discounts. An additional model includes the interaction of PTR with the prevalence of health savings accounts (hereafter, HSAs) and procedure electivity. The results show that PTR lowers costs by an additional 3 percent with each additional 10 percentage point increase in the availability of HSAs. In contrast, the cost reductions from PTR were much smaller for procedures more frequently coded as elective.
Conclusions: The study concludes price transparency regulations can lead to a decrease in a procedure’s costs on average, primarily through price discounts and slightly through lower cost procedures, but not due to patients moving to cheaper hospitals. This implies that hospitals are taking initiative and lowering prices as the competition’s prices become publically available suggesting that hospitals – not patients – are the biggest users of price transparency websites. Hospitals are also finding some ways to provide cheaper alternatives to more expensive procedures. State regulators should evaluate if a better metric other than charge prices, such as expected out-of-pocket payments, would evoke greater patient participation. Furthermore, states with higher prevalence of HSAs experience greater effects of PTR as expected since patients with HSAs have greater incentives to lower their costs. Patients should expect a shift towards plans that offer these types of savings accounts since they’ve shown to have a reduction of health costs on average per procedure in states with higher prevalence of HSAs.
In the Fall 2021 semester, the Behavioral Lab (in the Supply Chain Management department) was interested in researching the best warehousing inventory management practices. Poor warehouse management can lead to increased lead times and lower customer satisfaction due to errors during the inventory storage and picking processes. Students enrolled in the Supply Chain Management introductory course participated in a simulation called “Warehouseville” to test best practices. In Warehouseville, students completed a series of timed tasks. Participants were incentivized to perform to the best of their ability through financial compensation based on their performance relative to the participant pool average. After the results were summarized, data analysis was performed to derive best practices that can be applied not only to the partner company, Starbucks but also to other firms/industries. As a lab assistant, I assisted in the Warehouseville simulation by helping Professor Craig Carter with any tasks leading up to, during, and following the data collection sessions that he needed support for.
In the Fall 2021 semester, the Behavioral Lab (in the Supply Chain Management department) was interested in researching the best warehousing inventory management practices. Poor warehouse management can lead to increased lead times and lower customer satisfaction due to errors during the inventory storage and picking processes. Students enrolled in the Supply Chain Management introductory course participated in a simulation called “Warehouseville” to test best practices. In Warehouseville, students completed a series of timed tasks. Participants were incentivized to perform to the best of their ability through financial compensation based on their performance relative to the participant pool average. After the results were summarized, data analysis was performed to derive best practices that can be applied not only to the partner company, Starbucks but also to other firms/industries. As a lab assistant, I assisted in the Warehouseville simulation by helping Professor Craig Carter with any tasks leading up to, during, and following the data collection sessions that he needed support for.