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- Creators: Department of Supply Chain Management
- Status: Published
Description
This article summarizes exploratory research conducted on private and public hospital systems in Australia and Costa Rica analyzing the trends observed within supply chain procurement. Physician preferences and a general lack of available comparative effectiveness research—both of which are challenges unique to the health care industry—were found to be barriers to effective supply chain performance in both systems. Among other insights, the ability of policy to catalyze improved procurement performance in public hospital systems was also was observed. The role of centralization was also found to be fundamental to the success of the systems examined, allowing hospitals to focus on strategic rather than operational decisions and conduct value-streaming activities to generate increased cost savings.
ContributorsBudgett, Alexander Jay (Author) / Schneller, Eugene (Thesis director) / Gopalakrishnan, Mohan (Committee member) / Barrett, The Honors College (Contributor) / Department of Supply Chain Management (Contributor) / Department of English (Contributor)
Created2015-05
Description
Objective: To assess and quantify the effect of state’s price transparency regulations (hereafter, PTR) on healthcare pricing.
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.
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.
ContributorsSabol, Joshua Lawrence (Author) / Reiser, Mark (Thesis director) / Ketcham, Jonathan (Committee member) / Dassanayake, Maduranga (Committee member) / Barrett, The Honors College (Contributor) / School of Mathematical and Statistical Sciences (Contributor) / Department of Supply Chain Management (Contributor)
Created2015-05
Description
The purpose of this project is to create an affordable and low-environmental impact housing model for high-density urban living. Detailed research was completed to select the Arizonan city of Tempe for the basis of this model such as author's preference and alarming demographic and economic factors. The finalized model will consist of shipping containers that will be converted into housing. These domiciles are ideal for a maximum of 1-2 occupants. The units will be stacked into communities to accomplish high density. These shipping containers will be used rather than brand new, the community landscape will consist of natural desert landscaping, a recycling program will be offered, and solar panels will be used to power the units. The decision for these features fulfills both the mission of the project and markets to the main demographic group of residents in Tempe, Millennials, who usually place sustainability in high regard. These units are meant to be purchased by the target market and other citizens to increase homeownership rates in Tempe. Their ownership rights will be analogous owning a condo, where they will own the converted shipping container itself, but not the property the unit is placed on. In addition, these units qualify for traditional loans and will appreciate similar to normal housing options. After conceptualizing the idea, various costs were analyzed for construction of the units. A critical component of the project is to receive government grants to fund the venture in order to continue the mission and keep prices of these units low. This model is expandable and could be moved to other cities within the state or potentially other states through future government grant attainment and success with the first installation. These communities will be managed by a company, Shipping Designs, which will be a limited liability company created by the author, Shauna Burgoyne.
ContributorsBurgoyne, Shauna Cheyenne (Author) / Kellso, James (Thesis director) / Dooley, Kevin (Committee member) / Department of Supply Chain Management (Contributor) / Department of Information Systems (Contributor, Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
Description
The purpose of this thesis is to gain a more nuanced understanding of what research is currently going on in the academic realm of supply chain management. This thesis is composed of two parts. The first part contains summaries and personal takeaways from four different supply chain management seminars that were put on by professors who were visiting the ASU campus. These seminars include general topics such as RFID readability, supply chain cash conversion cycles, risk management within the healthcare supply chain, and building trust and trustworthiness in global business. The second part of the thesis will then use a literature review to expand upon the topic of risk management within the healthcare supply chain, and to explore how previous research ties into the current happenings of the industry, as well as its future implications.
ContributorsHemzacek, Noah (Author) / Printezis, Antonios (Thesis director) / Choi, Thomas (Committee member) / Department of Finance (Contributor) / Department of Supply Chain Management (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
The healthcare industry is currently facing significant changes. One of the changes in the industry is a movement towards patient-focused care, which considers the patient as a person and the impact of care on the person. Patient experience is part of patient-focused care, and has similarities to the marketing term customer experience, which contributes to happier customers and long-term financial growth and success for businesses. This thesis defines current issues in patient experience as it relates to hospital manager decision making. Through secondary research, this thesis demonstrates what patient experience is, the role it plays in healthcare and hospital settings, the pressures on hospitals to increase patient experience performance, how patient experience performance is measured, and what strategies or action drive improvements under current performance measurements. Many studies and articles exist examining each of these issues individually. However, these sources do not comprehensively define patient experience in hospitals with perspective on how this influences hospital strategy and decision-making. Previous works on patient experience from the perspective of hospital strategy do not include considerations for recent industry shifts, most notably the Patient Protection and Affordable Care Act. The collected definitions in this thesis provide guidance of relevant concerns hospital managers consider when formulating organization-wide strategy related to patient experience. This thesis explains how patient experience contributes to the success of hospitals in the short-term, medium-term, and long-term and how patient experience may shift its focus over time. Short-term concerns include specific regulations and definitions from the Centers for Medicare and Medicaid services, responsible for over half of all payments to hospitals. Conforming to CMS standards is a matter of survival for most hospitals in the short-term. Hospitals are adjusting to rules and payment models not in existence just two years ago. First, hospitals will adapt, and then hospitals will strive to optimize under new standards as well as respond to adjustments in the rules over the next several years. After patient experience standards are well established, certain aspects of patient experience will be part of long-term differentiation and success for hospitals. Responding comprehensively to the shift towards improving patient experience is a critical aspect for hospitals to weather the many changes in the healthcare industry. Patient experience will provide better care to patients and better financial health to the hospitals that perform above patient experience standards.
ContributorsWilton, Kara Alexandra (Author) / Ketcham, Jonathan (Thesis director) / Ostrom, Amy (Committee member) / Barrett, The Honors College (Contributor) / W. P. Carey School of Business (Contributor) / Department of Supply Chain Management (Contributor) / Department of Marketing (Contributor)
Created2014-05
Description
Thesis Abstract: Cygnal The healthcare market plays a vital role in how our team worked with innovation space to design a product that fit user needs and could be a sustainable business. Whatever product we design is going to be dictated based off of how the insurance market will pay for it and how much we can charge for our product and services. In fact, the healthcare market is so incredibly unclear with outdated regulations that all of these fraud schemes and inflammatory prices are bound to happen. Stronger government involvement in this instance, I believe would help the issue. In reality, there are so many people taking advantage of the system that you cannot put the blame on anyone exploiting the system. What is clear though, is that they are taking advantage of a system that looks like it was set up to allow them to do so, and in that sense, Medicare is responsible for allowing this market to become warped. The healthcare industry played a vital role in our team for Innovation Space is completing our project. If we do not have a firm understanding on how the insurance market works, how much wheelchair companies are pricing chair components for, and how easily customers can see a financial benefit in switching to our product, it will not survive in the market place. That is why I as the business student am dedicating a lot of time in the final months of our project to make sure that our pricing is accurate, and feasible. The health insurance market, even if it is dysfunctional, will be ultimately paying for our product, and in business if you do not truly know your customer, you are bound to lose him. This paper uncovers why this market is warped and how to do business within it.
ContributorsMefford, Michael James (Author) / Peck, Sidnee (Thesis director) / Boradkar, Prasad (Committee member) / Barrett, The Honors College (Contributor) / Department of Economics (Contributor) / Department of Supply Chain Management (Contributor) / W. P. Carey School of Business (Contributor)
Created2015-05
Description
The purpose of this research was to identify various problems within value analysis teams as well as provide solutions that will help to better align the agents involved in the value analysis process. As healthcare costs continue to rise, and hospital reimbursements fall, value analysis teams will play an even more pivotal role in the success of healthcare organizations. Also, the industry trend toward value-based care is highlighting the importance of these teams. However, interdisciplinary value analysis teams bring to light the underlying agency issue that exists between physicians and hospital administrators, and the general misalignment of values between the participants. In order for these teams to function properly, it is inherent that all of the professionals involved align their incentives. For this study, I studied relevant literature pertaining to value analysis, attended relevant speakers, and then performed interviews with several different professionals involved in healthcare value analysis. I organized and coded this data using the Grounded Theory approach, and was able to identify the underlying issues within these teams. I then created a typology of value analysis teams, based on my respondents, where I segment them into four tiers based on their utilization of data, and their level of physician involvement. Finally, I identified three distinct strategies for developing value analysis teams to implement in order to increase their efficiency and overall success.
ContributorsLindgren, Thomas John (Author) / Schneller, Eugene (Thesis director) / Choi, Thomas (Committee member) / Department of Supply Chain Management (Contributor) / Department of Economics (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
Description
To investigate the impacts of an energy efficiency retrofit, indoor air quality and resident health were evaluated at a low‐income senior housing apartment complex in Phoenix, Arizona, before and after a green energy building renovation. Indoor and outdoor air quality sampling was carried out simultaneously with a questionnaire to characterize personal habits and general health of residents. Measured indoor formaldehyde levels before the building retrofit routinely exceeded reference exposure limits, but in the long‐term follow‐up sampling, indoor formaldehyde decreased for the entire study population by a statistically significant margin. Indoor PM levels were dominated by fine particles and showed a statistically significant decrease in the long‐term follow‐up sampling within certain resident subpopulations (i.e. residents who report smoking and residents who had lived longer at the apartment complex).
ContributorsFrey, S.E. (Author) / Destaillats, H. (Author) / Cohn, S. (Author) / Ahrentzen, S. (Author) / Fraser, M.P. (Author)
Created2015
Description
This study aims to examine how the use of consensus-based transactions, smart contracts,and interoperability, provided by blockchain, may benefit the blood plasma industry. Plasmafractionation is the process of separating blood into multiple components to garner benefitsof increased lifespan, specialized allocation, and decreased waste, thereby creating a morecomplex and flexible supply chain. Traditional applications of blockchain are developed onthe basis of decentralization—an infeasible policy for this sector due to stringent governmentregulations, such as HIPAA. However, the trusted nature of the relations in the plasmaindustry’s taxonomy proves private and centralized blockchains as the viable alternative.Implementations of blockchain are widely seen across pharmaceutical supply chains to combatthe falsification of possibly afflictive drugs. This system is more difficult to manage withblood, due to the quick perishable time, tracking/tracing of recycled components, and thenecessity of real-time metrics. Key attributes of private blockchains, such as digital identity,smart contracts, and authorized ledgers, may have the possibility of providing a significantpositive impact on the allocation and management functions of blood banks. Herein, we willidentify the economy and risks of the plasma ecosystem to extrapolate specific applications forthe use of blockchain technology. To understand tangible effects of blockchain, we developeda proof of concept application, aiming to emulate the business logic of modern plasma supplychain ecosystems adopting a blockchain data structure. The application testing simulates thesupply chain via agent-based modeling to analyze the scalability, benefits, and limitations ofblockchain for the plasma fractionation industry.
ContributorsVallabhaneni, Saipavan K (Author) / Boscovic, Dragan (Thesis director) / Kellso, James (Committee member) / Department of Information Systems (Contributor) / Department of Supply Chain Management (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
Through Zero Waste at ASU, the Villas & Vista del Sol Community Compost Program (VVDS CCP) has been in operation for three years. Programs such as this one have been identified as a priority by the university due to the significance of food waste in the waste stream ASU produces and the opportunity to reduce climate impact by diverting this waste from landfill. However, the CCP has struggled to reach its participation targets throughout its time in operation and therefore ASU requires better understanding of marketing strategies that will lead to program success before investing in additional residential compost programs. This thesis addresses the fundamental question: What marketing and operational strategies are most effective within a residential composting program at Arizona State University? Using a combination of literature review, qualitative primary research, and experimentation, this thesis provides an explanation of how the university can effectively implement and grow residential composting programs.
ContributorsMiserlian, Rachel (Author) / Dooley, Kevin (Thesis director) / Jung, Kendon (Committee member) / Barrett, The Honors College (Contributor) / Walter Cronkite School of Journalism and Mass Comm (Contributor) / Department of Marketing (Contributor) / Department of Supply Chain Management (Contributor)
Created2022-05