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- Creators: College of Health Solutions
- Creators: Department of Supply Chain Management
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 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
Patients face tremendous challenges when attempting to navigate the United States health care system. This difficulty to navigate the system creates a burden that is placed on the patient and caregiver, in turn affecting the health outcomes of the patient, resulting in higher health care costs, less than desirable outcomes, and a large strain on the patient and caregiver's daily lives. There are several ways that people have tried to create a comprehensive theoretical framework to understand the system from multiple perspectives. This work will expand existing theoretical frameworks that observes the relationship between the patient, their social networks, and health care services such as the Burden of Treatment Theory. Consisting of a comprehensive, multidisciplinary literature review, research was derived from the disciplines of medicine, informatics, management, and ethics. In this paper, I attempt to identify key contributing factors and then develop and categorize these stressors into a typology. Since there are many contributing factors that affect the burden of work at multiple levels, a nested typology will be used which will link micro- and macro-leveled pressures to a single system while also showcasing how each level interacts and is influenced by the others. For the categorization of the contributing factors, they will be sorted into individual actors, organizational level, and macro-level factors. The implications of this work suggest that a combination of historical shifts, structural design, and secondary effects of policy contribute to patients' burden of work.
ContributorsTomlinson, Rachel Laiku (Author) / Pine, Katie (Thesis director) / Trinh, Mai (Committee member) / School for the Science of Health Care Delivery (Contributor) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2017-05
Description
Homelessness is a pervasive in American society. The causes of homelessness are complex, but health and homelessness are inextricably linked. Student-run free clinics care for underserved populations, including people experiencing homelessness, but they have multiple agendas—to provide care but also to give students hands-on experience. It is plausible that these two agendas may compete and give patients sub-par quality of care.
This study examines patient care in the SHOW free clinic in Phoenix, Arizona, which serves adults experiencing homelessness. This study asks two questions: First, do clinicians in Phoenix’s SHOW free clinic discuss with patients how to pay for and where to access follow-up services and medications? Second, how do the backgrounds of patients, measured by scales based on the Gelberg-Anderson behavioral model for vulnerable populations, correlate with patient outcomes, including number of unmet needs in clinic, patient satisfaction with care, and patient perceived health status? To answer these questions, structured surveys were administered to SHOW clinic patients at the end of their visits. Results were analyzed using Pearson’s correlations and odds ratios. 21 patients completed the survey over four weeks in February-March 2017. We did not identify any statistically significant correlations between predisposing factors such as severity/duration of homelessness, mental health history, ethnicity, or LGBTQ status and quality of care outcomes. Twenty nine percent of surveyed patients reported having one or more unmet needs following their SHOW clinic visit suggesting an important area for future research. The results from this study indicate that measuring unmet needs is a feasible alternative to patient satisfaction surveys for assessing quality of care in student-run free clinics for homeless populations.
This study examines patient care in the SHOW free clinic in Phoenix, Arizona, which serves adults experiencing homelessness. This study asks two questions: First, do clinicians in Phoenix’s SHOW free clinic discuss with patients how to pay for and where to access follow-up services and medications? Second, how do the backgrounds of patients, measured by scales based on the Gelberg-Anderson behavioral model for vulnerable populations, correlate with patient outcomes, including number of unmet needs in clinic, patient satisfaction with care, and patient perceived health status? To answer these questions, structured surveys were administered to SHOW clinic patients at the end of their visits. Results were analyzed using Pearson’s correlations and odds ratios. 21 patients completed the survey over four weeks in February-March 2017. We did not identify any statistically significant correlations between predisposing factors such as severity/duration of homelessness, mental health history, ethnicity, or LGBTQ status and quality of care outcomes. Twenty nine percent of surveyed patients reported having one or more unmet needs following their SHOW clinic visit suggesting an important area for future research. The results from this study indicate that measuring unmet needs is a feasible alternative to patient satisfaction surveys for assessing quality of care in student-run free clinics for homeless populations.
ContributorsWilson, Ethan Sinead (Author) / Jehn, Megan (Thesis director) / Harrell, Susan (Committee member) / School of Human Evolution and Social Change (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
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
“Let Food be Thy Medicine” focuses on alternative treatment for patients suffering from obesity, diabetes mellitus type 2, hypertension, and coronary artery disease. Nutrition is an important aspect of overall health and can contribute to prevention and management of these conditions, especially when combined with medication and physical activity. Obesity is a condition that people worldwide struggle with. Adequate nutrition can play a major role in contributing to the prevention of and management of obesity not only through calorie and macronutrient intake but also by affecting hormonal and energy balances in the body. Recommended physical activity levels are included along with dietary
utritional intake recommendations on the educational pamphlet to give patients a starting guideline and better understanding how to help this condition. Type 2 diabetes, high blood pressure, and coronary artery disease are also common conditions treated by healthcare professionals. There are currently several medications on the market to help manage these conditions that range in price and have many side effects. Nutrition and exercise are two factors that can further contribute to the management of type 2 diabetes, high blood pressure, and coronary artery disease, but they can also help prevent and delay their onset. Nutrition and physical activity education along with examples of certain foods that can aid in reaching nutritional goals are outlined in the educational pamphlet to give patients a visual of what is in the academic paper.
utritional intake recommendations on the educational pamphlet to give patients a starting guideline and better understanding how to help this condition. Type 2 diabetes, high blood pressure, and coronary artery disease are also common conditions treated by healthcare professionals. There are currently several medications on the market to help manage these conditions that range in price and have many side effects. Nutrition and exercise are two factors that can further contribute to the management of type 2 diabetes, high blood pressure, and coronary artery disease, but they can also help prevent and delay their onset. Nutrition and physical activity education along with examples of certain foods that can aid in reaching nutritional goals are outlined in the educational pamphlet to give patients a visual of what is in the academic paper.
ContributorsCarson, Caitlin Colleen (Author) / Day, Kimberly (Thesis director) / Levinson, Simin (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / College of Health Solutions (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
Healthcare is delivered in many ways across the world. Most countries use one of the four healthcare models, but the United States uses parts of the four models. This leads to issues for patients as they may not know what their insurance plans cover. Providers also have issues with health insurance in getting coverage for their patients. With both patients and providers having issues with insurances, insurance companies have not taken an action to help alleviate some of the issues that everyone faces. Providers are also faced with issues of burnout as they have a lot to do, and not enough time or energy to complete everything. This effects the quality of healthcare that is delivered to their patients as well as when a person can see a provider as there are not enough doctors and nurses to cover the case load all of the time. All in all, providers, insurance companies, and patients need to work together to help fix some of the issues with healthcare to be able to move towards a better healthcare model for all.
Contributorsde Mello, Julianna (Author) / Kingsbury, Jeffrey (Thesis director) / Grozier, Darren (Committee member) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2023-05