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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 In fact, the healthcare market is so incredibly unclear with outdated regulations that all of these fraud schemes and inflammatory prices are bound to happen.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
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
2015 marks the deadline for the UN Millennium Development Goal 5 to reduce global maternal mortality rate (MMR) by 75% since 1990. As of 2015, MMR has only been reduced by 45%. Many international organizations claim that more medically trained midwives can meet global maternal health care needs. This study investigates two major questions. What is the role of midwives in diverse international maternal healthcare contexts? How do midwives in these different contexts define their roles and the barriers to providing the best care for women? From May to August 2015, I conducted over 70 interviews with midwives in Netherlands, Sweden, Rwanda, Bangladesh, Australia and Guatemala, interviewing between 6 and 13 midwives from each country. The majority of midwives defined their roles as supporting women's individual capacities and power through normal birth, and knowing when to refer when high-risk complications arise. Although thematic barriers vary by country, midwives in all countries believed that maternal healthcare can be improved by increased collaboration between midwives and other health care professionals, better access to culturally appropriate services, and greater public awareness of the role of midwives.
ContributorsCarson, Anna Elizabeth (Author) / Hruschka, Daniel (Thesis director) / Maupin, Jonathan (Committee member) / School of International Letters and Cultures (Contributor) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
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
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
Short-term medical volunteer work via a nongovernmental organization is a popular tool for students in the health care field to gain experience, while further providing communities that normally lack health care options the opportunity to receive free care. One such organization, VIDA Volunteer Travel, has been successful in implementing this model in Central America. However, organizations of this form have not been evaluated for effectiveness or improvement. This exploratory study examines the effectiveness of VIDA based on six qualifying characteristics that make up a successful NGO. The researcher conducted in-depth, semi-structured interviews with 21 individuals, including VIDA staff members in Costa Rica and Nicaragua, health professionals working for VIDA, local community leaders, and volunteers participating in VIDA's programs. Summaries and quotes of these interviews were uploaded and analysed using Atlas.ti to identify common words and themes from the interviews. Informants frequently identified the organization as sustainable, both from a fiscal and ecological standpoint. The organization also successfully managed volunteers, although post-trip follow-up was lacking. Adherence to the mission statement and distribution of supplies allowed for improved organization and successful structure of the organization. Education and health promotion was also emphasized, although implementation of this education into the communities was lacking. Collaboration with the community and volunteers allowed for stringent, successful treatment to be given to patients, and ethical guidelines set up by the organization allowed for self-governance and improvement of the NGO. This study suggests future research opportunities for the organization, to evaluate its own impact and opportunities for improvement. Furthermore, suggestions are addressed that allow the organization to improve upon its well-implemented infrastructure, and allow for future organizations to use VIDA as a model for improvement.
ContributorsPearson, Presley Kyle (Author) / Yoshioka, Carlton (Thesis director) / Wang, Lili (Committee member) / Larsen, Dale (Committee member) / Barrett, The Honors College (Contributor) / School of International Letters and Cultures (Contributor)
Created2013-05
Description
As of March 2020, there were over 112,400 patients actively waiting on the United States national organ transplant waitlist with only about 3,300 donors1. Although transplantation is an effective treatment for end-stage organ failure, the access to a procedure will vary depending on national regulations, cost of health care, extensive screening processes, and the availability of organs2. Organ shortage is a worldwide problem, and the growing insufficiency has resulted patients becoming too for ill or dying while waiting3. Due to the varying wait times and costs of procedures, some patients have begun to outsource their own transplantation through international transactions, also known as transplant tourism2. The 2004 World Health Assembly resolution recognized these trades as a significant health policy issue, while also acknowledging the inability of national health care systems to meet the needs of patients4. To address this issue, a proposal will be made such that all live kidney and liver donors will be compensated $22,500 and $12,150 respectively through a cost-neutral scheme based on annual healthcare expenditures per organ that would be eliminated by a transplant. With this proposal, it is suggested that the organ transplant waitlist would not only be significantly reduced, but potentially eliminated, and the crisis of organ shortage would be defeated.
ContributorsMartin, Starla (Author) / Kingsbury, Jeffrey (Thesis director) / Edmonds, Hallie (Committee member) / School of Molecular Sciences (Contributor) / School of Human Evolution & Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
In 2017 alone, over 250,00 patients died due to medical errors and is the 3rd leading cause of death in America. These errors attributed to incorrect diagnosis and treatment of illnesses can be preventable. The solution to this major issue is the creation of an app called HealthKeep. Primary market research done during the first semester of the study included the creation of a school-wide survey across all ASU campuses that consisted of key questions for people of all ages in regards to their healthcare. These questions include how often patients of specific age ranges visit the doctor, their overall experience during appointments, and their attitudes towards the creation of a mobile health application that would be able to tabulate all your medical information neatly and securely. The overwhelming response stated that patient’s from all ranges would be open to the idea of having such an application. Further development included the creation of a business plan and application storyboard used when interviewing potential customers about the application. All of these tools aided in the first entry for Venture Devils in the first semester leading to the disappointing failure of winning funding. However, the feedback on the website created, executive summary, expanded pitch deck, and market research aided in the successful key revisions of the venture during this second semester and has resulted in placement in the final round of Pitch Playoffs where funding can be awarded.
ContributorsSiraj, Salim (Co-author) / Undrill, Grayson (Co-author) / Ott, Madison (Co-author) / Smith, Keaton (Co-author) / Byrne, Jared (Thesis director) / Sebold, Brent (Committee member) / School of Molecular Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
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
The rate of vaccinations has been consistently decreasing in the past years in children of ages 0-18. Multiple factors and barriers contribute to these low rates. This comparative case study investigated the accessibility of information regarding childhood vaccinations to parents in areas with differing poverty levels in the greater Phoenix region, specifically in the West Valley, Downtown Phoenix, and the East Valley. Pediatric clinics, public elementary schools, and public libraries were visited in each area to assess how much information was available where. The analysis produced unexpected results: the West Valley, which had the highest poverty level, contained the most amount of accessible information for parents in many languages, while the East Valley, with a low poverty level, had almost no information accessible to parents of these children. Implications for future research, policy, and practice are discussed. Based on these unexpected results, one recommendation is to develop a pamphlet that could be distributed to these public places to raise awareness of the importance of vaccinations in children to parents.
ContributorsShah, Veedhi (Author) / Bates, Denise (Thesis director) / Castillo, Elizabeth (Committee member) / College of Health Solutions (Contributor) / School of Life Sciences (Contributor) / School of International Letters and Cultures (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05