Impact of Physician Payment Scheme on Diagnostic Effort and Testing

References

• Abaluck J, Agha L, Kabrhel C, Raja A, Venkatesh A (2016) The determinants of productivity in medical testing: Intensity and allocation of care. Amer. Econom. Rev. 106(12):3730–3764.Crossref, Google Scholar
• Adida E, Bravo F (2019) Contracts for healthcare referral services: Coordination via outcome-based penalty contracts. Management Sci. 65(3):1322–1341.Link, Google Scholar
• Adida E, Mamani H, Nassiri S (2017) Bundled payment vs. fee-for-service: Impact of payment scheme on performance. Management Sci. 63(5):1606–1624.Link, Google Scholar
• Afendulis CC, Kessler DP (2007) Tradeoffs from integrating diagnosis and treatment in markets for healthcare. Amer. Econom. Rev. 97(3):1013–1020.Crossref, Google Scholar
• Aires DJ, Wick J, Shaath TS, Rajpara AN, Patel V, Badawi AH, Li C, Fraga GR, Doolittle G, Liu DY (2016) Economic costs avoided by diagnosing melanoma six months earlier justify > 100 benign biopsies. J. Drugs Dermatology 15(5):527–532.Google Scholar
• Alhassan S, Sayf A, Arsene C, Krayem H (2016) Suboptimal implementation of diagnostic algorithms and overuse of computed tomography-pulmonary angiography in patients with suspected pulmonary embolism. Ann. Thoracic Medicine 11(4):254–260.Crossref, Google Scholar
• Alizamir S, de Véricourt F, Sun P (2012) Diagnostic accuracy under congestion. Management Sci. 59(1):157–171.Link, Google Scholar
• Allard M, Jelovac I, Léger PT (2014) Payment mechanism and GP self-selection: Capitation vs. fee for service. Internat. J. Healthcare Finance Econom. 14(2):143–160.Crossref, Google Scholar
• Andritsos DA, Tang CS (2018) Incentive programs for reducing readmissions when patient care is co-produced. Production Oper. Management 27(6):999–1020.Crossref, Google Scholar
• Ayer T, Alagoz O, Stout NK (2012) OR forum—A POMDP approach to personalize mammography screening decisions. Oper. Res. 60(5):1019–1034.Link, Google Scholar
• Bastani H, Bayati M, Braverman M, Gummadi R, Johari R (2017) Analysis of Medicare pay-for-performance contracts. Technical report, EC Mechanism Design for Social Good Workshop, Wharton School, University of Pennsylvania.Google Scholar
• Berenson R, Singh H (2018) Payment innovations to improve diagnostic accuracy and reduce diagnostic error. Health Affairs 37(11):1828–1835.Crossref, Google Scholar
• Bergeson SC, Dean JD (2006) A systems approach to patient-centered care. JAMA 296(23):2848–2851.Crossref, Google Scholar
• Bertakis KD, Azari R (2011) Patient-centered care is associated with decreased healthcare utilization. J. Amer. Board Family Medicine 24(3):229–239.Crossref, Google Scholar
• Bester H, Dahm M (2017) Credence goods, costly diagnosis and subjective evaluation. Econom. J. 128(611):1367–1394.Google Scholar
• Betcheva L, Erhun F, Jiang H (2021) OM forum—Supply chain thinking in healthcare: Lessons and outlooks. Manufacturing Service Oper. Management 23(6):1333–1353.Link, Google Scholar
• Bish DR, Bish EK, El Hajj H (2022) Disease bundling or specimen bundling? Cost- and capacity-efficient strategies for multi-disease testing with genetic assays. Manufacturing Service Oper. Management, ePub ahead of print August 8, 2023, https://doi.org/10.1287/msom.2022.0296.Google Scholar
• Carr T (2021) Are we screening too much for skin cancer? It’s complicated. Accessed October 1, 2022, https://undark.org/2021/01/25/debate-over-melanoma-diagnosis/.Google Scholar
• Clemens J, Gottlieb JD (2014) Do physicians’ financial incentives affect medical treatment and patient health? Amer. Econom. Rev. 104(4):1320–1349.Crossref, Google Scholar
• Committee on Diagnostic Error in Health Care (2015) The path to improve diagnosis and reduce diagnostic error. Balogh EP, Miller BT, Ball JR, eds. Improving Diagnosis in Healthcare, chapter 9 (National Academies Press, Washington, DC).Google Scholar
• Dai T, Singh S (2020) Conspicuous by its absence: Diagnostic expert testing under uncertainty. Marketing Sci. 39(3):540–563.Link, Google Scholar
• Dai T, Singh S (2023) Artificial intelligence on call: The physician’s decision of whether to use AI in clinical practice. Working paper, Carey Business School, Johns Hopkins University.Google Scholar
• Dai T, Tayur S (2020) OM Forum—Healthcare operations management: A snapshot of emerging research. Manufacturing Service Oper. Management 22(5):869–887.Link, Google Scholar
• Dai T, Tayur S (2022) Designing AI-augmented healthcare delivery systems for physician buy-in and patient acceptance. Production Oper. Management 31(12):4443–4451.Crossref, Google Scholar
• Dai T, Akan M, Tayur S (2017) Imaging room and beyond: The underlying economics behind physicians’ test-ordering behavior in outpatient services. Manufacturing Service Oper. Management 19(1):99–113.Link, Google Scholar
• de Véricourt F, Gurkan H (2023) Is your machine better than you? You may never know. Management Sci., ePub ahead of print May 25, https://doi.org/10.1287/mnsc.2023.4791.Link, Google Scholar
• Debo LG, Toktay LB, Van Wassenhove LN (2008) Queuing for expert services. Management Sci. 54(8):1497–1512.Link, Google Scholar
• Dugdale DC, Epstein R, Pantilat SZ (1999) Time and the patient-physician relationship. J. General Internal Medicine 14(S1):S34–S40.Crossref, Google Scholar
• Dulleck U, Kerschbamer R (2006) On doctors, mechanics, and computer specialists: The economics of credence goods. J. Econom. Lit. 44(1):5–42.Crossref, Google Scholar
• Durbin E, Iyer G (2009) Corruptible advice. Amer. Econom. J. Microeconom. 1(2):220–242.Crossref, Google Scholar
• Eggleston K (2005) Multitasking and mixed systems for provider payment. J. Health Econom. 24(1):211–223.Crossref, Google Scholar
• Ellis RP, McGuire TG (1986) Provider behavior under prospective reimbursement: Cost sharing and supply. J. Health Econom. 5(2):129–151.Crossref, Google Scholar
• Epstein AJ, Johnson SJ (2012) Physician response to financial incentives when choosing drugs to treat breast cancer. Internat. J. Healthcare Finance Econom. 12(4):285–302.Crossref, Google Scholar
• Fuloria PC, Zenios SA (2001) Outcomes-adjusted reimbursement in a health-care delivery system. Management Sci. 47(6):735–751.Link, Google Scholar
• Godager G, Wiesen D (2013) Profit or patients’ health benefit? Exploring the heterogeneity in physician altruism. J. Health Econom. 32(6):1105–1116.Crossref, Google Scholar
• Goldsmith SM (2013) Cost analysis suggests overemphasis on biopsy rate for melanoma diagnosis. J. Amer. Acad. Dermatology 68(3):517–519.Crossref, Google Scholar
• Gromb D, Martimort D (2007) Collusion and the organization of delegated expertise. J. Econom. Theory 137(1):271–299.Crossref, Google Scholar
• Guo P, Tang CS, Wang Y, Zhao M (2019) The impact of reimbursement policy on social welfare, revisit rate, and waiting time in a public healthcare system: Fee-for-service vs. bundled payment. Manufacturing Service Oper. Management 21(1):154–170.Link, Google Scholar
• Hajjar A, Alagoz O (2022) Personalized disease screening decisions considering a chronic condition. Management Sci. 69(1):260–282.Link, Google Scholar
• Hamid RN, McGregor SP, Siegel DM, Feldman SR (2019) Assessment of provider utilization through skin biopsy rates. Dermatologic Surgery 45(8):1035–1041.Crossref, Google Scholar
• Hollmann P, Jagmin C, Levy B (2020) Evaluation and Management (E/M) office visits—2021. American Medical Association. Accessed October 3, 2023, https://www.ama-assn.org/system/files/2020-04/e-m-office-visit-changes.pdf.Google Scholar
• Jelovac I (2001) Physicians’ payment contracts, treatment decisions and diagnosis accuracy. Health Econom. 10(1):9–25.Crossref, Google Scholar
• Jiang H, Pang Z, Savin S (2012) Performance-based contracts for outpatient medical services. Manufacturing Service Oper. Management 14(4):654–669.Link, Google Scholar
• Jiang H, Pang Z, Savin S (2020) Performance incentives and competition in healthcare markets. Production Oper. Management 29(5):1145–1164.Crossref, Google Scholar
• Keskinocak P, Savva N (2020) A review of the healthcare-management (modeling) literature published in Manufacturing & Service Operations Management. Manufacturing Service Oper. Management 22(1):59–72.Link, Google Scholar
• Kline JA, Garrett JS, Sarmiento EJ, Strachan CC, Courtney DM (2020) Over-testing for suspected pulmonary embolism in American emergency departments. Circulation Cardiovascular Quality Outcomes 13(1):e005753.Crossref, Google Scholar
• Lee DK, Zenios SA (2012) An evidence-based incentive system for Medicare’s end-stage renal disease program. Management Sci. 58(6):1092–1105.Link, Google Scholar
• Lien HM, Ma CTA, McGuire TG (2004) Provider–client interactions and quantity of healthcare use. J. Health Econom. 23(6):1261–1283.Crossref, Google Scholar
• Maillart LM, Ivy JS, Ransom S, Diehl K (2008) Assessing dynamic breast cancer screening policies. Oper. Res. 56(6):1411–1427.Link, Google Scholar
• Marinoso BG, Jelovac I (2003) GPs’ payment contracts and their referral practice. J. Health Econom. 22(4):617–635.Crossref, Google Scholar
• Mullainathan S, Obermeyer Z (2021) Diagnosing physician error: A machine learning approach to low-value healthcare. Quart. J. Econom. 137(2):679–727.Crossref, Google Scholar
• Nassiri S, Adida E, Mamani H (2022) Reference pricing for healthcare services. Manufacturing Service Oper. Management 24(2):921–937.Link, Google Scholar
• Natarajan KV, Swaminathan JM (2018) Global health. Dai T, Tayur S, eds. Handbook of Healthcare Analytics: Theoretical Minimum for Conducting 21st Century Research on Healthcare Operations (John Wiley & Sons, Hoboken, NJ), 137–158.Crossref, Google Scholar
• Newhouse JP (2004) Pricing the Priceless: A Healthcare Conundrum (MIT Press, Cambridge, MA).Google Scholar
• Newman-Toker DE, McDonald KM, Meltzer DO (2013) How much diagnostic safety can we afford, and how should we decide? A health economics perspective. BMJ Quality Safety 22(Suppl 2):ii11–ii20.Crossref, Google Scholar
• Orfanoudaki A, Saghafian S, Song K, Chakkera HA, Cook C (2022) Algorithm, human, or the centaur: How to enhance clinical care? Working paper, Saïd Business School, University of Oxford.Google Scholar
• Paç MF, Veeraraghavan S (2015) False diagnosis and overtreatment in services. Working paper, The Wharton School, University of Pennsylvania, Philadelphia.Google Scholar
• Parikh RB, Helmchen LA (2022) Paying for artificial intelligence in medicine. npj Digital Medicine 5(1):63.Google Scholar
• Price WN, Gerke S, Cohen IG (2019) Potential liability for physicians using artificial intelligence. JAMA 322(18):1765–1766.Crossref, Google Scholar
• Shute N (2011) MRIs more likely to be negative when the doctor profits. NPR (December 1), https://n.pr/3KRBfSo.Google Scholar
• Singh H, Graber ML, Hofer TP (2019) Measures to improve diagnostic safety in clinical practice. J Patient Safety 15(4):311–316.Crossref, Google Scholar
• Singh H, Meyer AND, Thomas EJ (2014) The frequency of diagnostic errors in outpatient care: Estimations from three large observational studies involving US adult populations. BMJ Quality Safety 23(9):727–731.Crossref, Google Scholar
• Sirovich BE (2011) Too little? Too much? Primary care physicians’ views on US healthcare. Arch. Internal Medicine 171(17):1582–1585.Crossref, Google Scholar
• Skaggs R, Coldiron B (2021) Skin biopsy and skin cancer treatment use in the Medicare population, 1993 to 2016. J. Amer. Acad. Dermatology 84(1):53–59.Crossref, Google Scholar
• Smith JE, Ulu C (2017) Risk aversion, information acquisition, and technology adoption. Oper. Res. 65(4):1011–1028.Link, Google Scholar
• Swetter S, Geller A (2022) Melanoma: Clinical features and diagnosis. Accessed October 1, 2022, https://www.uptodate.com/contents/melanoma-clinical-features-and-diagnosis.Google Scholar
• Topol E (2019) Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again (Basic Books, New York).Google Scholar
• Trzeciak S, Mazzarelli A (2019) Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference (Studer Group, Pensacola, FL).Google Scholar
• U.S. National Cancer Institute (2022) Cancer stat facts: Melanoma of the skin. Accessed October 1, https://seer.cancer.gov/statfacts/html/melan.html.Google Scholar
• Vlachy J, Ayer T, Ayvaci M, Raghunathan S (2023) The business of healthcare: The role of physician integration in bundled payments. Manufacturing Service Oper. Management 25(3):996–1012.Link, Google Scholar
• Wahie S, Lawrence CM (2007) Wound complications following diagnostic skin biopsies in dermatology inpatients. Arch. Dermatology 143(10):1267–1271.Crossref, Google Scholar
• Welch HG, Mazer BL, Adamson AS (2021) The rapid rise in cutaneous melanoma diagnoses. New England J. Medicine 384(1):72–79.Crossref, Google Scholar
• Zhang DJ, Gurvich I, Van Mieghem JA, Park E, Young RS, Williams MV (2016) Hospital readmissions reduction program: An economic and operational analysis. Management Sci. 62(11):3351–3371.Link, Google Scholar
• Zorc S, Chick SE, Hasija S (2023) Outcomes-based reimbursement policies for chronic care pathways. Working paper, Darden School of Business, University of Virginia, Charlottesville.Google Scholar