This dissertation studies topics in health care operations management related to value-based care, where {\em value} can be thought of as the ratio of quality to cost. The objective in value-based care is to increase, or maximize, value by reducing costs and improving quality health outcomes. In Chapter 1 we study dynamic stochastic appointment scheduling when delaying appointments increases the risk of incurring costly failures, such as readmissions in health care or engine failures in preventative maintenance. When near-term {\em base} appointment capacity is full, the scheduler faces a trade-off between delaying an appointment at the risk of costly failures versus the additional cost of scheduling the appointment sooner using {\em surge} capacity. We show that intuitive appointment policies used in practice are robust under moderate capacity utilization, but their optimality gap can quadruple under high load. In Chapter 2 we study the role of physician volume accumulation (or experience) on quality and cost outcomes for treatment of congestive heart failure (CHF). In particular we wish to understand how volume over time relates to readmissions, mortality, and costs for CHF patients. We find that recent accumulated physician volume is associated with a reduction in readmissions, mortality, and costs for CHF patients. In Chapter 3 we study the impact of value-based payment contracts, such as Medicare's Bundled Payments for Care Improvement, on the health care supply chain. We are interested in how these incentives relate to costs, outcomes, and care-coordination.

Creator

• Grant, Benjamin Noah

DOI

• https://doi.org/10.21985/n2-tw5x-tm41

Subject

• Health care management
• Operations research

Language

• en

Alternate Identifier

• http://dissertations.umi.com/northwestern:14606
• etdadmin_upload_661472

Date created

• 2019-01-01

Resource type

• Dissertation

Rights statement

• In Copyright