I was so nervous to teach MBA students for the first time, but it ended up being an incredible experience. I am so honored to be one of the recipients of the Cheit Award for Excellence in Teaching 🥰 Also congrats to
@abhishekn
for winning and thanks for the pic!
@BerkeleyHaas
Excited and a bit nervous to present at my first ever
#NBERSI
! Tune in on Wednesday at 3pm to learn what
@julia_bodner
and I find when fertility clinics are acquired by chain organizations.
🚨 Not-so-new paper alert 🚨
A labor of love: After starting this in 2014, my JMP, “The Impact of Management on Clinical Performance: Evidence from Physician Practice Management Companies,” is published in
#ManagementScience
!
#EconTwitter
🧵 1/12
Are you interested in chain organizations, acquisitions, knowledge transfer, private equity, or IVF/fertility? Then check out the updated version of my paper joint w/
@julia_bodner
TLDR: Chains increase IVF volume and live birth rates! Thread below.
Today we feature
@ambarlaforgia
, Assistant Professor
@BerkeleyHaas
. Her research studies the relationship between organizational and managerial strategies and performance outcomes in the health care sector. You can learn more about her research at
🚨 New paper alert 🚨 We find that for states that passed comprehensive surprise billing legislation prices paid to in-network and OON anesthesiologists decreased
In CA, FL, and NY, prices paid to anesthesiologists in hospital outpatient departments and ASCs decreased after the introduction of surprise billing legislation, providing early insights into how prices may change under the federal No Surprises Act
Hi Twitter friends! I’m looking for opportunities to present a project on how affiliating with an organizational network impacts performance (joint w/
@julia_bodner
). We use data on US fertility clinics and get pretty stunning results. If this seems of interest, let me know!
Thanks for the cool video
@BerkeleyHaas
!! I’m gearing up to teach Leading People for the third time in just a few weeks and looking forward to meeting the next cohort of Blue and Gold!
New
@nberpubs
paper by
@ambarlaforgia
@asacarny
& Atul Gupta shows how hospitals gamed a
#Medicare
loophole to reap billions. For-profits funneled much of the windfall to payouts for execs and shareholders.
True story: at the end of my advanced econometrics seminar with Prof Jefferson I made him a book of all our final papers titled “Too Logit to Quit” 🤣 anyways, this is awesome news!!
Congrats to our
@swarthmoreecon
friend and colleague Philip Jefferson on this great honor! Seems like being chair of Swarthmore's economics department is a good omen for the future 😉
I won the Cheit Award for Excellence in Teaching, the highest honor for teaching
@BerkeleyHaas
! There is no such thing as humble bragging, so here is some plain bragging. A big thanks to my students for nominating me ❤️
Thank you
@WiEMecon
for the opportunity to get to present on a topic that is particularly relevant to many TT female profs and their partners! Paper draft here, thoughts welcome -
Track A continues with
@ambarlaforgia
(
@BerkeleyHaas
) presenting work with
@julia_bodner
showing that chain-acquired fertility clinics increase IVF volume and live birth rates. Effects likely driven by resource and knowledge transfers. Carola Frydman (
@KelloggSchool
) to discuss.
Awesome paper! I love that they show that *how* a provider receives funds affects how those funds are used (i.e., funds aren't treated as fully fungible). This has profound implications for how we should think the relationship between healthcare provider finance and quality.
SUMR Alum
@ambarlaforgia
was awarded an AHRQ Grant for Health Services Research Dissertation Program titled "Physician Consolidation and Incentives in Childbirth" Congrats Ambar!!
🚨📢 I’m delighted and proud to share our new
@Nature
paper “Online Images Amplify Gender Bias” What better day than Valentine’s Day to learn about gender stereotypes?🩷A thread 🧵
I'm excited to say this is my first week as an Associate Professor with tenure! Many thanks to my friends, family, collaborators (esp. brilliant students, RAs & TAs), and mentors who made this possible. And I'm so grateful to my dept & colleagues
@ColumbiaHPM
for their support.
Great summary of our research and certainly highlights how history seems to repeats itself with firms/individuals gaming govt programs for billions of dollars…. Which is ultimately borne by the taxpayer
Thanks to LDI for the opportunity to discuss work with
@asacarny
and
@ambarlaforgia
on the outlier payments scandal and its policy relevance today! Feels like there is a new scandal in some government program every week. This paper documents how firms used the windfall!
Excited to see this out! Part of a 3-year effort with the amazing Weill Cornell team 🙌 Focusing on NICUs, we find evidence that PMCs significantly increase prices and spending without any changes to LOS or adverse clinical outcomes.
📢 NEW PAPER ALERT: Our new study on Physician Management Companies (PMCs) and their impact on neonatal intensive care units (NICUs) was published in
@AmerAcadPeds
Hello
#AOM2021
! Are you interested in health care and strategy? Well then, tune in on Aug 1 @ 3pm for our symposium "Health Care Meets Strategy: Examining Reconfiguration and Innovation in the Health Care Sector"
This will be quite a change for me both personally and professionally, and I want to esp thank
@ashleyterese
, Ingrid Nembhard, Tom D'Aunno,
@matthewneidell
, and Bhaven Sampat for their mentorship and support
@Soleil_Shah
@NEJM
@efusebrown
@StanfordHP
@Hayrook
@StanfordMed
Great insights! While I'm looking at Ob-Gyns and not PCPs, I find evidence of some of the pros and cons discussed - VBP can motivate corporate owners to invest in quality improvement but overemphasis on financial management can lead to suboptimal care:
@ambarlaforgia
presented work showing productivity improvements at IVF clinics after acquisition by large chains. These results do not appear to be driven by selection of patients, but rather better knowledge transmission.
🚨New
@nberpubs
with
@andrewolenski
on major hidden profits in the healthcare sector! Bear with me as I explain how nursing homes are able to hide almost 2/3 of their profits from regulators and the public! I promise it's worth it!
🧵1/17
Paper:
1) First: Check out the just released Tradeoffs podcast discussing the role of PE in healthcare, w/ great interviews from
@gupta_atulk
,
@ysingh_hopkins
@rm_werner
. It compares our paper’s finding to other research on the corporatization of medicine:
@leightjessica
@elisaxchen
I’ve learned so much about fertility and IVF through my research on IVF clinics! Posting here for those interested and always happy to chat.
From a policy perspective, more efforts are needed to increase transparency in corporate ownership in health care for research purposes and for patients. States should also consider strengthening/enforcing corporate practice of medicine laws.
The ongoing corporatization of medicine impacts many stakeholders. Higher prices are likely passed on to patients in the form of higher premiums and cost-sharing. While PMCs appear to command higher prices, it is unclear whether this revenue is shared with clinicians.
I am so immensely grateful to all the people who supported me and this paper from its conception at Wharton, its gestation at Columbia HPM, and its birth at Berkeley Haas :)
We found that allowed amounts (price paid by insurer + patient cost share) increased by 16.5% post-PMC contract, and unit prices (allowed amounts standardized by procedure complexity and duration) increased by 18.7% post-PMC contract.
Summary: We use a staggered DiD design to compare fertility clinics that become acquired by fertility chains to those that do not (we use OG TWFE and show robustness to alternative estimators). We find that IVF cycles increase by 27.2%, and live birth rates increase by 13.6%.
Really cool (yet maddening) new WP by my colleague
@paul_gertler
! Less altruistic physicians essentially commit medical fraud by misrepresenting test results to increase their profits. 💵 💊
Profit-motivated medical providers report more false positive malaria tests and sell substantially more unnecessary drugs than altruistic providers, from
@paul_gertler
and Ada Kwan
After watching
@CrazyRichMovie
I realized I had never seen a woman portray an economics professor on tv or in a movie. Of course, the first article that came up when I googled this was questioning whether she was even a good economist...
#womenineconomics
Excited and a little scared to announce that I am retiring from the Army next summer and am on the academic job market. If you are looking for an organizational/health economist please keep me in mind!
#EconTwitter
4) Ask questions about the IVF laboratory the clinic uses and if there are best practices they adhere to. Ultimately, this is a highly personal choice, and a chain clinic may or may not be the best option for you.
In subsample analyses, we found that PMCs backed by PE had price increases of over 26% while those without PE funding saw increases of 12.9%. Potential reasons include greater market power and stronger incentives to create short-term returns.
@leightjessica
@elisaxchen
Bc egg freezing was experimental until 2012, we haven’t had good data until recently. Cryopreservation methods have also improved considerably. A study out of NYU lagone found that women who froze 20+ eggs under the age of 38 had 70% prob of a live birth.
Wow! I can't believe it's been almost a decade since I was a
@LDISUMR
scholar. Shout out to
@A_Schwa
for encouraging me to apply. Curious to know how many scholars went on to get PhDs?
Summer Undergraduate Minority Research scholars toured
@morrisarboretum
92 acres in Philly’s Chestnut Hill neighborhood with Victorian gardens, ornate water features, and thousands of botanical specimens from around the world.
1/2 Can a bad hospital be better than no hospital? (H/T
@ambarlaforgia
wisdom here)
My latest in
@KHNews
' investigation of two rural hospitals & their ownserhip shows how tricky it can be for state/federal regulators to answer this ?.
Another channel could be the types of clinics being acquired. While acquisitions are non-random, we show robustness to matching clinics on different pre-acquisition observables to make more apples-to-apples comparisons.
@leightjessica
@elisaxchen
Age at time of freezing and volume of eggs are the biggest predictors of success. Your probability is even higher if you freeze embryos, which many partnered women consider to delay for a few years while focusing on TT or until they are ready. But still, no guarantees!
The Sadie Collective relies on generous support from those in economics and related fields. Today we are launching our website and introducing our new team members. Please show your support and solidarity for Black lives and our voices by donating here:
3) Use FertilityIQ to read verified patient reviews of the clinics and specific doctors. IVF is a financially, physically, and emotionally exhausting experience, and you want to feel comfortable with your provider.
Until quite recently, there was limited insurance coverage, and patients paid mostly out-of-pocket. Patients can also easily access online report cards to look at clinic outcomes. Therefore, there may be more alignment between patient interests and corporate interests.
@Samantha_Burn
yes that would be amazing! In our setting, CMS had been warned about the loophole a decade before in public comments. The loophole could also have been prevented by a clawback system to monitor under/over payment (which was later introduced).
We also find chains improve clinical practices to achieve IVF gold standard: they reduce multiple birth rates (twins and above) and increase singleton birth rates, which reduce risk to mothers and infants. They also achieve higher birth rates among older patients!
Physician management companies (PMCs) are increasingly owning and managing the practices of clinicians, particularly in hospital-based specialties such as anesthesiology. By consolidating practices, PMCs may leverage their size and expertise to negotiate higher-paying contracts.
We are grateful to numerous seminar participants, our referees, and editors at Management Science (the paper has been conditionally accepted!) for their valuable feedback.
Key result: Using DID, the PPMC that focuses on clinical management significantly reduces C-sections for low-risk births (22% decrease), whereas the opposite result occurs in the PPMCs that focus on financial management (10-11% increase). 9/12
This study focused on prices, but PMCs argue that they can improve managerial and operational efficiency, so more research is needed on their influence on outcomes such as volume and quality of care.
But it’s not just price and quality transparency. Fertility markets are more competitive than other areas of healthcare, like hospital and dialysis markets. Fertility patients are also much more homogenous, which could make them a setting more amenable to standardization.