Other Research in OM

Working Papers:

1. Incentive-Compatible Prehospital Triage in Emergency Medical Services
Status: Under 2nd round review at Production and Operations Management, Working Paper Available
Collaborator: Alex Mills
Abstract: The Emergency Medical Services (EMS) system is designed to handle life-threatening emergencies, but a large and growing number of non-emergency patients are accessing hospital-based healthcare through EMS. These non-emergency patients are a controllable arrival stream that can be re-directed to an appropriate care provider, reducing congestion in EDs, reducing costs to patients and healthcare payers, and improving patient health, but prehospital triage to identify these patients is almost never implemented by EMS providers in the United States. By studying healthcare reimbursement structures, we find that prehospital triage is unlikely to occur with the current practice of fee-for-service reimbursements, regardless of how effective the triage process may be. Changing the fee-for-service reimbursements to make prehospital triage incentive-compatible is possible, but it would violate rules about how Medicare determines such fees. On the other hand, offering bundled payments to EMS providers would provide them with an incentive to conduct prehospital triage, and, moreover, with incentive to improve their triage effectiveness. Using data from a 2013 survey, we estimate that Medicare could save between $20 and $140 million per year by providing incentives for prehospital triage, making it a practical and cost-effective step to address hospital ED crowding.

Presented at
o POMS Annual Meeting, Orlando, FL, 2016
o INFORMS Annual Meeting, Philadelphia, PA, 2015
o INFORMS Healthcare, Nashville, TN, 2015 (by Alex Mills)
o Cincinnati-Dayton INFORMS Symposium, Dayton, OH, 2014
o Seminar at the Kelley School of Business, Indiana University, Bloomington, IN, 2014