A Game Theoretic Setting of Capitation Versus Fee-For-Service Payment Systems

We aim to determine whether a game-theoretic model between an insurer and a healthcare practice yields a predictive equilibrium that incentivizes either player to deviate from a fee-for-service to capitation payment system. Using United States data from various primary care surveys, we find that non-extreme equilibria (i.e., shares of patients, or shares of patient visits, seen under a fee-for-service payment system) can be derived from a Stackelberg game if insurers award a non-linear bonus to practices based on performance. Overall, both insurers and practices can be incentivized to embrace capitation payments somewhat, but potentially at the expense of practice performance

Popular Support for Balancing Equity and Efficiency in Resource Allocation: A Case Study in Online Advertising to Increase Welfare Program Awareness

Algorithmically optimizing the provision of limited resources is commonplace across domains from healthcare to lending. Optimization can lead to efficient resource allocation, but, if deployed without additional scrutiny, can also exacerbate inequality. Little is known about popular preferences regarding acceptable efficiency-equity trade-offs, making it difficult to design algorithms that are responsive to community needs and desires. Here we examine this trade-off and concomitant preferences in the context of GetCalFresh, an online service that streamlines the application process for California's Supplementary Nutrition Assistance Program (SNAP, formerly known as food stamps). GetCalFresh runs online advertisements to raise awareness of their multilingual SNAP application service. We first demonstrate that when ads are optimized to garner the most enrollments per dollar, a disproportionately small number of Spanish speakers enroll due to relatively higher costs of non-English language advertising. Embedding these results in a survey (N = 1,532) of a diverse set of Americans, we find broad popular support for valuing equity in addition to efficiency: respondents generally preferred reducing total enrollments to facilitate increased enrollment of Spanish speakers. These results buttress recent calls to reevaluate the efficiency-centric paradigm popular in algorithmic resource allocation.Comment: This paper will be presented at the 2023 International Conference on Web and Social Media (ICWSM'23

Federated Causal Inference in Heterogeneous Observational Data

We are interested in estimating the effect of a treatment applied to individuals at multiple sites, where data is stored locally for each site. Due to privacy constraints, individual-level data cannot be shared across sites; the sites may also have heterogeneous populations and treatment assignment mechanisms. Motivated by these considerations, we develop federated methods to draw inference on the average treatment effects of combined data across sites. Our methods first compute summary statistics locally using propensity scores and then aggregate these statistics across sites to obtain point and variance estimators of average treatment effects. We show that these estimators are consistent and asymptotically normal. To achieve these asymptotic properties, we find that the aggregation schemes need to account for the heterogeneity in treatment assignments and in outcomes across sites. We demonstrate the validity of our federated methods through a comparative study of two large medical claims databases

Should I Stop or Should I Go: Early Stopping with Heterogeneous Populations

Randomized experiments often need to be stopped prematurely due to the treatment having an unintended harmful effect. Existing methods that determine when to stop an experiment early are typically applied to the data in aggregate and do not account for treatment effect heterogeneity. In this paper, we study the early stopping of experiments for harm on heterogeneous populations. We first establish that current methods often fail to stop experiments when the treatment harms a minority group of participants. We then use causal machine learning to develop CLASH, the first broadly-applicable method for heterogeneous early stopping. We demonstrate CLASH's performance on simulated and real data and show that it yields effective early stopping for both clinical trials and A/B tests.Comment: NeurIPS 2023 (spotlight

Potential for allocative harm in an environmental justice data tool

Neighborhood-level screening algorithms are increasingly being deployed to inform policy decisions. We evaluate one such algorithm, CalEnviroScreen - designed to promote environmental justice and used to guide hundreds of millions of dollars in public funding annually - assessing its potential for allocative harm. We observe the model to be sensitive to subjective model decisions, with 16% of tracts potentially changing designation, as well as financially consequential, estimating the effect of its positive designations as a 104% (62-145%) increase in funding, equivalent to \$2.08 billion (\$1.56-2.41 billion) over four years. We also observe allocative tradeoffs and susceptibility to manipulation, raising ethical concerns. We recommend incorporating sensitivity analyses to mitigate allocative harm and accountability mechanisms to prevent misuse