Design of reimbursement schemes and process improvement in service systems: applications in healthcare

Thesis (Ph. D.)--University of Rochester. William E. Simon Graduate School of Business Administration, 2017.We study the economics of and process improvements in service systems with a particular focus on applications in healthcare systems. Motivated by the increasingly high congestion that is prevalent in Emergency Departments (EDs) this dissertation is an effort to alleviate the excessively long ED waiting times. In particular, we aim to understand (i) how we can guide EDs in making better use of the available process improvement measures, and (ii) how payment schemes translate into operational outcomes, e.g., waiting times, and how we can design payment systems that result in operational outcomes desired by the healthcare payers (such as the Centers for Medicare and Medicaid). In the studies presented in this dissertation, we provide practical guidelines on when to use alternative triage methods in EDs and propose modifications of the commonly-used healthcare payment schemes to incentivize hospitals to lower their waiting times to socially desired levels