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Wilfrid Laurier University Leaf
October 21, 2014
 
 
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Graduate and Postdoctoral Studies

Dissertation Examination for the Degree of Doctor of Philosophy in Management


Aug 13/14

Date: Aug 13/14
Time: 9:30 - 12:30
Location: Waterloo Campus Schlegel Centre Ernst and Young Boardroom (SBE 3220)
Cost: free


Tannaz Mahootchi
PhD in Management

Modeling and Analysis of Value-based Healthcare Delivery

Healthcare reforms are emerging in order to control the increasing healthcare expenditures and to improve the health outcomes. In the context of the “Value- based Healthcare Delivery” reform, Michael Porter defines value as a patient’s health outcome per dollar spent. Porter’s proposal is comprised of organizing care around a medical condition (or around patient segments for primary care). Specifically, care will be provided by a dedicated, multidisciplinary team of providers, called an Integrated Practice Unit (IPU). The IPU is jointly accountable for the health outcomes of patients and the costs of providing care during the full cycle of care.

The main objective of this dissertation is to use analytics to determine enabling factors for the successful implementation of the value-based healthcare delivery reform in three distinct chapters.

Chapter 2 provides insights on strengths, shortcomings, and applicability of current payment systems, including fee-for-service, capitation, and pay-for-performance, in fulfilling value-based healthcare delivery objectives.

Chapter 3 determines the optimal payment system between the healthcare purchaser and the IPU. The current payment systems do not pay for health outcomes. Most importantly, they do not consider health outcomes over the care cycle and fail to provide dynamic incentives for the providers. This study investigates the contract that can coordinate the healthcare purchaser-IPU relationship over the care cycle.

Chapter 4 studies the effects of different contractual arrangements on collaboration dynamics among the providers involved in an IPU. A mathematical representation that characterizes the relationship between the providers throughout the care cycle is proposed. When efforts are not contractible, the contractual agreement will determine the dynamics of the collaboration. Aside from characterizing the first-best solution, the effects of reward-sharing and relational contracts, together with traditional schemes, such as capitation, are studied in this chapter. 

Chair
Dr. Steven Roberts

Advisors
Dr. Ignacio Castillo
Dr. Logan McLeod

Committee
Dr. Sapna Isotupa
Dr. Michael Pavlin
Dr. Hideki Ariizumi

External
Dr. Hossein Abouee Mehrizi
(University of Waterloo

Contact: Meghan Delaney
Email: mdelaney@wlu.ca
Phone: 4182

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