Working Paper: NBER ID: w24338
Authors: Leila Agha; Keith Marzilli Ericson; Kimberley H. Geissler; James B. Rebitzer
Abstract: How does team-specific capital affect productivity? We examine the teams that primary care physicians (PCPs) assemble when referring patients to specialists. Our theoretical model finds that team-specific capital is greater when PCPs concentrate their referrals within a smaller set of specialists. Empirically, we find patients of PCPs with concentrated referrals have lower healthcare costs, with no discernable reduction in quality. This effect exists for commercially insured and Medicare populations; is statistically and economically significant; and holds under identification strategies that account for unobserved patient and physician characteristics.
Keywords: team-specific capital; healthcare costs; referral networks; primary care physicians; specialists
JEL Codes: D85; I10; I11; L2; M5
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| PCP referral concentration (I11) | lower healthcare costs (I10) |
| PCP referral concentration (I11) | lower total healthcare utilization (I18) |
| 1 standard deviation increase in team referral concentration (C92) | 40% lower utilization (L97) |
| 1 standard deviation increase in team referral concentration (C92) | 74% lower spending (H51) |
| increased team referral concentration (Y80) | improved coordination and efficiency in care delivery (I11) |