IDEAS home Printed from https://ideas.repec.org/a/inm/ormnsc/v68y2022i5p3735-3754.html
   My bibliography  Save this article

Team Relationships and Performance: Evidence from Healthcare Referral Networks

Author

Listed:
  • Leila Agha

    (Department of Economics, Dartmouth College, Hanover, New Hampshire 03755; National Bureau of Economic Research, Cambridge, Massachusetts 02138)

  • Keith Marzilli Ericson

    (National Bureau of Economic Research, Cambridge, Massachusetts 02138; Questrom School of Business, Boston University, Boston, Massachusetts 02215)

  • Kimberley H. Geissler

    (School of Public Health and Health Sciences, University of Massachusetts at Amherst, Amherst, Massachusetts 01003)

  • James B. Rebitzer

    (National Bureau of Economic Research, Cambridge, Massachusetts 02138; Questrom School of Business, Boston University, Boston, Massachusetts 02215)

Abstract

We examine the teams that emerge when a primary care physician (PCP) refers patients to specialists. When PCPs concentrate their specialist referrals—for instance, by sending their cardiology patients to fewer distinct cardiologists—repeat interactions between PCPs and specialists are encouraged. Repeated interactions provide more opportunities and incentives to develop productive team relationships. Using data from the Massachusetts All Payer Claims Database, we construct a new measure of PCP team referral concentration and document that it varies widely across PCPs, even among PCPs in the same organization. Chronically ill patients treated by PCPs with a one standard deviation higher team referral concentration have 4% lower healthcare utilization on average, with no discernible reduction in quality. We corroborate this finding using a national sample of Medicare claims and show that it holds under various identification strategies that account for observed and unobserved patient and physician characteristics. The results suggest that repeated PCP-specialist interactions improve team performance.

Suggested Citation

  • Leila Agha & Keith Marzilli Ericson & Kimberley H. Geissler & James B. Rebitzer, 2022. "Team Relationships and Performance: Evidence from Healthcare Referral Networks," Management Science, INFORMS, vol. 68(5), pages 3735-3754, May.
    • Handle: RePEc:inm:ormnsc:v:68:y:2022:i:5:p:3735-3754
    DOI: 10.1287/mnsc.2021.4091
    as

    Download full text from publisher

    File URL: http://dx.doi.org/10.1287/mnsc.2021.4091
    Download Restriction: no
    File URL: https://libkey.io/10.1287/mnsc.2021.4091?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Gary S. Becker & Kevin M. Murphy, 1994. "The Division of Labor, Coordination Costs, and Knowledge," NBER Chapters, in: Human Capital: A Theoretical and Empirical Analysis with Special Reference to Education, Third Edition, pages 299-322, National Bureau of Economic Research, Inc.
    2. Samer Faraj & Yan Xiao, 2006. "Coordination in Fast-Response Organizations," Management Science, INFORMS, vol. 52(8), pages 1155-1169, August.
    3. Leila Agha & Keith Marzilli Ericson & Xiaoxi Zhao, 2020. "The Impact of Organizational Boundaries on Healthcare Coordination and Utilization," NBER Working Papers 28179, National Bureau of Economic Research, Inc.
    4. Robert S. Huckman & Bradley R. Staats, 2011. "Fluid Tasks and Fluid Teams: The Impact of Diversity in Experience and Team Familiarity on Team Performance," Manufacturing & Service Operations Management, INFORMS, vol. 13(3), pages 310-328, July.
    5. Leila Agha & Keith Marzilli Ericson & Kimberley H. Geissler & James B. Rebitzer, 2018. "Team Formation and Performance: Evidence from Healthcare Referral Networks," NBER Working Papers 24338, National Bureau of Economic Research, Inc.
    6. Vincent P. Crawford, 1990. "Relationship-Specific Investment," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 105(2), pages 561-574.
    7. Amy Finkelstein & Matthew Gentzkow & Heidi Williams, 2016. "Sources of Geographic Variation in Health Care: Evidence From PatientMigration," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 131(4), pages 1681-1726.
    8. James B. Rebitzer & Mark E. Votruba, 2011. "Organizational Economics and Physician Practices," NBER Working Papers 17535, National Bureau of Economic Research, Inc.
    9. Beth A. Bechky, 2006. "Gaffers, Gofers, and Grips: Role-Based Coordination in Temporary Organizations," Organization Science, INFORMS, vol. 17(1), pages 3-21, February.
    10. Ray Reagans & Linda Argote & Daria Brooks, 2005. "Individual Experience and Experience Working Together: Predicting Learning Rates from Knowing Who Knows What and Knowing How to Work Together," Management Science, INFORMS, vol. 51(6), pages 869-881, June.
    11. Edward P. Lazear, 2009. "Firm-Specific Human Capital: A Skill-Weights Approach," Journal of Political Economy, University of Chicago Press, vol. 117(5), pages 914-940, October.
    12. Wouter Dessein & Tano Santos, 2006. "Adaptive Organizations," Journal of Political Economy, University of Chicago Press, vol. 114(5), pages 956-985, October.
    13. Jason Abaluck & Mauricio Caceres Bravo & Peter Hull: & Amanda Starc, 2021. "Mortality Effects and Choice Across Private Health Insurance Plans," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 136(3), pages 1557-1610.
    14. Keith Marzilli Ericson & Amanda Starc, 2015. "Measuring Consumer Valuation of Limited Provider Networks," American Economic Review, American Economic Association, vol. 105(5), pages 115-119, May.
    15. Agha, Leila & Frandsen, Brigham & Rebitzer, James B., 2019. "Fragmented division of labor and healthcare costs: Evidence from moves across regions," Journal of Public Economics, Elsevier, vol. 169(C), pages 144-159.
    16. George Baker & Robert Gibbons & Kevin J. Murphy, 2002. "Relational Contracts and the Theory of the Firm," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 117(1), pages 39-84.
    17. Barton H. Hamilton & Jack A. Nickerson & Hideo Owan, 2003. "Team Incentives and Worker Heterogeneity: An Empirical Analysis of the Impact of Teams on Productivity and Participation," Journal of Political Economy, University of Chicago Press, vol. 111(3), pages 465-497, June.
    18. Randall D. Cebul & James B. Rebitzer & Lowell J. Taylor & Mark E. Votruba, 2008. "Organizational Fragmentation and Care Quality in the U.S. Healthcare System," Journal of Economic Perspectives, American Economic Association, vol. 22(4), pages 93-113, Fall.
    19. David Cutler & Jonathan S. Skinner & Ariel Dora Stern & David Wennberg, 2019. "Physician Beliefs and Patient Preferences: A New Look at Regional Variation in Health Care Spending," American Economic Journal: Economic Policy, American Economic Association, vol. 11(1), pages 192-221, February.
    20. Roberto A. Weber, 2006. "Managing Growth to Achieve Efficient Coordination in Large Groups," American Economic Review, American Economic Association, vol. 96(1), pages 114-126, March.
    21. Robert S. Huckman & Gary P. Pisano, 2006. "The Firm Specificity of Individual Performance: Evidence from Cardiac Surgery," Management Science, INFORMS, vol. 52(4), pages 473-488, April.
    22. Stefan Grosse & Louis Putterman & Bettina Rockenbach, 2011. "Monitoring In Teams: Using Laboratory Experiments To Study A Theory Of The Firm," Journal of the European Economic Association, European Economic Association, vol. 9(4), pages 785-816, August.
    23. Robert S. Huckman & Bradley R. Staats & David M. Upton, 2009. "Team Familiarity, Role Experience, and Performance: Evidence from Indian Software Services," Management Science, INFORMS, vol. 55(1), pages 85-100, January.
    24. Samer Faraj & Lee Sproull, 2000. "Coordinating Expertise in Software Development Teams," Management Science, INFORMS, vol. 46(12), pages 1554-1568, December.
    25. Jody Hoffer Gittell, 2002. "Coordinating Mechanisms in Care Provider Groups: Relational Coordination as a Mediator and Input Uncertainty as a Moderator of Performance Effects," Management Science, INFORMS, vol. 48(11), pages 1408-1426, November.
    26. Robert Gibbons & Rebecca Henderson, 2012. "Relational Contracts and Organizational Capabilities," Organization Science, INFORMS, vol. 23(5), pages 1350-1364, October.
    27. Brigham Frandsen & James B. Rebitzer, 2014. "Structuring Incentives Within Organizations: The Case of Accountable Care Organizations," NBER Working Papers 20034, National Bureau of Economic Research, Inc.
    28. Chillemi, Ottorino & Gui, Benedetto, 1997. "Team Human Capital and Worker Mobility," Journal of Labor Economics, University of Chicago Press, vol. 15(4), pages 567-585, October.
    29. Andrew J. Epstein & Jonathan D. Ketcham & Sean Nicholson, 2010. "Specialization and matching in professional services firms," RAND Journal of Economics, RAND Corporation, vol. 41(4), pages 811-834, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Li, Zhong-Ping & Chang, Aichih (Jasmine) & Zou, Zongbao, 2023. "Design mechanism to coordinate a hierarchical healthcare system: Patient subsidy vs. capacity investment," Omega, Elsevier, vol. 118(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Leila Agha & Keith Marzilli Ericson & Kimberley H. Geissler & James B. Rebitzer, 2018. "Team Formation and Performance: Evidence from Healthcare Referral Networks," NBER Working Papers 24338, National Bureau of Economic Research, Inc.
    2. Leila Agha & Keith Marzilli Ericson & Xiaoxi Zhao, 2020. "The Impact of Organizational Boundaries on Healthcare Coordination and Utilization," NBER Working Papers 28179, National Bureau of Economic Research, Inc.
    3. Böckerman, Petri & Laine, Liisa T. & Nurminen, Mikko & Saxell, Tanja, 2020. "Information Integration, Coordination Failures, and Quality of Prescribing," IZA Discussion Papers 13926, Institute of Labor Economics (IZA).
    4. Emmanouil Avgerinos & Bilal Gokpinar, 2017. "Team Familiarity and Productivity in Cardiac Surgery Operations: The Effect of Dispersion, Bottlenecks, and Task Complexity," Manufacturing & Service Operations Management, INFORMS, vol. 19(1), pages 19-35, February.
    5. Matt Marx & Bram Timmermans, 2017. "Hiring Molecules, Not Atoms: Comobility and Wages," Organization Science, INFORMS, vol. 28(6), pages 1115-1133, December.
    6. Agha, Leila & Frandsen, Brigham & Rebitzer, James B., 2019. "Fragmented division of labor and healthcare costs: Evidence from moves across regions," Journal of Public Economics, Elsevier, vol. 169(C), pages 144-159.
    7. H. Colleen Stuart, 2017. "Structural Disruption, Relational Experimentation, and Performance in Professional Hockey Teams: A Network Perspective on Member Change," Organization Science, INFORMS, vol. 28(2), pages 283-300, April.
    8. Christoph Engel, 2022. "Lucky you: Your case is heard by a seasoned panel—Panel effects in the German Constitutional Court," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 19(4), pages 1179-1221, December.
    9. Diwas Singh KC & Bradley R. Staats, 2012. "Accumulating a Portfolio of Experience: The Effect of Focal and Related Experience on Surgeon Performance," Manufacturing & Service Operations Management, INFORMS, vol. 14(4), pages 618-633, October.
    10. David J. Deming, 2017. "The Growing Importance of Social Skills in the Labor Market," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 132(4), pages 1593-1640.
    11. Simona Grassi & Ching-to Albert Ma, 2016. "Information acquisition, referral, and organization," RAND Journal of Economics, RAND Corporation, vol. 47(4), pages 935-960, November.
    12. Robert S. Huckman & Bradley R. Staats, 2011. "Fluid Tasks and Fluid Teams: The Impact of Diversity in Experience and Team Familiarity on Team Performance," Manufacturing & Service Operations Management, INFORMS, vol. 13(3), pages 310-328, July.
    13. David G. Lugo‐Palacios & Jonathan M. Clarke & Søren Rud Kristensen, 2023. "Back to basics: A mediation analysis approach to addressing the fundamental questions of integrated care evaluations," Health Economics, John Wiley & Sons, Ltd., vol. 32(9), pages 2080-2097, September.
    14. Hessam Bavafa & Jónas Oddur Jónasson, 2021. "The Variance Learning Curve," Management Science, INFORMS, vol. 67(5), pages 3104-3116, May.
    15. Ray Reagans & Ella Miron-Spektor & Linda Argote, 2016. "Knowledge Utilization, Coordination, and Team Performance," Organization Science, INFORMS, vol. 27(5), pages 1108-1124, October.
    16. Jonathan R. Clark & Robert S. Huckman & Bradley R. Staats, 2013. "Learning from Customers: Individual and Organizational Effects in Outsourced Radiological Services," Organization Science, INFORMS, vol. 24(5), pages 1539-1557, October.
    17. Tamara Bischof & Boris Kaiser, 2021. "Who cares when you close down? The effects of primary care practice closures on patients," Health Economics, John Wiley & Sons, Ltd., vol. 30(9), pages 2004-2025, September.
    18. Amit Jain & Will Mitchell, 2022. "Specialization as a double‐edged sword: The relationship of scientist specialization with R&D productivity and impact following collaborator change," Strategic Management Journal, Wiley Blackwell, vol. 43(5), pages 986-1024, May.
    19. Bradley R. Staats & Francesca Gino, 2012. "Specialization and Variety in Repetitive Tasks: Evidence from a Japanese Bank," Management Science, INFORMS, vol. 58(6), pages 1141-1159, June.
    20. Kamalini Ramdas & Khaled Saleh & Steven Stern & Haiyan Liu, 2018. "Variety and Experience: Learning and Forgetting in the Use of Surgical Devices," Management Science, INFORMS, vol. 64(6), pages 2590-2608, June.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:inm:ormnsc:v:68:y:2022:i:5:p:3735-3754. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Chris Asher (email available below). General contact details of provider: https://edirc.repec.org/data/inforea.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.