Time Is the Wisest Counselor of All: The Value of Provider–Patient Engagement Length in Home Healthcare

Hummy Song (), Elena Andreyeva () and Guy David ()
Additional contact information
Hummy Song: Operations, Information, and Decisions Department, The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania 19104
Elena Andreyeva: Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, Texas 77843
Guy David: Health Care Management Department, The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania 19104

Management Science, 2022, vol. 68, issue 1, 420-441

Abstract: Home healthcare is a rapidly growing area of the health sector in the United States. We study its role in the shift toward value-based care, as it is viewed as an avenue for achieving reductions in the cost and utilization of expensive downstream healthcare services. Using a novel data set on home healthcare visits, we examine whether and how the amount of time that a provider spends during a home health visit with a recently discharged patient impacts the patient’s likelihood of being readmitted to the hospital. Because unobserved patient health status may influence both the length of a home health visit and the likelihood of hospital readmission, we use the within-provider average visit length of all other episodes’ visits conducted by each provider in the 30-day period before and after the focal visit as an instrument for visit length. Using this instrumental variable approach and controlling for operational, demographic, and patient condition-related characteristics, we find the following: on average, an extra minute during a focal home health visit is associated with a 1.39% decrease in the likelihood of readmission to the hospital following that visit. Our finding suggests that a 10% increase in visit length would decrease the likelihood of readmission following a home health visit by 6%. We document heterogeneity in this effect across different patient types and visit types. We conduct a cost–benefit analysis that suggests that the cost of investing in additional home health capacity is outweighed by the cost savings arising from fewer hospitalizations.

Keywords: home healthcare; postacute care; readmissions; value-based care; empirical operations (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

Downloads: (external link)
http://dx.doi.org/10.1287/mnsc.2020.3921 (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:inm:ormnsc:v:68:y:2022:i:1:p:420-441

Access Statistics for this article

More articles in Management Science from INFORMS Contact information at EDIRC.
Bibliographic data for series maintained by Chris Asher ().