Team Relationships and Performance: Evidence from Healthcare Referral Networks

Leila Agha (), Keith Marzilli Ericson (), Kimberley H. Geissler () and James Rebitzer
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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

Management Science, 2022, vol. 68, issue 5, 3735-3754

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.

Keywords: healthcare; team organization and productivity; coordination; referrals (search for similar items in EconPapers)
Date: 2022
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Citations: View citations in EconPapers (2)

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