Harriet Jeon Archives

From Gatekeeping to Audits: Rethinking Prior Authorization in Health Care

Prior authorization (PA) is widely used to manage utilization of high-cost health services, yet it imposes administrative burdens and can delay care. As generative AI is increasingly deployed to automate both the submission of prior authorization requests by providers and authorization decisions by insurers, raising questions about the effectiveness of gatekeeping as a utilization management strategy in the AI era. This project studies whether an alternative lever—provider-level audits—can reduce administrative burden while preserving oversight for utilization management. We examine a “gold-carding” policy that exempts providers with low historical denial rates from prior authorization while conditioning continued exemption on periodic audits of ordering behavior.…Read More

A Second Opinion: Impact of Generative AI on Information Acquisition Processes, Performance, and Service Quality

Since ChatGPT’s launch in November 2022, a surge of studies has underscored generative AI’s potential across a wide range of applications, including improving entrepreneurial performance, spurring innovation, and even providing more ethical advice. Less attention has been garnered about how AI impacts the efficiency of a decision-maker’s information search process. In the context of health care, medical providers review existing patient information (i.e., their medical history) and then must ask a series of questions to the patient or run diagnostic tests to make their diagnosis. While there is inherent uncertainty, the provider faces a trade-off between acquiring additional information from the patient to increase certainty over a diagnosis and…Read More

Innovating Shift Work Design to Incorporate Heterogeneous Worker Preferences

Shifts are the dominant way to work in many contexts requiring 24/7 coverage, including call centers, police departments, and hospitals. While the detriments of shift work are well-documented both at the individual and organizational levels, its deployment is often unavoidable given round-the-clock staffing needs. We explore a potential organizational lever—incorporating heterogeneous preferences over shift design—to mitigate ramifications of shift work in the context of acute care bedside nurses. Using survey, administrative, and shift data, we examine whether and the extent to which individual choice over dimensions of their shifts mitigates the impact of shift work on work (dis)satisfaction and turnover of nurses.…Read More

Leapfrogging for Last-Mile Delivery in Health Care

Lowering the cost and increasing the speed of last mile delivery are major challenges for the distribution channels of most industries. These challenges are even more severe in developing countries, where a large part of the population is located in rural areas, and where the lack of physical infrastructure results in a sizable part of the population residing in isolated areas, compromising their access to important services for their investment in human capital, such as timely health care.…Read More