Mark V. Pauly

• Mark V. Pauly, Lawton R. Burns, David A. Asch, Kevin Volpp, Flaura Winston, Mary Naylor, Ralph Muller, Rachel Werner, Seemed Like a Good Idea: Alchemy versus Evidence-Based Approaches to Healthcare Management Innovation (Cambridge, UK: Cambridge University Press, 2022)
• Mark V. Pauly and Lawton R. Burns, “When is Medical Care Price Transparency a Good Thing (And When Isn’t It)?”. In Advances in Health Care Management – Transforming Health: A Focus on Consumerism and Profitability, edited by Jennifer Hefner and Mona Al-Amin, (Emerald Press, 2020), pp. 75-97 Abstract

  There is a widespread push by government and private payers to make the prices of health care services more transparent to consumers. The main goal is to promote more effective consumer shopping; secondary goals include promoting provider competition and reducing pricing variation. There are several headwinds opposing these efforts. One problem is that there may be several valid reasons for why price variations persist. Another is that provider (and other health care) markets are not very competitive, and sometimes widespread information about prices may make them even less so. A third is that price discrimination may be economically efficient. Any analysis of price transparency must take the specific market setting into account. This chapter analyzes markets characterized by monopolistic, oligopolistic, and competitive conditions to determine when and under what economic and managerial circumstances price transparency will be useful.

• Lawton R. Burns and Mark V. Pauly (2018), Transformation of the Healthcare Industry: Curb Your Enthusiasm?, Milbank Quarterly, 96(1) (), pp. 57-109.
• Philip Rea, Lawton R. Burns, Mark V. Pauly, Managing Discovery: Harnessing Creativity to Drive Biomedical Innovation (Cambridge, UK: Cambridge University Press, 2018)
• Mark V. Pauly and Ashley Swanson (2017), Social Impact Bonds: New Product or New Package?, The Journal of Law, Economics, and Organization, 33 (4), pp. 718-760. Abstract

  This paper considers a relatively new form of financing for social services, the “social impact bond (SIB).” Proponents of SIBs argue that they present a solution to several problems in funding social services, including performance incentives and risk allocation. Using a simple model, we first demonstrate that, despite their apparent novelty, SIBs in concept need not produce any difference in outcome from standard financing arrangements with private nonprofit firms. We then argue that SIBs will lead to greater program success if investors’ effort responds to incentives and can positively influence outcomes, either directly (e.g., effort exerted in production) or indirectly (e.g., effort devoted to screening), but are unlikely to do so otherwise. We conclude that, as in the more general theoretical literature, the value of this particular application in terms of funding innovation will be strongly context-dependent.

• Mark V. Pauly, Scott E. Harrington, Adam Leive (2015), “Sticker Shock” in Individual Insurance under Health Reform?, American Journal of Health Economics, 1 (), pp. 494-514. Description
  with Mark Pauly and Adam Leive
• Howard Kunreuther and Mark V. Pauly (Work In Progress), Behavioral Economics and Insurance: Principles and Solutions.
• J Doshi, P Li, Sean McElligott, Aditi Sen, M Olfson, Mark V. Pauly, Robert Rosenheck, Steven C. Marcus (Draft), Antipsychotic Copayment, Adherence, and Hospital Admission in Dual Eligibles with Schizophrenia. Abstract
  BACKGROUND: Limited evidence exists on the impact of cost-sharing on access to prescription drugs among vulnerable patients enrolled in both Medicare and Medicaid (“dual-eligibles”), in particular, those with schizophrenia. METHODS: Medicare Part D, passed in 2006, required dual-eligibles to switch from prescription coverage through Medicaid to a private Part D plan and resulted in higher drug copayments for dual-eligibles in many states. We use a quasi-experimental design to compare changes in antipsychotic use and schizophrenia-related hospitalization  before (2005) and after (2006-2007) the implementation of Part D among dual-eligibles with schizophrenia. Patients in a state that provided copayment assistance to eliminate copayments (Connecticut) are compared to patients in a state that did not provide such assistance (Florida). RESULTS: The increase in copayments among dual-eligibles in Florida was associated with significantly higher odds of having continuous medication gaps of ≥60 days in 2006 than in 2005 compared to the change over the same period in Connecticut (odds ratio OR: 1.18, 95% confidence interval CI: 1.06-1.32) and in 2007 (OR: 1.28, 95% CI: 1.12-1.46). This reduction in antipsychotic use among dual-eligibles in Florida was accompanied by higher odds of an inpatient hospitalization related to schizophrenia in 2006 (OR: 1.58, 95% CI: 1.30-1.94) and in 2007 (OR: 1.73, 95% CI: 1.39-2.15). CONCLUSIONS: Dual-eligibles with schizophrenia appeared to suffer adverse consequences from copayment increases due to the transition to Part D. The increase cost in hospital admissions in the state that did not provide assistance likely offset any savings from not providing copayment assistance. 
• Howard Kunreuther, Mark V. Pauly, Stacey McMorrow, Behavioral Economics and Insurance: Improving Decisions in the Most Misunderstood Industry (:, 2013)
• Lawton R. Burns and Mark V. Pauly (2012), Accountable Care Organizations May Have Difficulty Avoiding The Failures of Integrated Delivery Networks Of The 1990s, Health Affairs, 31 (), pp. 2407-2416. 10.1377/hlthaff.2011.0675 Abstract
  Accountable care organizations are intended to improve the

  quality and lower the cost of health care through several mechanisms,

  such as disease management programs, care coordination, and aligning

  financial incentives for hospitals and physicians. Providers employed

  several of these mechanisms in forming the integrated delivery networks

  of the 1990s. The networks failed, however, because of heavy financial

  losses stemming from hospitals’ purchase of physician practices and their

  inability to align incentives, garner capitated contracts, and develop the

  infrastructure to manage risk. Although the current mechanisms

  underlying accountable care organizations continue to evolve, whether

  and how they will have an impact on quality and costs remains open to

  question. Care coordination and information technology are proving

  more complicated and expensive to implement than anticipated,

  providers may lack the ability to implement these mechanisms, and

  primary care providers are in short supply. As in the 1990s, success

  depends on targeting specific populations, such as people with multiple

  chronic conditions who need and may benefit from coordinated care.
• All Research from Mark V. Pauly »

Past Courses

• HCMG6530 - HCMG Field App Project

  This course focuses on leadership and management issues in health care organizations while providing students with a practice setting to examine and develop their own management skills. Each team acts as a consultant to a healthcare organization which has submitted a project proposal to the course. The teams define the issue and negotiate a contract with the client organization. By the end of the semester, teams present assessments and recommendations for action to their clients and share their experience and key lessons learned in a final presentation to their classmates.

• HCMG8520 - Health Care Services Del

  The purpose of this course is to apply economics to an analysis of the health care industry, with special emphasis on the unique characteristics of the US healthcare markets, from pre-hospital to post-acute care. This course focuses on salient economic features of health care delivery, including: the role of nonprofit providers, the effects of regulation and antitrust activity on hospitals, the degree of input substitutability within hospitals, the nature of competition in home health care, public versus private provision of emergency medical services, the effect of specialty hospitals and ambulatory surgery centers, defining and improving medical performance in hospitals, specialization and investment in physical and human capital, shifting of services between inpatient and outpatient settings and its effect on health care costs and quality, and innovation in primary care from retail clinics to patient-centered medical homes and retainer-based medicine.

• HCMG8990 - Independent Study

  Arranged with members of the Faculty of the Health Care Systems Department. For further information contact the Department office, Room 204, Colonial Penn Center, 3641 Locust Walk, 898-6861.

• HPR5010 - Econ Hlth Care Deliv

  This course examines how medical care is produced and financed in private and public sectors, economic models of consumer and producer behavior, applications of economic theory to health care. Prerequisite: Course only open to Masters of Science in Heath Policy Research students unless by special request.

• HPR9900 - Hpr Thesis I

  Each student completes a mentored research project that includes a thesis proposal and a thesis committee and results in a publishable scholarly product. Prerequisite: Course only open to Masters of Science in Health Policy Research students.

• HPR9901 - Hpr Thesis II

  Each student completes a mentored research project that includes a thesis proposal and a thesis committee and results in a publishable scholarly product. Prerequisite: Course only open to Masters of Science in Health Policy Research students.

• Victor R, Fuchs Lifetime Achievement Award from ASHEcon, 2012
• President of the American Society of Health Economics, 2012
• William B. Graham Prize for Health Services Research from the Baxter International Foundation and the Association of University Programs in Health Administration, 2012
• University of Pennsylvania Provost's Award for Distinguished Ph.D. Teaching and Mentoring, 2012
• John M. Eisenberg Excellence in Mentorship Award from the Agency for Health Care Research and Quality, 2007
• Distinguished Investigator Award from AcademyHealth, 2007
• National Institute of Health Care Management Foundation's Research Award (with M. Kate Bundorf) for "Is Health Insurance Affordable for the Uninsured?" (Journal of Health Economics 2006), 2007
• Spencer Kimball Article Award (with Howard Kunreuther) from the Journal of Insurance Regulation for, 2006

• American Morning, CNN - 03/10/2010
• Morning Edition, NPR - 02/15/2010

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