Mark V. Pauly

Mark V. Pauly
  • John M. Bendheim, W’40 and Thomas L. Bendheim, WG’90 Professor Emeritus of Health Care Management

Contact Information

  • office Address:

    208 Colonial Penn Center
    3641 Locust Walk
    Philadelphia, PA 19104

Research Interests: health insurance, health policy, medical economics, other insurance, public finance/public choice, regulation

Overview

Education

PhD, University of Virginia, 1967; MA, University of Delaware, 1965; AB, Xavier University, 1963

Recent Consulting

Office of Assistant Secretary for Policy Evaluation, U.S. Department of Health and Human Services – Merck, Inc. American Enterprise Institute

Career and Recent Professional Awards; Teaching Awards

Spencer Kimball Article Award from the Journal of Insurance Regulation for “Terrorism Losses and All Perils Insurance” with Howard Kunreuther, December 2006 National Institute of Health Care Management Foundation’s Research Award for “Is Health Insurance Affordable for the Uninsured?” with M. Kate Bundorf (Journal of Health Economics, July 2006), May 2007 John M. Eisenberg Excellence in Mentorship Award, Agency for Health Care Research and Quality, June 2007 Distinguished Investigator Award, AcademyHealth, June 2007

Academic Positions Held

Wharton: 1983-present (Chairperson, Health Care Systems Department, 1997-2004; Vice Dean and Director, Doctoral Programs, 1995-99; named Bendheim Professor, 1990; Chairperson, Health Care Systems Department, 1990-94; Robert D. Eilers Professor of Health Care Management and Economics, 1984-89). University of Pennsylvania: 1984-present (Co-Director, Roy and Diana Vagelos Program in Life Sciences and Management, 2005-present; Professor of Economics, 1983-present; Executive Director, Leonard Davis Institute of Health Economics, 1984-89). Previous appointments: Northwestern University; University of Virginia. Visiting appointments: International Institute for Applied Systems Analysis, Laxenburg, Austria; International Institute of Management, Berlin, Germany

Professional Leadership 2005-2009

Co-Editor-in-Chief, International Journal of Health Care Finance and Economics, 2001-present; Advisory Editor, Journal of Risk and Uncertainty, 1987-present;

Corporate and Public Sector Leadership 2005-2009

Medicare Technical Advisory Panel; National Advisory Committee, National Institutes of Health, National Center for Research Resources; National Vaccine Advisory Commission Finance Working Group; Board Member, Independent Health

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Research

  • 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.

  • Mark V. Pauly and Robert J. Town (2012), “Counterpoint: Maryland Exceptionalism? All-Payers Regulation and Health Care System Efficiency”, Journal of Health Politics, Policy and Law, 37 (4), pp. 697-707.

  • Mark V. Pauly and A Saxena (2012), Health Employment, Medical Spending, and Long Term Health Reform, CESifo Economic Studies, 58 (1), pp. 49-72.

  • Mark V. Pauly, TG McGuire, PP Barros, Handbook of Health Economics, Vol. 2 (2012)

  • Mark V. Pauly (Forthcoming), Medical Spending Reform and the Fiscal Future of the United States.

Teaching

All 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.

  • HCMG8900 - Advanced Study Project

    HCMG 8900-001: This course examines issues related to the Services Sector of the health care industry. For those interested in management, investing, or banking in the health care industry, the services sector will likely be the largest and most dynamic sector within all of health care. We will study key management issues related to a number of different health care services businesses with a focus on common challenges related to reimbursement, regulatory, margin, growth, and competitive issues. We will look at a number of different businesses and subsectors that may have been unfamiliar to students prior to taking the course. We will make extensive use of outside speakers, many of whom are true industry leaders within different sectors of the health care services industry. Speakers will address the current management issues they face in running their businesses as well as discuss the career decisions and leadership styles that enables them to reach the top of their profession. Students will be asked to develop a plan to both buy out and manage a specific health care services business of their choosing and will present their final plans to a panel of leading Health Care Private Equity investors who will evaluate their analysis. Prerequisites: HCMG 8410. Health Care Management MBA majors only

  • 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.

Awards and Honors

  • 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, 2011-2012
  • 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

In the News

Knowledge at Wharton

Activity

Latest Research

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.
All Research

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