I study how people and systems interact to shape organizational performance.

Working papers

Nguyen CA. When Low Performance Takes Root: Deadwood and Delay at the U.S. Patent Office.

  • Organizations rely on accountability systems to maintain productivity. Yet when both sanctions for low performance and incentives for high performance are weak, employees may scale back their discretionary effort. This erosion of commitment undermines the informal norms of cooperation that support group performance. I develop and examine the concept of deadwood, a colloquial label for employees who shift from adequate productivity into a sustained period of low productivity but persist in the organization, often protected by tenure or other safeguards. Using administrative and personnel records from the U.S. Patent and Trademark Office and the U.S. Office of Personnel Management, I find that deadwood-heavy groups face longer processing delays among non-low performers and higher exit rates, particularly of highly educated examiners. These delays became especially pronounced after Alice Corporation v. CLS Bank International, an institutional shock that disrupted examination routines and exposed the vulnerability of deadwood-heavy groups. These results suggest that entrenched low performers not only depress peers’ output, potentially through weakened morale, but also hinder adaptation when organizations are under pressure.

  • Doctoral Research Forum Viewers’ Choice Award, MIT Sloan, 2026.

  • Best Thesis Prize Runner-Up, MIT Sloan, 2026.

Nguyen CA. The Value Added of Innovation Managers: Evidence from the National Institutes of Health.

  • Allocation of authority to innovation managers is a central question that all R&D organizations face. Giving managers the power to choose the people and projects to which they allocate resources means some loss of control for the principal. However, delegating this responsibility can leverage the experience of skilled managers to make optimal choices. Building on models of authority in organizations, this paper investigates how discretion affects the impacts of innovation managers (program officers) at the National Institutes of Health on the performance of researchers who receive public grant funding. Using value-added measures of managerial quality, I find differences in value added depending on whether I examine first-time grantees versus researchers who have already received a grant in the past. My findings suggest that discretion matters most for the short-term outcomes of first-time grantees. Specifically, variation in value added is more salient for publication quantity when the program officer has discretion than when she does not. However, the opposite is true for their long-run citations and for established grantees overall. Having a program officer with a doctorate degree has a positive impact on value added for investigators' publications.

  • Distinguished Paper Award in Organizational Structure, Networks, and Relational Strategies, Strategic Management (STR) Division, Academy of Management (AOM), 2025.

  • Robert J. Litschert Best Doctoral Student Paper Award, STR Division, AOM, 2025.

  • AOM Best Paper Proceedings, 2025.

Nguyen CA. Do Externally Hired Managers Increase Innovation? Evidence from the U.S. Government.

  • Although the U.S. government spends nearly $40 billion on intramural research and development, little is known about its own scientists’ innovative output and the managers who are responsible for their performance. Using individual-level data from 2000 to 2013, I investigate the impact of externally-hired federal managers on the innovation output of employees in science, technology, engineering, math, health, and social science occupations. By leveraging the variation in agencies' hiring of external managers, I find positive effects on scientists' number of publications, citations, and outside collaborations following an agency's shift to external management for treated scientists compared to matched controls. In addition, the impact varies for scientists in different occupational fields and is particularly large and positive for citations of shorter-tenured scientists and for outside collaborations of longer-tenured scientists. All together, these findings could inform strategies for hiring public managers and their potential influences on the scientific and technological progress of their organizations.

Nguyen CA. Legitimizing the Loophole: How Organizations Shape the Meaning of Work.

publications

Nguyen CA, Beaulieu ND, Wright AA, Cutler DM, Keating NL, Landrum MB. Organization of Cancer Specialists in U.S. Physician Practices and Health Systems. Journal of Clinical Oncology. 2023; 41(26):4226-4235.

Nguyen CA, Gilstrap LG, Chernew ME, McWilliams JM, Landon BE, Landrum MB. Using Consistently Low Performance to Identify Low-Quality Physician Groups. JAMA Network Open. 2021; 4(7):e2117954.

Nguyen CA (corresponding author), Chernew ME, Ostrer I, Beaulieu ND. Comparison of Healthcare Delivery Systems in Low- and High-Income Communities. The American Journal of Accountable Care. 2019; 7(4):11-18. (Lead article)

Gilstrap LG, Chernew ME, Nguyen CA, Alam S, Bai B, McWilliams JM, Landon BE, Landrum MB. Association Between Clinical Practice Group Adherence to Quality Measures and Adverse Outcomes Among Adult Patients with Diabetes. JAMA Network Open. 2019; 2(8):e199139.

Nguyen CA, Gilstrap LG, Chernew ME, McWilliams JM, Landon BE, Landrum MB. Social Risk Adjustment of Quality Measures for Diabetes and Cardiovascular Disease in a Commercially-Insured US Population. JAMA Network Open. 2019; 2(3):e190838.

McDowell A, Nguyen CA, Chernew ME, Tran KN, McWilliams JM, Landon BE, Landrum MB. Comparison of Approaches for Aggregating Quality Measures in Population-based Payment Models. Health Services Research. 2018; 53(6):4477-4490.

Auriemma CL, Chen L, Olorunnisola M, Delman A, Nguyen CA, Cooney E, Gabler NB, Halpern SD. Public opinion regarding financial incentives to engage in advance care planning and complete advance directives. American Journal of Hospice and Palliative Care. 2017; 34(8):721-728.

Nguyen CA. The Importance of Country of Origin for Health Service Utilization Among Immigrants in the United States. The Harvard Undergraduate Research Journal. Fall 2014; 7(2):24-31.

Nguyen CA (corresponding author), Shih JA, Lin KV, Aladesanmi OA. Targeting National Emergency Department Overuse: A Case for Primary Care, Financial Incentives, and Community Awareness. Harvard Health Policy Review. Fall 2014; 14(1):23-26.

Auriemma CL, Nguyen CA, Bronheim R, Kent S, Nadigu S, Pardo D, Halpern SD. Stability of End-of-Life Preferences: A Systematic Review of the Evidence. JAMA Internal Medicine. 2014; 174(7):1085-1092.

White papers and policy writing

Felber S, Meire C, Nadadur G, Nguyen CA, Higuchi A, Jayanti A. Tech Hub Competition and Federal R&D Funding. Belfer Center for Science and International Affairs, Harvard Kennedy School. June 2022.

Landrum MB, Nguyen C, O’Rourke E, Jung M, Amin T, Chernew M. Measurement Systems: A Framework for Next Generation Measurement of Quality in Health Care. National Quality Forum. Mar. 2019.

Nguyen C. The Translation of Research into Policy: Sharing Experiences Between Experts in Both Fields. SUMR Blog, Leonard Davis Institute of Health Economics. Aug. 2013.