Algorithm Design and Physician Liability

A single clinical algorithm can deliver unequal accuracy across patient groups, and concern about such disparity has grown as artificial intelligence (AI) spreads through clinical decision-making. In response, a liability rule introduced in the United States holds healthcare providers responsible when their reliance on disparate algorithms contributes to erroneous clinical decisions. We examine how such liability considerations reshape (i) an AI firm's algorithm design decisions that drive group-specific accuracy and (ii) a physician's decisions to use AI in healthcare delivery. The AI firm designs an algorithm for two patient groups, and improving accuracy for the disadvantaged group is more costly. The physician (who remains the accountable decision-maker) then decides whether to consult AI, weighing the reduction in clinical uncertainty against expected liability exposure when AI errors disproportionately affect the disadvantaged group. We find the liability rule can induce disparate use of AI: the physician may reduce AI use overall and, over an intermediate range of liability, rely on AI less for disadvantaged patients. The effect is non-monotone. As liability increases, the physician's use of AI for disadvantaged patients first declines, then rises as the firm reallocates investment toward reducing disparity or switches to an equal-accuracy design. Mandating equal algorithmic accuracy across patient groups can then inadvertently harm both groups, because a uniform accuracy requirement distorts the firm's investment incentives and the physician's equilibrium AI-use decisions.

Managing the Human Fallback: Skill Investment Under Improving AI and Worker Mobility

When firms deploy autonomous AI, they must decide how much work to leave to the system and how much to keep workers engaged. This decision affects current output and future human capital. We develop a parsimonious two-period model in which AI may outperform the worker when it functions, but may fail with positive probability. A firm chooses worker engagement; engagement lowers current output for below-benchmark workers, but changes future skill through learning and erosion. We distinguish two dimensions of AI progress: capability, the system's output when it works, and reliability, the probability that it works. In a single-firm benchmark, engagement is valuable only as fallback investment. The firm engages the least-skilled workers most, because they have the largest skill gaps and are least costly to bring toward a useful fallback level. With worker mobility, engagement also affects labor-market sorting: workers prefer jobs that build more valuable skill trajectories. This sorting motive targets higher-skill workers near the AI frontier, where skill gains are more valuable and engagement is less costly. Mobility can therefore reverse the engagement pattern, shifting investment from the least-skilled toward the most-skilled workers below the AI benchmark. Mobility also reshapes how AI progress affects engagement: greater capability raises engagement by increasing the value of the skill trajectory a firm offers, whereas greater reliability can raise or lower it because it reduces fallback need while also changing learning opportunities. Under worker mobility, human-AI work design becomes a problem of human-capital investment, in which allocating work today shapes future skill.

Assured Autonomy: How Operations Research Powers and Orchestrates Generative AI Systems

Generative artificial intelligence (GenAI) is shifting from conversational assistants toward agentic systems -- autonomous decision-making systems that sense, decide, and act within operational workflows. This shift creates an autonomy paradox: as GenAI systems are granted greater operational autonomy, they should, by design, embody more formal structure, more explicit constraints, and stronger tail-risk discipline. We argue stochastic generative models can be fragile in operational domains unless paired with mechanisms that provide verifiable feasibility, robustness to distribution shift, and stress testing under high-consequence scenarios. To address this challenge, we develop a conceptual framework for assured autonomy grounded in operations research (OR), built on two complementary approaches. First, flow-based generative models frame generation as deterministic transport characterized by an ordinary differential equation, enabling auditability, constraint-aware generation, and connections to optimal transport, robust optimization, and sequential decision control. Second, operational safety is formulated through an adversarial robustness lens: decision rules are evaluated against worst-case perturbations within uncertainty or ambiguity sets, making unmodeled risks part of the design. This framework clarifies how increasing autonomy shifts OR's role from solver to guardrail to system architect, with responsibility for control logic, incentive protocols, monitoring regimes, and safety boundaries. These elements define a research agenda for assured autonomy in safety-critical, reliability-sensitive operational domains.