Predictability as organizational capital: Managing workforce stability and performance in appointment-based services

Institutional attendance policies shape predictability in human capital utilization with important consequences for utilization volatility and risk-adjusted performance. We conceptualized predictability as a time-varying organizational capability that captures the stability of utilization outcome around expected levels, rather than average utilization alone. To operationalize this, we developed a high-frequency predictability measure based on daily deviations from provider-specific utilization benchmarks. We analyzed detailed operational records from 100 universities in the USA, comprising 22,140 provider–day observations spanning the years 2016 to 2025. The econometric analyses show that higher predictability is associated with significantly improved risk-adjusted performance, primarily through reductions in utilization volatility rather than increases in mean utilization. These effects are stronger in units operating under attendance enforcement policies and intensify at higher levels of predictability, indicating complementarity between institutional design and utilization stability. By distinguishing predictability from average efficiency, this study clarifies why institutional mechanisms can generate sustained performance gains that are obscured in conventional utilization analyses and highlights predictability as a central mechanism linking operational design to performance under uncertainty.