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Jel Classification:I12 

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Did the Medicaid Expansion Crowd Out Other Payment Sources for Medications for Opioid Use Disorder? Evidence from Rhode Island

Using information from the all-payer claims database for Rhode Island covering more than three-quarters of health insurance enrollees in the state from April 2011 through May 2019, this paper offers new measures of the association between the Medicaid expansion and the rate of receipt of buprenorphine and methadone for opioid use disorder (OUD). These robust measures adjust for the extent to which new Medicaid payments for these medications that started in 2014 crowded out payments from either non-Medicaid insurance or from non-insurance subsidies for the treatment of opioid abuse. We find ...
Current Policy Perspectives

Working Paper
Optimal Management of an Epidemic: Lockdown, Vaccine and Value of Life

This paper analyzes the optimal management of a pandemic (stay-at-home and vaccination policies) in a dynamic model. The optimal lockdown policies respond to the spread of the virus with significant restrictions to employment, followed by partial loosening before the peak of the epidemic. Upon the availability of a vaccine, the optimal vaccination policy has an almost bang-bang property, despite the loss of immunity of the vaccinated: vaccinate at the highest possible rate, and then rapidly converge to the steady state. The model illustrates interesting trade-offs as it implies that lower ...
Working Papers , Paper 2020-046

Working Paper
Do Stay-at-Home Orders Cause People to Stay at Home? Effects of Stay-at-Home Orders on Consumer Behavior

We link the county-level rollout of stay-at-home orders to anonymized cellphone records and consumer spending data. We document three patterns. First, stay-at-home orders caused people to stay at home: county-level measures of mobility declined by between 9% and 13% by the day after the stay-at-home order went into effect. Second, stay-at-home orders caused large reductions in spending in sectors associated with mobility: restaurants and retail stores. However, food delivery sharply increased after orders went into effect. Third, there is substantial county-level heterogeneity in consumer ...
Working Paper Series , Paper WP-2020-12

Working Paper
Do Stay-at-Home Orders Cause People to Stay at Home? Effects of Stay-at-Home Orders on Consumer Behavior

We link the county-level rollout of stay-at-home orders during the Covid-19 pandemic to anonymized cell phone records and consumer spending data. We document three patterns. First, stay-at-home orders caused people to stay home: county-level measures of mobility declined 6–7% within two days of when the stay-at-home order went into effect. Second, stay-at-home orders caused large reductions in spending in sectors associated with mobility: small businesses and large retail chains. Third, we estimate fairly uniform responses to stay-at-home orders across the country; effects do not vary by ...
Working Paper Series , Paper WP-2020-12

Working Paper
Technology adoption, mortality and population dynamics

We develop a quantitative theory of mortality trends and population dynamics. Our theory emphasizes individual choices on costly adoption of healthy technologies and diffusion of knowledge about infections as a key channel for reducing mortality. Our theory is consistent with three observations on mortality: (i) The cross-country correlation between levels of mortality and income is negative; (ii) mortality in poor countries has converged to that of rich countries despite no convergence in income; and (iii) economic growth is not a prerequisite for mortality to decline. We calibrate our model ...
Working Papers , Paper 2020-039

Working Paper
The Relationship Between Race, Type of Work, and Covid-19 Infection Rates

This paper explores the relationship between Covid-19 infection rates, race, and type of work. We focus on three U.S. cities—Chicago, New York, and Philadelphia—allowing us to exploit zip code-level variation in infection rates and testing rates over time, while controlling for a variety of neighborhood demographic characteristics. We find that neighborhoods with higher Black and Hispanic population shares, and neighborhoods with higher shares of workers in high-social contact jobs within essential businesses, had disproportionately higher Covid-19 infection rates, even after applying our ...
Working Paper Series , Paper WP2020-18

Working Paper
Technology Adoption, Mortality, and Population Dynamics

We develop a quantitative theory of mortality trends and population dynamics. We emphasize diseases as causes of death and individuals' decisions to reduce their mortality by adopting, at some cost, a modern health-related technology. Adoption confers a dynamic externality: Adoption becomes cheaper as more individuals acquire the modern technology. Our model generates an S-shaped diffusion curve, whose shape dictates the pace of mortality reduction in each country. We use the model to explain the gradual decline of mortality in Western Europe in the 19th and 20th centuries as well as the ...
Working Papers , Paper 2020-039

Working Paper
Did the Affordable Care Act Affect Access to Medications for Opioid Use Disorder among the Already Insured? Evidence from the Rhode Island All-payer Claims Database

Previous research suggests that state Medicaid expansions implemented under the Patient Protection and Affordable Care Act (ACA) helped large numbers of patients suffering from opioid use disorder (OUD) gain access to life-saving medications, including buprenorphine. However, Medicaid expansions could have impeded access to care among individuals already enrolled in Medicaid, as new enrollees would have placed added demands on a limited supply of buprenorphine providers. Using a panel data set of medical claims from Rhode Island, we estimate the causal effects of the state’s January 2014 ...
Working Papers , Paper 21-17

Working Paper
Does Physician Pay Affect Procedure Choice and Patient Health? Evidence from Medicaid C-section Use

I investigate the relationship between physician pay, C-section use, and infant health, using vital statistics data and newly collected data on Medicaid payments to physicians. First, I confirm past results?when Medicaid pays doctors relatively more for C-sections, they perform them more often. I bolster the causal interpretation of this result by showing that salaried doctors do not respond to this pay differential, and by using a much larger sample of states and years. Second, unlike past work, I look at how changing physician pay affects infant health outcomes. I find that increased ...
Working Paper Series , Paper WP-2017-7

Working Paper
Indian Residential Schools, Height, and Body Mass Post-1930

We study the effects of Canadian Indian residential schooling on two anthropometric measures of health during childhood: adult height and body weight. We use repeated cross sectional data from the 1991 and 2001 Aboriginal Peoples Survey and leverage detailed historical data on school closures and location to make causal inferences. We ?nd evidence that, on average, residential schooling increases adult height and the likelihood of a healthy adult body weight for those who attended. These effects are concentrated after the 1950s when the schools were subject to tighter health regulations and ...
Center for Indian Country Development series , Paper 3-2019

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