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Jel Classification:I18 

Working Paper
Health Insurance and Hospital Supply: Evidence from 1950s Coal Country

The United States government spends billions on public health insurance and has funded a number of programs to build health care facilities. However, the government runs these two types of programs separately: in different places, at different times, and for different populations. We explore whether access to both health insurance and hospitals can improve health outcomes and access to health care. We analyze a coal mining union health insurance program in 1950s Appalachia with and without a complementary hospital construction program. Our results show that the union insurance alone increased ...
Finance and Economics Discussion Series , Paper 2020-033

Working Paper
How do Doctors Respond to Incentives? Unintended Consequences of Paying Doctors to Reduce Costs

Billions of dollars have been spent on pilot programs searching for ways to reduce healthcare costs. I study one such program, where hospitals pay doctors bonuses for reducing the total hospital costs of admitted Medicare patients (a ?bundled payment?). Doctors respond to the bonuses by becoming more likely to admit patients whose treatment can generate high bonuses, and sorting healthier patients into participating hospitals. Conditional on patient health, however, doctors do not reduce costs or change procedure use. These results highlight the ability of doctors to game incentive schemes, ...
Working Paper Series , Paper WP-2017-9

Working Paper
The Effect of the Patient Protection and Affordable Care Act Medicaid Expansions on Financial Wellbeing

We examine the effect of the Medicaid expansions under the 2010 Patient Protection and Affordable Care Act (ACA) on consumer, financial outcomes using data from a major credit reporting agency for a large, national sample of adults. We employ the synthetic control method to compare individuals living in states that expanded Medicaid to those that did not. We find that the Medicaid expansions significantly reduced the number of unpaid bills and the amount of debt sent to third-party collection agencies among those residing in zip codes with the highest share of low-income, uninsured ...
Working Paper Series , Paper WP-2016-10

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
Closing the Gap: The Impact of the Medicaid Primary Care Rate Increase on Access and Health

The difficulties that Medicaid beneficiaries face accessing medical care are often attributed to the program?s low reimbursement rates relative to other payers. There is little evidence, however, as to the actual effects of Medicaid payment rates for providers on access and health outcomes for beneficiaries. In this paper, we exploit time-series variation in Medicaid reimbursement rates primarily driven by the Medicaid fee bump?a provision of the Affordable Care Act mandating that states raise Medicaid payments to match Medicare rates for primary care visits for 2013 and 2014?to quantify the ...
Working Paper Series , Paper WP-2017-10

Working Paper
What Happened to the US Economy During the 1918 Influenza Pandemic? A View Through High-Frequency Data

Burns and Mitchell (1946, 109) found a recession of “exceptional brevity and moderate amplitude.” I confirm their judgment by examining a variety of high-frequency data. Industrial output fell sharply but rebounded within months. Retail seemed little affected and there is no evidence of increased business failures or stressed financial system. Cross-sectional data from the coal industry documents the short-lived impact of the epidemic on labor supply. The Armistice possibly prolonged the 1918 recession, short as it was, by injecting momentary uncertainty. Interventions to hinder the ...
Working Paper Series , Paper WP 2020-11

Working Paper
Self-employment and health care reform: evidence from Massachusetts

We study the e ect of the Massachusetts health care reform on the uninsured rate and the self-employment rate in the state. The reform required all individuals to obtain health insurance, required most employers to o er health insurance to their employees, formed a private marketplace that o ered subsidized health insurance options and ex- panded public insurance. We examine data from the Current Population Survey (CPS)for 1994-2012 and its Annual Social and Economic (ASEC) Supplement for 1996-2013. We show that the reform led to a dramatic reduction in the state's uninsured rate due to ...
Research Working Paper , Paper RWP 14-16

Report
Access to medication-assisted treatment for opioid use disorder: is Rhode Island different, and why?

This paper assesses the prevalence of medication-assisted treatment (MAT) among treatment episodes for opioid use disorder (OUD) in Rhode Island, as compared with the remaining New England states and the United States as a whole. Based on the Treatment Episode Data Set (TEDS-A), a national census of admissions into publicly funded treatment facilities for substance use disorders, we find that during the period beginning in 2000 through 2017, Rhode Island exhibited a greater tendency to use MAT as part of OUD treatment compared with the average state in the United States and compared with the ...
Current Policy Perspectives , Paper 19-2

Working Paper
Medicaid Expansion and the Unemployed

We examine how a key provision of the Affordable Care Act—the expansion of Medicaid eligibility—affected health insurance coverage, access to care, and labor market transitions of unemployed workers. Comparing trends in states that implemented the Medicaid expansion to those that did not, we find that the ACA Medicaid expansion substantially increased insurance coverage and improved access to health care among unemployed workers. We then test whether this strengthening of the safety net affected transitions from unemployment to employment or out of the labor force. We find no meaningful ...
Working Paper Series , Paper 2019-29

Working Paper
You can be too thin (but not too tall): social desirability bias in self-reports of weight and height

Previous studies of survey data for the United States and other countries find that on average women tend to understate their body weight, while on average both men and women overstate their height. Social norms have been posited as a potential explanation for misreporting of weight and height, but researchers disagree on the validity of that explanation. This paper is the first to present a theoretical model of self-reporting behavior for weight and height that explicitly incorporates social desirability bias. The model generates testable implications that can be contrasted with predictions ...
Working Papers , Paper 16-15

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