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Working Paper
The Consequences of Medicare Pricing: An Explanation of Treatment Choice
Primary care physicians (PCPs) provide more specialty procedures in less-urban areas, where specialists are fewer. Using a structural random-coefficient model and the demographic and time variation in the data, this paper shows that changes in policy-set reimbursements lead to a reallocation of the suddenly-more-remunerative procedures away from specialists and toward PCPs, and this effect is stronger, the more rural an area is. A reimbursement-unit increase for a given procedure leads to outside-metro PCPs gaining 7-15% market share more than metro PCPs in that procedure, at the expense of ...
Newsletter
Higher Home Prices and Higher Rates Mean Bigger Affordability Hurdles for the U.S. Consumer
In the U.S., homeownership is often described as part of the “American dream,” a way for consumers to accumulate wealth and gain other economic benefits. Almost two out of three U.S. households own the home they live in, a relatively stable amount over the last decade. Buying a home is usually the largest investment that a consumer will make, and the purchase price usually far exceeds what most can afford out of their current savings. In 2022, roughly 70% of home purchases were made with the help of mortgage financing.
Discussion Paper
From Good Bones to Healthy Homes: Housing Quality in the Rural Fifth District
We've previously explored how rural Fifth District households encounter housing affordability challenges, finding low-to-moderate income (LMI) households to be at greatest risk. A home's quality can also profoundly affect residents' well-being. Resolving housing quality issues caused by repair needs can be quite costly. If left unaddressed, housing quality issues can lead to stress or chronic illness, which in turn can hurt adults' workforce activity and children's educational outcomes. As with affordability, not all households are equally likely to face housing quality challenges. In the ...
Working Paper
The Pitfalls of Using Location Quotients to Identify Clusters and Represent Industry Specialization in Small Regions
This paper examines the use of location quotients, a measure of regional business activity relative to the national benchmark, as an indicator of sectoral agglomeration in small cities and towns, and as a measure of industry specialization that might impact the number of new business startups in these places. Using establishment-level data on businesses located in Maine, our findings suggest that the addition of one "hypothetical" establishment in very small towns leads to a dramatic change in the magnitude of the region-industry location quotient. At population sizes of about 4,100 or more ...
Working Paper
Rural Affordable Rental Housing : Quantifying Need, Reviewing Recent Federal Support, and Assessing the Use of Low Income Housing Tax Credits in Rural Areas
Recently, there has been significant interest in the high levels of rental cost burden being experienced across the United States. Much of this scholarship has focused on rental cost burdens in larger urban areas, or at the national level, and has not explored differences in the prevalence of rental cost burden in urban versus rural communities. In this paper, I find that rental cost burdens are a challenge facing both urban and rural communities. However, despite the need for affordable rental housing in rural communities identified, I find the amount of resources made available by the ...
Briefing
School Quality as a Tool for Attracting People to Rural Areas
Many rural localities are interested in strategies for retaining residents and attracting newcomers. Recent research indicates that one promising strategy for rural development is maintaining and improving the quality of an area’s public schools. In this research, which is the first national study of the relationship between school quality and migration flows in and out of rural areas, better outcomes for students in a rural county’s schools were associated with higher migration into that county.