Health Economics Commons^™

Debt And The Medicare Eligibility Discontinuity: Disparate Effects Across Households, Olivia Falck

Honors Theses

Public health insurance programs like Medicare and Medicaid have been shown to help reduce household debt caused by healthcare costs. The impact of health insurance literacy makes the relationship between public health programs and debt more ambiguous. The increasing complexity of Medicare raises the question of whether cost savings associated with enrollment might be mitigated by the complexity of choosing the ideal plan for those with low health insurance literacy. In this study, I utilize the Medicare eligibility cutoff at age 65 to implement a regression discontinuity design that analyzes the impact of Medicare eligibility on household debt and out …

Pre-Existing Illness Discrimination In Healthcare: How Barriers To Specialty Medication Effect Public Health Costs And Access, Charles M. Coryell

Senior Projects Spring 2023

Abstract: Rising costs in specialty meds are at the center of the problems in healthcare. Pharmaceutical companies have grown to have nearly unchecked pricing power with specialty medications. Insurance companies have responded to rising prices in specialty medications by making these medications difficult to access for patients who need them. Policies to address the problems in healthcare have failed because they do not recognize the impact that the specialty medicine market has on the overarching story. Healthcare policy will be effective if it directly addresses specialty med costs and accessibility. This paper proposes an expansion of Medicare part D to …

The Evolution Of The Southern Nevada Healthcare Economy: Building The Unlv Academic Health Center, The Lincy Institute

Lincy Institute Events

With the successful launch of the Kirk Kerkorian School of Medicine at UNLV and the completion of its medical education building, Southern Nevada is positioned to expand its healthcare infrastructure - and its healthcare economy - to create a comprehensive, integrated healthcare system to serve our fast-growing community. As UNLV moves forward with the development of an integrated academic health center within the Las Vegas Medical District, understanding the economic and social benefits of such a transformational project is important to stakeholders throughout the region.

The Lincy Institute hosted representatives of Tripp Umbach - the nation's leading consultant on community …

Population Aging And Healthcare Costs In China And Japan, Sean Brown

Honors Theses

This study focuses on the natural demographic phenomenon known as population aging and its intersection with healthcare expenditures. Healthcare spending can be a major burden on a country’s economy, so it is important to accurately assess the connection between these two factors. Population aging occurs when countries reach a point in their demographic transitions characterized by declining total fertility rates and high life expectancy. This natural but undesirable position has implications for virtually all aspects of society, and all countries are trending towards aging. This study examines the cases of China and Japan in an effort to assess the validity …

Political, Racial, And Household Income Barriers For Access To Healthcare In Illinois Counties, Kennedy Bray '23

Student Publications & Research

Access to health care impacts many people throughout the United States, as it restricts their ability to solve their health concerns. People who have the highest risk of a lack of access include people who are uninsured, people a part of a specific social class, or people belonging to a specific political party. In a particular geographical region, these factors could lead to groups of people suffering because of circumstances that they cannot control in their region. In my project, I determine how better access to healthcare and the percentage of people insured are affected by a measurement of the …

Behavioral Economic Modeling Of The Effects Of Symptom, Severity, And Cost On Seeking Medical Care, Mark J. Rzeszutek

Dissertations

While the United States has some of the highest healthcare spending in the world, it has some of the worst health outcomes. For example, maternal mortality in the United States is almost five times as high as in other similarly wealthy countries. It also has the highest rates of avoidable deaths. One of the reasons for this may be the cost of accessing healthcare due to privatized insurance. For example, Americans may avoid important preventive medical visits and other health screeners due to cost. While lack of health insurance has been correlated with decreased health utilization, a precise understanding of …

Social Determinants Of Health: The Impact On Health Outcomes And Hospital Profitability, Danielle Mcpherson

Doctor of Business Administration Dissertations

Hospitals are experiencing decreasing profitability due to increasing healthcare cost. In this paper, I demonstrate that there is financial value to hospitals by addressing social determinants of health (SDOH) as this strategy improves health outcomes and yields cost savings. I estimate the impact of SDOH on the health outcomes using an IV probit regression analysis and estimated the impact of health outcomes on cost using a basic linear regression. I estimate that improving SDOH by one standard deviation will result in hospital cost savings as follows: addressing Violent Crime will decrease hospital cost between 0.16% and 0.21%, addressing Supplemental Nutrition …

Effect Of The Affordable Care Act Medicaid Expansion On Labor Participation Of Female Registered Nurses In Outpatient Care, Deborah R. Weissner

Theses and Dissertations

Medicaid expansions were used to examine the effects of a surge in demand for primary care on the labor participation of registered nurses (RN) in outpatient settings relative to hospitals. Using difference-in-differences and two-way fixed effects with the American Community Survey Public Use Microdata Sample single-year 2010 through 2017 files, I find an increase in the probability of an RN working in an outpatient setting among (1) young, unmarried RNs with a maximum household income of 501 percent of the federal poverty level and (2) young unmarried RNs who have at least one child under age 6. These results are …

Onecare Vermont Aco Quality Metric Evaluation, Alexander Braun

Family Medicine Clerkship Student Projects

This project explores OneCare Vermont ACO quality metrics and how they can be used to improve patient care and reimbursement in a Vermont family medicine practice. Perspectives of physicians within the practice and others familiar with OneCare Vermont operations are shared. Several metrics were identified as areas for improvement within the practice by comparing ACO metrics with patient data.

Comparative Spending Of Medicaid Dollars On Child Participants Of Kentucky’S Sobriety Treatment And Recovery Teams Program Versus A Matched Comparison Group., Matthew Thomas Walton

Electronic Theses and Dissertations

Child protective services agencies have long observed the complicating role that parental substance use and addiction plays in cases of child maltreatment. Families who struggle with these problems present unique challenges for child welfare professionals. These families are typically more difficult to engage, more likely to have children removed from the home, and have poorer outcomes when compared to other families. These poorer outcomes often include health problems. Addiction has well-known effects on health, and the specific manifestations of these problems for parents have been documented for years in child protection casework. However, what has been less investigated are the …

Supporting Medicaid In Virginia, Scott Burns

Exigence

This report analyzes Medicaid in Virginia, the needs-based social health insurance program providing health coverage to children, pregnant women, working parents, the disabled, and elderly who cannot afford health costs on their own. It supports the value of the Medicaid program to these beneficiaries’ long term health, the healthcare sector, cost control and Virginia’s economy. Additionally, it analyzes healthcare policy looking at what effects the Affordable Care Act has had in improving healthcare access and what effects healthcare reform under president-elect Donald Trump’s administration and the Republican controlled 115^th United States Congress might have targeting healthcare cost. Ultimately this …

Unveil The Mysterious Reality Of Management Healthcare In China: A Case Study On Institutional Arrangement, Yasha Zhang

Scripps Senior Theses

This thesis identifies and analyzes current problems in the healthcare market in China. Although many health indicators of China such as life expectancy and child mortality rates have improved significantly and suggest that the healthcare reform in China is successful, there have been many more reports of patient's violent attack towards the doctor, the sudden death of doctors, and decreasing doctor supplies that suggest otherwise. I observed that the relationship between doctors and patients are intense, doctors experience enormous working pressure, and many doctors are leaving the market. It makes me wonder how did government fail to improve its healthcare …

Hospital Merger And Acquisition Effects On Healthcare Quality And Cost, Emily Su

Honors Theses

Healthcare is as much a business subject to market dynamics as it is a public service, with enormous sums of money and resources devoted to it. Since a person’s health is one of his or her most valuable assets, healthcare will always be in high demand, regardless of the price of medical goods and services. Considering healthcare’s nature as a necessary good and the irreplaceable importance of a medical facility to its service area, any changes in capacity or method of healthcare delivery may have profound effects on the dependent population. Situations in which a hospital merges with a healthcare …

The Design Of An Instrument To Assess Clinical Laboratories Efficacy Post Implementation Of The Patient Protection Affordable Care Act, Harry Mcdonald Jr.

Dissertations

The healthcare system in the United States has undergone substantial changes in support of the Patient Protection and Affordable Care Act (PPACA). On March 23, 2010, the implementation of the new healthcare law brought universal healthcare access to all Americans, while attempting to increase quality and decrease medical costs. The new law promotes more of a quality-focused, outcome-based model rather than a pay-for-fee service model; thus, moving the paradigm from infrequent to preemptive healthcare. The PPACA postulates as the only way to achieve cost savings while increasing quality and access. Never before has there been such an extensive change to …

How "Costly" Is Healthcare For The Elderly?, Ruchika Majumdar

Scripps Senior Theses

This study focuses on the possible ways to improve healthcare services around the world, which increase the life expectancy for aging people. Utilizing a cost-effective analysis, the relationship between various healthcare expenditures and conditional life expectancy for people aged 60 and above was examined. A linear regression model was used to analyze data from 122 WHO (World Health Organization) countries obtained from the year 2000. The model included additional health-adjusted life years (HALE) at age 60 as the dependent variable and healthcare cost indicators as the independent variables. Regression results revealed that cost of healthcare was overall significant in contributing …

The Influence Of Projection Bias On Outcomes Of Healthcare Financial Incentive Programs, Jordyn M. Bader

Department of Agricultural Economics: Dissertations, Theses, and Student Research

This thesis contributes to the behavioral health literature and literature regarding healthcare financial incentive programs by discussing the influences of the behavioral economic concept of projection bias on programs designed to recruit healthcare providers to rural or under served areas. First, I propose an adaptation to the model of projection bias by introducing a term that captures variability in individuals’ propensity to exhibit projection bias based on the amount of effort expended in predicting future preferences. Next, I conduct a probit model regression to observe what incentive program design features and participant characteristics are likely to influence the probability of …

The Effects Of Social Status On The Quality And Affordability Of Healthcare, Robert O. Burns

Honors College Theses

Access to healthcare is very important in today's society, as is the quality of said healthcare. The socioeconomic status (SES) of an individual is the most important factor when it comes to determining both the accessibility and quality of said care, and as such has been studied extensively. Across different countries, lower SES has been linked to the decreased affordability and success rates of medical treatments such as coronary heart disease medication or health risk prevention regimes. In many cases, low SES patients were found to be less likely to seek treatment than higher SES patients as the debt they …

Geographic Variation Of Health Care Spending On Heart Failure In Metropolitan Areas, Kevin Mcmillan

Department of Geography: Dissertations, Theses, and Student Research

The costs of healthcare have long been a concern in the United States. It is well known that these costs vary geographically, but attempts to explain this variation have been met with limited and varied success. This is partly attributable to the fact that data available have restricted analyses to assessing the issue to using Medicare cost per beneficiary. In June, 2013, the Center for Medicare and Medicaid Services (CMS) released new Medicare data that detailed the charges and payments made to hospitals throughout the United States in 2011. In this thesis, this new dataset was used to examine costs …

Can Consumers Make Affordable Care Affordable? The Value Of Choice Architecture, Eric J. Johnson, Ran Hassin, Tom Baker, Allison T. Bajger, Galen Treuer

All Faculty Scholarship

Starting this October, tens of millions will be choosing health coverage on a state or federal health insurance exchange as part of the Patient Protection and Affordable Care Act. We examine how well people make these choices, how well they think they do, and what can be done to improve these choices. We conducted 6 experiments asking people to choose the most cost-effective policy using websites modeled on current exchanges. Our results suggest there is significant room for improvement. Without interventions, respondents perform at near chance levels and show a significant bias, overweighting out-of-pocket expenses and deductibles. Financial incentives do …

Health Insurance Exchanges: A Panacea Or A Band-Aid?, Luisa Sanchez De Tagle

Electronic Theses and Dissertations

In 2010, the 111th Congress passed the first national health care reform in the United States, the Patient Protection and Affordable Care Act (ACA). This landmark legislation is intended to "fix" a health care system renowned for decreasing access and escalating costs. This paper examines one of the principal reforms in the ACA, the state health insurance exchanges. The author finds theoretical and empirical evidence to support the exchanges' potential (in conjunction with other relevant ACA reforms) to increase access, decrease insurers' excess profits and shift health care costs away from those least able to afford them. The exchanges fall …

Specialty Service Lines In The United States Hospital System: Old Wine, New Bottles, Michael Sajovetz

Electronic Theses and Dissertations

The emergence of specialty service lines in the United States health care system presents many significant questions regarding the access to, provision of, and financing of healthcare. In general terms, specialty service lines represent the newest development in several important trends in the American hospital system and reflect important trends in the wider economy. Many claims have been made regarding the effect of physician-owned specialty hospitals, from their exemption from self-referral prohibitions, their diversion of services away from general hospitals that use high profit margins to subsidize the "safety net," and concerns regarding the over-provision of technologically complex treatments in …

Does The Provision Of Healthcare Vary With Race? Evidence From Health Shocks To Patients Far From Home, Ajay Sridhar

CMC Senior Theses

A vast literature acknowledges that minority groups, particularly African-Americans, receive less, and lower-quality treatment than Caucasians in U.S. health facilities. It remains an open question as to how much of this disparity is a result of poverty, and how much, a result of more overt discrimination. Former empirical studies are far from conclusive given the endogeneity of hospital quality, as minorities are overrepresented in areas served by poor health facilities. To remedy this endogeneity issue, we observe visitors to the state of Florida, as well as travelers within Florida. When an individual experiences a health shock far from home, her …

Workforce In Indian Health Care Sector, Venkatanarayana Motkuri Mr., Suresh V. Naik Mr.

Venkatanarayana Motkuri Mr.

The paper estimates the total workforce in Indian Helath Care Sector based on NSSO 61st (2004-05) round employment and unemployment survey.