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Imperfect Synthetic Controls: Did The Massachusetts Health Care Reform Save Lives?, David Powell 2017 RAND Corporation

Imperfect Synthetic Controls: Did The Massachusetts Health Care Reform Save Lives?, David Powell

David Powell

In 2006, Massachusetts enacted comprehensive health care reform which served as a model for the Affordable Care Act. I study the mortality effects of the reform using synthetic control estimation, relaxing two critical assumptions required to implement this method.  The traditional approach assumes the existence of a perfect synthetic control, which cannot exist if the outcomes of the treated unit are outside of the "convex hull" or functions of transitory shocks.  I propose simple modifications to relax these restrictions.  The new estimator outperforms the traditional method in simulations.   I estimate that the Massachusetts Health Care Reform reduced mortality by 3%.


Health Policy And The Tax Cuts And Jobs Act, Rachel Gershon 2017 University of Massachusetts Medical School

Health Policy And The Tax Cuts And Jobs Act, Rachel Gershon

Commonwealth Medicine Publications

Congress passed the Tax Cuts and Jobs Act. What does the Act mean for health policy?


Of Rats And Men, Thomas S. Walsh 2017 Cuny Graduate School of Journalism

Of Rats And Men, Thomas S. Walsh

Capstones

This capstone is a data-driven investigation into New York City's rat problem. By using publicly available government data to map rat activity in NYC, I identified several socio-economic variables that correlate with rat populations at the community district, borough, and city-scale. I used these findings (mainly that rat problems are linked to lower incomes) as the basis of an investigation, which includes interviews with residents, experts, and city officials. Prof. Bobby Corrigan, urban rodentologist and formerly with the NYC Department of Health criticizes the city's efforts for the first time on the record.

https://thomasseiyawalsh.wixsite.com/ratstone


The Effectiveness And Effects Of Alcohol Regulation: Evidence From India, Dara Lee Luca, Emily Owens, Gunjan Sharma 2017 Mathematica Policy Research

The Effectiveness And Effects Of Alcohol Regulation: Evidence From India, Dara Lee Luca, Emily Owens, Gunjan Sharma

WCOB Faculty Publications

We provide quasi-experimental evidence on the effects of alcohol regulation on alcohol consumption and associated public health outcomes using detailed individual level and aggregate data from India, where state level laws generate substantial variation in the availability of commercially produced alcohol across people of different ages. We find that despite significant law evasion, men who are legally allowed to drink are substantially more likely to consume alcohol. Further, men who are legally allowed to drink are significantly more likely to commit violence against their partners, suggesting a causal channel between alcohol consumption and domestic violence. We also examine the effects ...


Evaluation Of The Cost And Effectiveness Of Direct Nutrition Education To Low-Income Audiences In Iowa: Efnep And Snap-Ed Graduates Practicing Optimal Nutritional Behaviors (Onb), Christine Hradek, Helen H. Jensen, Nicole Schimerowski Miller, Miyoung Oh 2017 Iowa State University

Evaluation Of The Cost And Effectiveness Of Direct Nutrition Education To Low-Income Audiences In Iowa: Efnep And Snap-Ed Graduates Practicing Optimal Nutritional Behaviors (Onb), Christine Hradek, Helen H. Jensen, Nicole Schimerowski Miller, Miyoung Oh

CARD Staff Reports

The Expanded Food and Nutrition Education Program (EFNEP) and the Family Nutrition Program (FNP) (the Supplemental Nutrition Assistance Program-Education, or SNAP-Ed in Iowa) are community outreach programs in Iowa designed to help teens and adults who have limited income and are parenting acquire the knowledge, skills, attitudes, and practices to improve total family diet and nutritional well-being. This study uses current information on Iowa’s EFNEP and FNP today to evaluate the costs and benefits of the two related programs and provides updated information to a study conducted in Iowa from 1998 to 2000.

Full Text 0.33 MB


Actavis And Error Costs: A Reply To Critics, Aaron S. Edlin, C. Scott Hemphill, Herbert J. Hovenkamp, Carl Shapiro 2017 University of California - Berkeley

Actavis And Error Costs: A Reply To Critics, Aaron S. Edlin, C. Scott Hemphill, Herbert J. Hovenkamp, Carl Shapiro

Aaron Edlin

The Supreme Court’s opinion in Federal Trade Commission v. Actavis, Inc. provided fundamental guidance about how courts should handle antitrust challenges to reverse payment patent settlements. In our previous article, Activating Actavis, we identified and operationalized the essential features of the Court’s analysis. Our analysis has been challenged by four economists, who argue that our approach might condemn procompetitive settlements.As we explain in this reply, such settlements are feasible, however, only under special circumstances. Moreover, even where feasible, the parties would not actually choose such a settlement in equilibrium. These considerations, and others discussed in the reply ...


The Long-Term Health Effects Of Fetal Malnutrition: Evidence From The 1959-1961 China Great Leap Forward Famine, Seonghoon KIM, Belton FLEISHER, Jessica Ya SUN 2017 Singapore Management University

The Long-Term Health Effects Of Fetal Malnutrition: Evidence From The 1959-1961 China Great Leap Forward Famine, Seonghoon Kim, Belton Fleisher, Jessica Ya Sun

Research Collection School Of Economics

We report evidence of long-term adverse health impacts of fetal malnutrition exposure of middle-aged survivors of the 1959-1961 China Famine using data from the China Health and Retirement Longitudinal Study. We find that fetal exposure to malnutrition has large and long-lasting impacts on both physical health and cognitive abilities, including the risks of suffering a stroke, physical disabilities in speech, walking and vision, and measures of mental acuity even half a century after the tragic event. Our findings imply that policies and programs that improve the nutritional status of pregnant women yield benefits on the health of a fetus that ...


Networks In Aca Marketplaces Are Narrower For Mental Health Care Than For Primary Care, Jane M. Zhu, Yuehan Zhang, Daniel Polsky 2017 University of Pennsylvania

Networks In Aca Marketplaces Are Narrower For Mental Health Care Than For Primary Care, Jane M. Zhu, Yuehan Zhang, Daniel Polsky

Research Briefs

In 2016, ACA marketplace plans offered provider networks that were far narrower for mental health care than for primary care. On average, plan networks included 24 percent of all primary care providers and 11 percent of all mental health care providers in a given market. Just 43 percent of psychiatrists and 19 percent of nonphysician mental health providers participate in any network. These findings raise important questions about network sufficiency, consumer choice, and access to mental health care in marketplace plans.


Narrow Networks On The Individual Marketplace In 2017, Daniel Polsky, Janet Weiner, Yuehan Zhang 2017 University of Pennsylvania

Narrow Networks On The Individual Marketplace In 2017, Daniel Polsky, Janet Weiner, Yuehan Zhang

Issue Briefs

This Issue Brief describes the breadth of physician networks on the ACA marketplaces in 2017. We find that the overall rate of narrow networks is 21%, which is a decline since 2014 (31%) and 2016 (25%). Narrow networks are concentrated in plans sold on state-based marketplaces, at 42%, compared to 10% of plans on federally-facilitated marketplaces. Issuers that have traditionally offered Medicaid coverage have the highest prevalence of narrow network plans at 36%, with regional/local plans and provider-based plans close behind at 27% and 30%. We also find large differences in narrow networks by state and by plan type.


Wealth Disparities For Early Childhood Anthropometrics And Skills: Evidence From Chilean Longitudinal Data, Jere R. Behrman, Dante Contreras, Isidora Palma, Esteban Puentes 2017 University of Pennsylvania

Wealth Disparities For Early Childhood Anthropometrics And Skills: Evidence From Chilean Longitudinal Data, Jere R. Behrman, Dante Contreras, Isidora Palma, Esteban Puentes

Population Center Working Papers (PSC/PARC)

We study wealth disparities in the formation of anthropometrics, cognitive skills and socio-emotional skills. We use a sample of preschool and early school children in Chile. We extend the previous literature by using longitudinal data, which allow us to study the dynamics of child growth and skills formation. Also, we include information on mother's and father's schooling attainment and mother's cognitive ability. We find that there are no significant anthropometric differences favoring the better-off at birth (and indeed length differences at birth to the disadvantage of the better-off), but during the first 30 months of life wealth ...


Stabilizing Individual Health Insurance Markets With Subsidized Reinsurance, Scott E. Harrington 2017 University of Pennsylvania

Stabilizing Individual Health Insurance Markets With Subsidized Reinsurance, Scott E. Harrington

Issue Briefs

Subsidized reinsurance represents a potentially important tool to help stabilize individual health insurance markets. This brief describes alternative forms of subsidized reinsurance and the mechanisms by which they spread risk and reduce premiums. It summarizes specific state initiatives and Congressional proposals that include subsidized reinsurance. It compares approaches to each other and to more direct subsidies of individual market enrollment. For a given amount of funding, a particular program’s efficacy will depend on how it affects insurers’ risk and the risk margins built into premiums, incentives for selecting or avoiding risks, incentives for coordinating and managing care, and the ...


Sources Of Health Financing And Health Outcomes: A Panel Data Analysis, Tomoki FUJII 2017 Singapore Management University

Sources Of Health Financing And Health Outcomes: A Panel Data Analysis, Tomoki Fujii

Research Collection School Of Economics

We study the differential impacts of public and private sources of health spending on health outcomes using a triple difference approach. We find that private health spending has on average a higher health-promoting effect than public health spending. This result is robust with respect to the choice of outcome measure and covariates in the regression and driven primarily by the countries with ineffective governments. Once we restrict our sample to countries with effective governments, private health spending is no better than public health spending for improving the health outcome.


Integrating Third Party Liability (Tpl) Across Medicaid Operations And Enterprise Systems In Massachusetts, Jenifer Hartman 2017 University of Massachusetts Medical School

Integrating Third Party Liability (Tpl) Across Medicaid Operations And Enterprise Systems In Massachusetts, Jenifer Hartman

Commonwealth Medicine Publications

This poster highlights the results of a UMass Medical School partnership with MassHealth, the Massachusetts Medicaid program, to integrate third party liability (TPL) activities across all aspects of the Medicaid program. By embedding TPL at all stages of Medicaid operations and interfacing with all Medicaid systems, the partners optimized identification of and access to TPL sources for all Medicaid members.

The TPL activities include eligibility coordination, coverage coordination, payment coordination and recovery coordination. The partnership has achieved over $40 million in cost avoidance through the identification of missed Medicare benefits, over $64 million in cost avoidance over enhanced coordination of ...


Longevity And Lifetime Education: Global Evidence From 919 Surveys, Mohammad Mainul Hoque, Elizabeth M. King, Claudio M. Montenegro, Peter Orazem 2017 Bangladesh Institute of Development Studies

Longevity And Lifetime Education: Global Evidence From 919 Surveys, Mohammad Mainul Hoque, Elizabeth M. King, Claudio M. Montenegro, Peter Orazem

Economics Working Papers

Data from 919 household surveys conducted between 1960 and 2012 spanning 147 countries are used to evaluate the relationship between rising life expectancy at birth and lifetime years of schooling for successive birth cohorts between 1905 and 1988. We find significant positive effects of increased life expectancy at birth on lifetime completed years of schooling in 95% of the surveys with significant negative effects found in only 2.3%.

Rising life expectancy at birth for a birth cohort has intergenerational benefits in that their children’s schooling also increases. Rising life expectancy at birth since 1905 can explain 70% of ...


Direct Effects Of Bundled Payments For Care Improvement Initiative: A County-Level Approach, Konstantinos Panitsas Mr 2017 City University of New York (CUNY)

Direct Effects Of Bundled Payments For Care Improvement Initiative: A County-Level Approach, Konstantinos Panitsas Mr

School of Arts & Sciences Theses

Implementing a nonlinear, Difference-in-Differences estimation method, I quantify the positive impact bundled payment reforms have on vulnerable population groups living in U.S. counties where this cost reducing initiative was implemented. I find statistically significant effects of this health-care initiative on the elderly and the economically disadvantaged individuals.


The Effect Of Paid Sick Leave On Physician Office-Based Visits, Korvin Vicente 2017 CUNY Hunter College

The Effect Of Paid Sick Leave On Physician Office-Based Visits, Korvin Vicente

School of Arts & Sciences Theses

This paper uses a balanced sample of workers from cross-sections of the National Health Interview Survey to estimate the causal effects of paid sick leave on the medical care seeking behavior of individuals, as measured by physician office-based visits.


Community Health Worker Support For Disadvantaged Patients With Multiple Chronic Diseases: A Randomized Clinical Trial, Shreya Kangovi, Nandita Mitra, David Grande, Hairong Huo, Robyn A. Smith, Judith A. Long 2017 University of Pennsylvania

Community Health Worker Support For Disadvantaged Patients With Multiple Chronic Diseases: A Randomized Clinical Trial, Shreya Kangovi, Nandita Mitra, David Grande, Hairong Huo, Robyn A. Smith, Judith A. Long

Research Briefs

In a randomized trial, a community health worker intervention reduced hospitalization and improved outcomes in uninsured or publicly insured patients with multiple chronic conditions such as diabetes, obesity, and smoking. Community health workers can improve health and lower costs, and provide a scalable strategy to improve population health.


Pregnancy Medicaid Expansions And Fertility: Differentiating Between The Intensive And Extensive Margins, Lincoln H. Groves, Sarah Hamersma, Leonard M. Lopoo 2017 University of Wisconsin-Madison

Pregnancy Medicaid Expansions And Fertility: Differentiating Between The Intensive And Extensive Margins, Lincoln H. Groves, Sarah Hamersma, Leonard M. Lopoo

Center for Policy Research

The theoretical and empirical links between public health insurance access and fertility in the United States remain unclear. Utilizing a demographic cell-based estimation approach with panel data (1987-1997), we revisit the large-scale Medicaid expansions to pregnant women during the 1980s to estimate the heterogeneous impacts of public health insurance access on childbirth. While the decision to become a parent (i.e., the extensive margin) appears to be unaffected by increased access to Medicaid, we find that increased access to public health insurance positively influenced the number of high parity births (i.e., the intensive margin) for select groups of women ...


A Cross-Sectional Exploration Of Household Financial Reactions And Homebuyer Awareness Of Registered Sex Offenders In A Rural, Suburban, And Urban County., John Charles Navarro 2017 University of Louisville

A Cross-Sectional Exploration Of Household Financial Reactions And Homebuyer Awareness Of Registered Sex Offenders In A Rural, Suburban, And Urban County., John Charles Navarro

Electronic Theses and Dissertations

As stigmatized persons, registered sex offenders betoken instability in communities. Depressed home sale values are associated with the presence of registered sex offenders even though the public is largely unaware of the presence of registered sex offenders. Using a spatial multilevel approach, the current study examines the role registered sex offenders influence sale values of homes sold in 2015 for three U.S. counties (rural, suburban, and urban) located in Illinois and Kentucky within the social disorganization framework. Homebuyers were surveyed to examine whether awareness of local registered sex offenders and the homebuyer’s community type operate as moderators between ...


A Paradigm Shift For Socioeconomic Justice And Health: From Focusing On Inequalities To Aiming At Sustainable Equity, Juan E. Garay, David E. Chiriboga 2017 University of California Berkeley

A Paradigm Shift For Socioeconomic Justice And Health: From Focusing On Inequalities To Aiming At Sustainable Equity, Juan E. Garay, David E. Chiriboga

Open Access Articles

OBJECTIVES: To measure the 'best possible health for all', incorporating sustainability, and to establish the magnitude of global health inequity.

STUDY DESIGN: Observational, retrospective.

METHODS: We identified countries with three criteria: (1) a healthy population-life expectancy above world average; (2) living conditions feasible to replicate worldwide-per-capita gross domestic product (GDP-pc) below the world average; and (3) sustainability-per-capita carbon dioxide emissions lower than the planetary pollution boundary. Using these healthy, feasible, and sustainable (HFS) countries as the gold standard, we estimated the burden of global health inequity (BGHiE) in terms of excess deaths, analyzing time-trends (1950-2012) by age, sex, and geographic ...


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