Health Economics Commons^™

Essays On Health And Immigration Policy, Selen Ozdogan

Dissertations, Theses, and Capstone Projects

This dissertation consists of two essays in applied microeconomics, each examining how individuals and institutions respond to policy changes. Both essays leverage natural experiments and recent advances in difference-in-differences estimation to identify causal effects. Both also speak to a common theme in public policy: the gap between intended and actual consequences of government intervention, and the role that policy design plays in shaping those consequences.

The first essay examines the impact of state-level e-cigarette excise taxes on nicotine and tobacco exposure among adults aged 18 and older. A central contribution is its use of individual-level panel biomarker data from urine …

Cooling Deserts For Renters: Heat Equity Inside The Nyc Housing System, Tahreem Ashraf

Dissertations, Theses, and Capstone Projects

This study introduces the Cooling Desert Index (CDI), a composite spatial measure designed to identify census tracts in New York City where extreme heat vulnerability and structural barriers to adaptive cooling converge. Drawing on five publicly available datasets and a seven phase statistical pipeline, the CDI scores all 2,231 NYC census tracts on a continuous 0 to 100 scale by integrating heat exposure, severe rent burden, household income, racial composition, language access, disability status, and housing crowding. The analysis identifies 557 cooling deserts, defined as tracts where environmental heat risk is high and financial constraints make effective cooling structurally inaccessible, …

The Effects Of Private Equity Ownership Of Acute Care Hospitals On Patient Experience, Abigail M. Huffman

Theses and Dissertations

In 10 years, private-equity firms' share of hospitals has grown from 2-3% to 8%.  Using data from two sources: the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient surveys and the Private Equity Stakeholder Project (PESP), I demonstrate a causal effect of private-equity ownership on patient satisfaction using difference-in-difference methods.

Effects Of Punitive Immigration Enforcement On The Health Of Latinos With Lower Educational Attainment, Andrea Sofia Mendoza

Theses and Dissertations

This paper analyzes the effects of the Secure Communities (SC) immigration enforcement program on self reported health and healthcare-seeking behaviors of citizen and non-citizen Latinos with lower educational attainment. SC allowed local jails to use FBI and DHS data to determine whether arrested individuals were eligible for deportation. SC was rolled out across counties from late 2008 through 2013. Using data from the Behavioral Risk Factors Surveillance Survey (BRFSS) and implementation records from Alsan and Yang (2024), staggered difference-in- difference regression estimates show that SC implementation increased the likelihood of a reported heart attack and heart disease across the sample. …

The Effect Of Prenatal Substance Use Policies On Women's Well-Being, Zukruf Alam

Theses and Dissertations

This paper examines the effects of punitive and priority treatment policies relating to the use of illicit substances during pregnancy on women's health and health-related behavior. Punitive interventions criminalize substance use during pregnancy, which can even lead to termination of parental rights. In contrast, priority treatment policies support pregnant women and grant them priority access to substance use disorder treatment programs. I use staggered difference-in-differences methods and data from the Behavioral Risk Factor Surveillance System data from 2004 to 2018 to estimate the impact of prenatal substance use policies on women's mental health, physical health, self-reported poor health, and cigarette …

Private Equity, State Enforcement, And Arbitration Outcomes Under The No Surprises Act: Evidence From Air Ambulance Disputes, Peter Readman

Theses and Dissertations

The No Surprises Act (NSA) removed patients from responsibility for out-of-network surprise medical bills. In its place, the NSA established an independent dispute resolution (IDR) process through which providers and insurers submit competing payment offers to an arbitrator, who selects one offer in full. Using the universe of federal air ambulance IDR disputes from Q1 2023 through Q2 2025 (57,368 dispute line items), I examine whether provider ownership structure and enforcement jurisdiction jointly predict arbitration outcomes. The two outcomes, whether the provider offer prevails, and how large that prevailing offer is relative to the benchmark payment rate, the Qualifying Payment …

Air Pollution And Self-Reported Health Outcomes In The United States, Alina Dervisevic

Theses and Dissertations

This study examines the relationship between short-term PM2.5 exposure and self-reported health outcomes among U.S. adults using BRFSS data from 2000 to 2012 linked to county-level pollution and weather data. Results show that PM2.5 exposure is associated with worse mental health and gender specific behavioral responses.

Retroactive Eligibility Waivers: Innovative Or Ineffective?, Mohamed Kacem Benyamine

Theses and Dissertations

Medicaid’s retroactive eligibility provision covers medical expenses for beneficiaries up to 90 days before the application date. Retroactive eligibility insulates uninsured, low-income households from expensive healthcare emergencies. New Hampshire, Arkansas, and Iowa recently obtained waivers to end retroactive coverage. Using a difference-in-differences design and data from the Behavioral Risk Factor Surveillance System, I evaluate whether changes in retroactive coverage affect enrollment rates and self-reported health. Removing retroactive eligibility has no statistically significant effects on insurance enrollment or self-reported health. However, it does increase rates of access to a doctor by 1.0% overall and by 1.6% for women. Removing retroactive eligibility …

The Effect Of Medical Aid In Dying On Health Outcomes And Risky Behavior Of The Elderly, Jacky Wu

Theses and Dissertations

This study examines the effects of Medical Aid in Dying (MAiD) legalization on health outcomes and behavior among elderly U.S. adults using BRFSS data from 2005-2022. Using staggered difference-in-differences, this paper finds that MAiD increases exercise, lowers BMI, and reduces blood pressure medication use.

Intergenerational Transmission Of Health: Evidence From Indonesia, Fatima Khan

Theses and Dissertations

This study estimates the causal transmission of health from mothers to their children. Intergenerational associations in health and other human capital outcomes are well established, but those associations may not be causal due to common unobserved factors between a mother and her child. This study employs two-stage least squares, using weather variation as an instrument, to causally identify the relationship between maternal health and child health outcomes in five dimensions: height-for-age, self-reported health, blood pressure, lung capacity, and hemoglobin levels. The data are from the Indonesian Family Life Survey (1993--2014), a longitudinal survey that provides a 21-year look into the …

Menstrual Math: The Price Of Bleeding, Gabrielle Langston

Dissertations, Theses, and Capstone Projects

This project examines the landscape of menstrual equity in the United States through a data storytelling lens, focusing on state-level policies regarding taxation and access to menstrual products. The analysis explores which states impose sales tax on menstrual products, if state schools provide free menstrual products, and which states ensure access for incarcerated individuals using publicly available datasets from advocacy groups. Additionally, there is an investigation into potential correlations between the gender wage gap and states that tax menstrual products, shedding light on economic and policy disparities.

Through its data visualizations, this project aims to provide a clear, although not …

An Exploratory Study Of Household Alcohol Consumption From The Us Bureau Of Labor Statistics Consumer Expenditure Survey With A Focus On Market Conditions And Regulatory Structures, Mayya Makarycheva

Dissertations, Theses, and Capstone Projects

Alcohol consumption and use is not just a harmful behavior or a potential recreational activity, but it also may form a way of self-identification.

Each type of beverage apparently has their own profile of dedicated drinkers. Those drinkers are also apparently loyal to the location of purchase. However, one may also consider whether consumption in one location is a predictor of consumption in the other location. This distinct tendency highlights the intricacy of consumption patterns, as on-premise and off-premise consumption simultaneously serve as complements and substitutes in the long run in terms of both location and type of beverage.

The …

Behavioral Responses To The Medicare Part D Coverage Gap And Its Closure, Selene Urbatsch

Theses and Dissertations

The author examines how exposure to the Medicare Part D coverage gap affects future prescription drug use and whether the closure of the gap under the Affordable Care Act (ACA) altered beneficiary behavior. Using 2007–2019 MEPS data, the analysis compares Part D enrollees to similarly aged, privately insured individuals, producing first-differences and difference-in-differences estimates. Before the ACA, exposure to the gap was associated with 4.9 fewer prescription fills relative to comparable non-Part D individuals. After the ACA, the effect fell to a reduction of 2.2 generic fills, with no significant decline in branded use. Sudden out-of-pocket cost increases prompted sharp …

Essays In Applied Microeconomics, Ege Aksu

Dissertations, Theses, and Capstone Projects

This dissertation consists of two chapters that investigate the effect of public health policies on health outcomes.

The first chapter evaluates the impact of the extensive health care reforms enacted between 2003–2013 under the Health Transformation Program (HTP) in Turkey on maternal and infant health outcomes for the poor. By focusing on a specific insurance program (Green Card) expansion that was a part of HTP, I explore changes in infant survival, fertility, and children’s vaccination status. Before 2004, all public health insurance beneficiaries (the control group) were covered for outpatient services, including prenatal and postnatal doctor visits, gestational diabetes screenings, …

The Effects Of Pre-Abortion Restrictions On Women's Well-Being, Reesa Sooklall

Theses and Dissertations

Eleven states require women seeking abortions to undergo mandated ultrasounds prior to the procedure while twenty-four states require women to wait either 24, 48 or 72 hours between receiving state mandated counseling and the procedure. I examine the effects of abortion restrictions on health behaviors and health care of women. I apply staggered difference-in-differences to the Behavioral Risk Factor Surveillance System data to estimate the causal effects of the two-trip mandatory waiting period (MWP) law and mandatory ultrasounds (MUS) law on women’s mental health, use of alcohol and tobacco, and whether women are obtaining routine mammograms and pap smears. The …

Budget Capping Health Care: Its Impact On Health, Susan Chen

Theses and Dissertations

The goal of a budget cap on healthcare is to constrain total healthcare expenditure without compromising quality. This paper examines the impacts of budget capping on health and behavioral health outcomes, exploiting the completed Maryland All-Payer Model and the ongoing, extensional Maryland Total Cost of Care model, both of which capped healthcare budgets in Maryland. I use data from 2011-2021 surveys of the Behavioral Risk Factor Surveillance system and generalized difference-in-difference regression models to find that budget capping improves health and behavioral health outcomes with a greater favorable effect during the Maryland Total Cost of Care model.

The Role Of Place Of Birth And Residence In Puerto Rican Health Disparities: Evidence From Disability Prevalence Among Archipelago- Vs. Mainland-Born Puerto Ricans, Mara Getz Sheftel, Frank W. Heiland

Publications and Research

Objectives: This paper provides new estimates of disability prevalence for the archipelago and mainland-residing Puerto Rican populations ages 40 and above and compares disability by place of birth and place of residence to investigate drivers of middle and older age health.

Methods: Large nationally representative samples from 2013 to 2017 American Community Survey and Puerto Rico Community Survey data are used to estimate age-specific disability prevalence for archipelago-born/archipelago-residing, archipelago-born/mainland-residing, mainland-born/mainland-residing Puerto Ricans.

Results: Mainland-born/ mainland-residing Puerto Ricans have the lowest age-adjusted disability rates and archipelago-born/archipelago-residing Puerto Ricans have the highest rates. Differences in education explain part of this disparity.

Discussion: …

Understanding The Impact Of Incentive-Driven Changes In Hospital And Physician Practice Styles, Ke Zeng

Dissertations, Theses, and Capstone Projects

This dissertation consists of three chapters that investigate impact of incentive changes on hospital and physician practice styles, as well as patient outcomes.

In an effort to curb the escalating healthcare expenditure, the Center for Medicare \& Medicaid Innovation has introduced several alternative payment models, which have garnered significant attention in numerous studies with varied findings. This first chapter introduces the focal point of this thesis, namely the Comprehensive Care for Joint Replacement (CJR) model, and provides a review of pertinent studies that have examined this model and related areas. Specifically, this chapter reviews and summarizes the findings from studies …

Essays In Health Economics, Chuxin Liu

Dissertations, Theses, and Capstone Projects

In Chapter 1, I investigate the effect of a financial incentive from the Centers for Medicare and Medicaid Services (CMS) on new medical procedure technology diffusion. I examine how the incentive affects diffusion among Medicare patients, for whom hospitals receive the incentives, and non-Medicare patients for whom there are no incentives. I answer these two questions by studying the New Technology Add-on Payment (NTAP) program offered by Medicare (Part A). It is unknown whether its incentive is enough to encourage diffusion under the prospective payment system and it also remains unknown whether it spills over to non-Medicare patients or crowds …

Skilled Workers’ Mobility And Attrition: The Case Of Florida Emergency Medicine Physicians, Vassina Hassane Meite

Theses and Dissertations

Emergency medicine (EM) physicians constitute the front line of healthcare providers. They work swiftly to address critical situations, diagnose illnesses, and stabilize patients. Amidst a growing need and shortage of EM physicians, this longitudinal descriptive study captures EM physicians’ preferences for practice locations by studying Florida EM physicians’ relocation patterns between 2006 and 2020. Esti- mates from a Cox Proportional-Hazards model and fixed effects logistic regressions suggest that wage amenities are not a strong determinant of relocation over time. Physician attrition and relocation are instead more saliently affected by high work volumes within the EM physician’s primary work location.

Effects Of The Raising The Minimum Legal Purchasing Age For Tobacco On Cigarette, Cocaine And Inhalant Consumption, Ahmed Adil

Theses and Dissertations

Over the past few years, several states have passed laws that increase the minimum legal purchasing age (MLPA) for tobacco from 18 to 21 years. This study examines the impact of statewide MLPA laws on youth tobacco consumption. Using data from the 2009-2019 Youth Risky Behavior Surveys (YRBS) and a difference-in-differences approach, I find that the enactment of MLPA laws is associated with a decrease in tobacco usage among adolescents. I also find that MLPA laws have important spillover effects to other youth risky behaviors. MLPA law adoption is associated with a reduction in cocaine use and inhalant abuse.

Essays On Impacts Of Women Empowerment On The Health Outcomes Of Children, Sagnik Das

Dissertations, Theses, and Capstone Projects

Chapter 1: Taking cognizance of the lack of representation of women in politics, the Indian government in 1993, enacted the 73rd constitutional amendment which led to a sudden increase in the representation of women in the local governments. Exploiting the exogenous variation in the timing of implementation of the 73rd amendment across the states, I study the spillover effects of this mandated empowerment of women on the health outcomes of children by using nationally representative survey data and employing a difference-in-difference estimation strategy. In this study, I find evidence of a positive impact of mandated women empowerment on the survival …

Episode Based Payment Models And The Hospital Safety-Net: An Evaluation Of The Center For Medicare And Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program, John A. Gravina

Dissertations and Theses

Episode Based Payment Models and the Hospital Safety-net: An Evaluation of the Center for Medicare and Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program

By John Anthony Gravina

Advisor: Alexis Pozen, Ph.D.

Introduction: Payments for Healthcare services are increasingly being tied to clinical quality, patient experience, health outcomes, and efficiency through value-based payment arrangements (VBP). VBP presents a potential opportunity to reduce healthcare expenditures by requiring providers to take on financial risk associated with the cost and quality of care, therefore aligning payment incentives with the goals of providing higher quality and efficient care. As of 2020, 80 percent of …

Family Structure Variables As Proxies For Socialization And Their Effect On Cognitive Decline: An Empirical Analysis, Peter Amato

Theses and Dissertations

The risk of several common diseases causing dramatic cognitive decline (Alzheimer’s, dementia, anterograde memory loss) and short-term memory impairment are all common, even inevitable ailments as one continues to age. There is a body of literature that suggests stronger social networks reduce the chance of cognitive decline through mentally stimulating activities or socializing. This study examines the rates of cognitive decline in people with larger families by using ordinary least squares (OLS) regression and a cox hazard proportion hazards model to examine the protective effects of different family structures on the rates of cognitive decline using the American Community Supplement …

A Latent Class Approach To The Utilization Effects Of The Aca, Dennis Jones

Theses and Dissertations

The dependent coverage provision of the Affordable Care Act raised eligibility for young adults to remain eligible their parents’ health care up to the age of 26. This study uses a combination of latent class analysis and difference-in-difference regression to examine the effect the intervention had on health care utilization.

The Effect Of The Fresh Program On Fruit And Vegetable Consumption In Nyc, Haido Andrianos

Theses and Dissertations

This study examines whether the NYCEDC's FRESH Program has had an effect on the fruit and vegetable consumption of NYC residents. Using data collected by the NYC DOHMH, a difference-in-difference regression with fixed effects was run. Stratifications for race and sex were also performed.

The Effects Of Hospital-Acquired Condition (Hac) Reduction Program On Hospital Services And Finances, Yuting Chen

Theses and Dissertations

Effective 10/01/2014, the HAC Reduction Program was implemented by CMS. Using 2015-2017 hospital-level data, this paper measures the effects of this Program on hospital days, discharges, revenues, costs, and service performance. I find penalized hospitals barely improved healthcare performance; meanwhile they increased patients numbers by 12.0% to cover penalties received.

The Case For Public Investment In Higher Pay For New York State Home Care Workers: Estimated Costs And Savings, Isaac Jabola-Carolus, Stephanie Luce, Ruth Milkman

Publications and Research

This report explores one potential solution to the mounting home care labor shortage in New York State: substantially raising wages for the state's home care workers. The analysis presents detailed projections, based on the best available data, of the economic effects of such an intervention, estimating the costs and benefits that would result. We find that public funding to raise home care wages would require significant resources, but those costs would be surpassed by the resulting savings, tax revenues, and economic spillover effects. The net economic gain would total at least $3.7 billion. Lifting wages would also help fill nearly …

Framing Inclusion: The Media Treatment Of Irregular Immigrants' Right To Health Care In Spain, Alisa Petroff, Anahí Viladrich, Sònia Parella

Publications and Research

With the passing of Royal Decree-Law 16/2012, Spain’s national health system switched from a model defined by universal and free health care principles, to a private insurance system that excluded large population groups. Based on a qualitative research design, this paper examines the media treatment of undocumented immigrants’ prerogatives to public health care in Spain (2012–2018). The analysis of 234 articles, drawn from three major Spanish newspapers, reveals three frames that underscore the media’s "rhetorics of inclusion," which argue for the extension of free medical services to irregular immigrants a topic traditionally underestimated by the literature. The moralist frame, supported …

The Cost Effectiveness Of Mental Health Treatment In The Lifetime Of Older Adults With Hiv In New York City: A Markov Approach, Juan J. Delacruz, Mark Brennan-Ing, Andreas Kakolyris, Omar Martinez

Publications and Research

Background

There are noticeable gaps in knowledge regarding the cost and effectiveness of integrated medical and behavioral services for older adults with HIV. Their lifespan is close to the population’s level but their quality of life has sharply declined due to depression and substance use. Mental health disorders are widespread among an aging population with HIV. Objective The aim of this study was to build a decision analytic model to evaluate medical interventions with and without mental health treatment using primary data of 139 older adults with HIV and health outcomes from the literature.

Methods

We tracked the progression of …