“Social Security Eligibility and Healthcare Utilization: Evidence from Administrative Data” (Draft)
I estimate the impact of Social Security receipt and retirement on healthcare utilization by exploiting the discontinuous increase in claiming and labor market exit at the Early Eligibility Age of 62. Using administrative data on several types of healthcare encounters from New York and California, I find a discontinuous increase in emergency department visits that do not result in hospitalization by 1-2% at this age. I also provide some evidence that this effect is not due to concurrent changes in health insurance status and may instead be attributed to an increase in free time.
“How Access to Addictive Drugs Affects Substance Abuse Treatment Capacity: Evidence from Medicare Part D” Health Economics, 31 (8), August 2022, 1649-1675
This paper explores how a shock to the demand for substance abuse treatment (SAT) due to Medicare Part D caused an increase the supply of treatment capacity. Previous work has already documented that Part D exacerbated national upward trends in opioid-related treatment admissions and mortality by allowing for greater ease of access to prescription narcotics. However, there is still little research on how SAT providers respond to increases in demand for their services, especially regarding the expansion of overall capacity. I show that states which experienced greater demand for SAT due to Medicare Part D saw larger increases in the prevalence of residential and hospital SAT facilities and beds. Furthermore, these states also saw increases in providers offering medication-assisted treatment for opioid-use disorder.
“A Fine Predicament: Conditioning, Compliance and Consequences in a Labeled Cash Transfer Program” (with Carolyn J. Heinrich), World Development, 129, May 2020, 104876
The Kenya Cash Transfer Programme for Orphans and Vulnerable Children (CT-OVC) presents a valuable opportunity to examine the effects of imposing monetary penalties for noncompliance with conditions in cash transfer programs, in contrast to providing only guidance (or “labeling”) for cash transfer use. We take advantage of random assignment to a conditional arm within the CT-OVC treatment locations to understand the impact of imposing conditions with penalties on program beneficiaries, as well as how this effect varies by household wealth. Program beneficiaries (orphans and vulnerable children) were expected to visit health facilities for immunizations, growth monitoring and nutrition supplements and to enroll in and attend school. We find little difference in program outcomes between households in the conditional treatment arm compared to those in the treatment arm with labeling only (in which information was provided about these expectations but compliance was not monitored). However, among the poorest CT-OVC beneficiaries, assignment to the conditional arm was associated with penalty fines and a significant decrease in non-food consumption. This suggests that in comparison to labeled cash transfers, conditional cash transfers may produce unintended, regressive policy effects for the most vulnerable participants.
Works in Progress
“Pediatric Versus Adult Health Care for the Marginal Patient“
This paper uses a regression discontinuity design to exploit a common hospital policy whereby new inpatients below 18 years of age are directed to pediatric services and new inpatients above 18 years of age to adult services. Using administrative data on the near-universe of inpatient, emergency department, and ambulatory surgery admissions from New York between 2002-2017 provided by HCUP, I obtain the following results. First, admission after 18 discontinuously decreases the likelihood of being billed for pediatric accommodations by 12.3 percentage points. Additionally, admission after 18 causes the hospital to assign an attending physician who treats patients that are 8.2 years older, on average, than the patients treated by physicians assigned to those admitted under 18. I also examine how admission after 18 affects treatment intensity and quality of care outcomes.
“Mortality Effects of the Rollout of 9-11 Services”
(w/ Dhaval Dave, Maoyong Fan, and Kosali Simon)