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Craig Garthwaite - One of the best experts on this subject based on the ideXlab platform.

  • Public Health Insurance, Labor Supply, and Employment Lock*
    The Quarterly Journal of Economics, 2014
    Co-Authors: Craig Garthwaite, Tal Gross, Matthew J. Notowidigdo
    Abstract:

    We study the effect of Public Health Insurance on labor supply by exploiting a large Public Health Insurance disenrollment. In 2005, approximately 170,000 Tennessee residents abruptly lost Medicaid coverage. Using both across- and within-state variation in exposure to the disenrollment, we estimate large increases in labor supply, primarily along the extensive margin. The increased employment is concentrated among individuals working at least 20 hours a week and receiving private, employer-provided Health Insurance. We explore the dynamic effects of the disenrollment and find an immediate increase in job search behavior and a steady rise in both employment and Health Insurance coverage following the disenrollment. Our results are consistent with a significant degree of ‘‘employment lock’’—workers who are employed primarily to secure private Health Insurance coverage. JEL Codes: I1, J22, H75.

  • Public Health Insurance, Labor Supply, and Employment Lock
    2013
    Co-Authors: Craig Garthwaite, Tal Gross, Matthew J. Notowidigdo
    Abstract:

    We study the effect of Public Health Insurance eligibility on labor supply by exploiting the largest Public Health Insurance disenrollment in the history of the United States. In 2005, approximately 170,000 Tennessee residents abruptly lost Public Health Insurance coverage. Using both across- and within-state variation in exposure to the disenrollment, we estimate large increases in labor supply, primarily along the extensive margin. The increased employment is concentrated among individuals working at least 20 hours per week and receiving private, employer-provided Health Insurance. We explore the dynamic effects of the disenrollment and find an immediate increase in job search behavior and a steady rise in both employment and Health Insurance coverage following the disenrollment. Our results suggest a significant degree of "employment lock" - workers employed primarily in order to secure private Health Insurance coverage. The results also suggest that the Affordable Care Act - which similarly affects adults not traditionally eligible for Public Health Insurance - may cause large reductions in the labor supply of low-income adults.

  • the doctor might see you now the supply side effects of Public Health Insurance expansions
    American Economic Journal: Economic Policy, 2012
    Co-Authors: Craig Garthwaite
    Abstract:

    In the United States, Public Health Insurance programs cover over 90 million individuals. Expansions of these programs, such as the recently passed Patient Protection and Affordable Care Act (PPACA), may have large effects on physician behavior. This study finds that following the implementation of the State Children's Health Insurance Program (SCHIP), physicians decreased the num ber of hours spent with patients, but increased their program partici pation. Suggestive evidence shows that this decrease resulted from shorter office visits. These findings are consistent with the predic tions from a mixed-economy model of physician behavior and pro vide evidence of crowd out resulting from the creation of SCHIP. {JEL H75, 111, 113,118)

  • The Doctor Might See You Now: The Supply Side Effects of Public Health Insurance Expansions
    2011
    Co-Authors: Craig Garthwaite
    Abstract:

    In the United States, Public Health Insurance programs cover over 90 million individuals. Changes in the scope of these programs, such as the Medicaid expansions under the recently passed Patient Protection and Affordable Care Act, may have large effects on physician behavior. This study finds that following the implementation of the State Children's Health Insurance Program, physicians decreased the number of hours spent with patients, but increased their participation in the expanded program. Suggestive evidence is found that this decrease in hours was a result of shorter office visits. These findings are consistent with the predictions from a mixed-economy model of physician behavior with Public and private payers and also provide evidence of crowd out resulting from the creation of SCHIP.

Jonathan Gruber - One of the best experts on this subject based on the ideXlab platform.

  • delivering Public Health Insurance through private plan choice in the united states
    Journal of Economic Perspectives, 2017
    Co-Authors: Jonathan Gruber
    Abstract:

    The United States has seen a sea change in the way that Publicly financed Health Insurance coverage is provided to low-income, elderly, and disabled enrollees. When programs such as Medicare and Medicaid were introduced in the 1960s, the government directly reimbursed medical providers for the care that they provided, through a classic "single payer system." Since the mid-1980s, however, there has been an evolution towards a model where the government subsidizes enrollees who choose among privately provided Insurance options. In the United States, privatized delivery of Public Health Insurance appears to be here to stay, with debates now focused on how much to expand its reach. Yet such privatized delivery raises a variety of thorny issues. Will choice among private Insurance options lead to adverse selection and market failures in privatized Insurance markets? Can individuals choose appropriately over a wide range of expensive and confusing plan options? Will a privatized approach deliver the promised increases in delivery efficiency claimed by advocates? What policy mechanisms have been used, or might be used, to address these issues? A growing literature in Health economics has begun to make headway on these questions. In this essay, I discuss that literature and the lessons for both economics more generally and Health care policymakers more specifically.

  • Public Health Insurance and medical treatment the equalizing impact of the medicaid expansions
    Journal of Public Economics, 2001
    Co-Authors: Janet Currie, Jonathan Gruber
    Abstract:

    Abstract We investigate the impact of expanding Public Health Insurance on the medical treatment received by women at childbirth, using Vital Statistics data on every birth in the US over the 1987–1992 period. The effects of Insurance status on treatment are identified using the tremendous variation in eligibility for Public Insurance coverage under the Medicaid program over this period. Among low education mothers who were largely uninsured before being made eligible for Medicaid, eligibility for this program was associated with significant increases in the use of a variety of obstetric procedures. Among women with more education, however, there is a countervailing effect on procedure use. Most of these women had private Insurance before becoming Medicaid-eligible, and some may have been ‘crowded out’ onto the Public program, moving from Insurance which reimburses medical care more generously to Insurance with much less generous reimbursement. This movement was accompanied by reductions in procedure use. Thus, on net, the Medicaid expansions had an equalizing effect, increasing the treatment intensity of the previously uninsured while lowering it among the previously insured.

Jennifer E. Devoe - One of the best experts on this subject based on the ideXlab platform.

  • Designing Health information technology tools to prevent gaps in Public Health Insurance
    Journal of innovation in health informatics, 2017
    Co-Authors: Jennifer D. Hall, Rose L Harding, Jennifer E. Devoe, Rachel Gold, Heather Angier, Aleksandra Sumic, Christine Nelson, Sonja Likumahuwa-ackman, Deborah J. Cohen
    Abstract:

    Background: Changes in Health Insurance policies have increased coverage opportunities, but enrollees are required to annually reapply for benefits which, if not managed appropriately, can lead to Insurance gaps. Electronic Health records (EHRs) can automate processes for assisting patients with Health Insurance enrollment and re-enrollment. Objective: We describe community Health centers' (CHC) workflow, documentation, and tracking needs for assisting families with Insurance application processes, and the Health information technology (IT) tool components that were developed to meet those needs. Method: We conducted a qualitative study using semi-structured interviews and observation of clinic operations and Insurance application assistance processes. Data were analyzed using a grounded theory approach. We diagramed workflows and shared information with a team of developers who built the EHR-based tools. Results: Four steps to the Insurance assistance workflow were common among CHCs: 1) Identifying patients for Public Health Insurance application assistance; 2) Completing and submitting the Public Health Insurance application when clinic staff met with patients to collect requisite information and helped them apply for benefits; 3) Tracking Public Health Insurance approval to monitor for decisions; and 4) assisting with annual Health Insurance reapplication. We developed EHR-based tools to support clinical staff with each of these steps. Conclusion: CHCs are uniquely positioned to help patients and families with Public Health Insurance applications. CHCs have invested in staff to assist patients with Insurance applications and help prevent coverage gaps. To best assist patients and to foster efficiency, EHR based Insurance tools need comprehensive, timely, and accurate Health Insurance information.

  • Linkage Methods for Connecting Children with Parents in Electronic Health Record and State Public Health Insurance Data
    Maternal and Child Health Journal, 2014
    Co-Authors: Heather Angier, Rachel Gold, Courtney Crawford, Jean O’malley, Carrie Tillotson, Miguel Marino, Jennifer E. Devoe
    Abstract:

    The objective of this study was to develop methodologies for creating child–parent ‘links’ in two Healthcare-related data sources. We linked children and parents who were patients in a network of Oregon clinics with a shared electronic Health record (EHR), using data that reported the child’s emergency contact information or the ‘guarantor’ for the child’s visits. We also linked children and parents enrolled in the Oregon Health Plan (OHP; Oregon’s Public Health Insurance programs), using administrative data; here, we defined a ‘child’ as aged

  • linkage methods for connecting children with parents in electronic Health record and state Public Health Insurance data
    Maternal and Child Health Journal, 2014
    Co-Authors: Heather Angier, Rachel Gold, Courtney Crawford, Miguel Marino, Jean P Omalley, Carrie J Tillotson, Jennifer E. Devoe
    Abstract:

    The objective of this study was to develop methodologies for creating child–parent ‘links’ in two Healthcare-related data sources. We linked children and parents who were patients in a network of Oregon clinics with a shared electronic Health record (EHR), using data that reported the child’s emergency contact information or the ‘guarantor’ for the child’s visits. We also linked children and parents enrolled in the Oregon Health Plan (OHP; Oregon’s Public Health Insurance programs), using administrative data; here, we defined a ‘child’ as aged <19 years and identified potential ‘parents’ from among adults sharing the same OHP household identification (ID) number. In both data sources, parents had to be 12–55 years older than the child. We used OHP individual client ID and EHR patient ID numbers to assess the quality of our linkages through cross-validation. Of the 249,079 children in the EHR dataset, we identified 62,967 who had a ‘linkable’ parent with patient information in the EHR. In the OHP data, 889,452 household IDs were assigned to at least one child; 525,578 with a household ID had a ‘linkable’ parent (272,578 households). Cross-validation of linkages revealed 99.8 % of EHR links validated in OHP data and 97.7 % of OHP links validated in EHR data. The ability to link children and their parents in Healthcare-related datasets will be useful to inform efforts to improve children’s Health. Thus, we developed strategies for linking children with their parents in an EHR and a Public Health Insurance administrative dataset.

Anna Aizer - One of the best experts on this subject based on the ideXlab platform.

  • Public Health Insurance, Program Take-Up, and Child Health
    Review of Economics and Statistics, 2007
    Co-Authors: Anna Aizer
    Abstract:

    Of the ten million uninsured children in 1996, nearly half were eligible for Public Health Insurance (Medicaid) but not enrolled. In response, policy efforts to reduce the uninsured have shifted from expanding Medicaid eligibility to increasing take-up among those eligible. However, little is known about the reasons poor families fail to enroll or the consequences. Using a unique data set I find that information and administrative costs are important barriers to enrollment, especially for Hispanics and Asians. In addition, enrolling children in Medicaid before they get sick promotes the use of preventative care, reduces the need for hospitalization, and improves Health. Copyright by the President and Fellows of Harvard College and the Massachusetts Institute of Technology.

  • Public Health Insurance, Program Take-Up, and Child Health
    National Bureau of Economic Research, 2006
    Co-Authors: Anna Aizer
    Abstract:

    Of the ten million uninsured children in 1996, nearly half were eligible for Medicaid, the Public Health Insurance program for poor families, but not enrolled. In response, policy efforts to improve coverage have shifted to increasing Medicaid take-up among those already eligible rather than expanding eligibility. However, little is known about the reasons poor families fail to use Public programs or the consequences of failing to enroll. The latter is of particular relevance to Medicaid given that children are typically enrolled when they become sufficiently sick as to require hospitalization. Using new data on Medicaid outreach, enrollment and child hospitalizations in California, I find that information and administrative costs are important barriers to program enrollment, with the latter particularly true for Hispanic and Asian families. In addition, enrolling children in Medicaid before they get sick promotes the use of preventative care, reduces the need for hospitalization and improves Health.

  • Public Health Insurance, Program Take-Up, and Child Health
    2006
    Co-Authors: Anna Aizer
    Abstract:

    Abstract Of the ten million uninsured children in 1996, nearly half were eligible for Public Health Insurance (Medicaid) but not enrolled. In response, policy efforts to reduce the uninsured have shifted from expanding Medicaid eligibility to increasing take-up among those eligible. However, little is known about the reasons poor families fail to enroll or the consequences. Using a unique data set I find that information and administrative costs are important barriers to enrollment, especially for Hispanics and Asians. In addition, enrolling children in Medicaid before they get sick promotes the use of preventative care, reduces the need for hospitalization, and improves Health.

Peter C. Coyte - One of the best experts on this subject based on the ideXlab platform.

  • childhood nutrition in rural china what impact does Public Health Insurance have
    Value in Health, 2021
    Co-Authors: Hongli Fan, Qingyue Yan, Suchun Liu, Jiaoli Cai, Peter C. Coyte
    Abstract:

    Abstract Objectives To investigate the impact of Public Health Insurance coverage, specifically the New Cooperative Medical Scheme (NCMS), on childhood nutrition in poor rural households in China, and to identify the mechanisms through which Health Insurance coverage affects nutritional intake. Methods Longitudinal data on 3291 children were taken from four time periods (2004, 2006, 2009, and 2011) from the China Health and Nutrition Survey (CHNS). Panel data analysis was performed with the fixed-effect model and the propensity score matching with difference-in-differences (PSM-DID) approach. Results The introduction of the NCMS was associated with a decline in calories, fat, and protein intake, and an increase in the intake of carbohydrates. The NCMS had the greatest negative effect on children aged 0 to 5 years, particularly girls. Out-of-pocket medical expenses were identified as the main channel through which the NCMS affected the nutritional intake of children. Conclusions The study showed that the NCMS neither significantly improved the nutritional status of children nor enhanced intake of high-quality nutrients among rural poor households. These findings were attributed to the way in which Health-seeking behavior was modified in the light of NCMS coverage. Specifically, NCMS coverage tended to increase Healthcare utilization, which in turn increased out-of-pocket medical expenditures. This encouraged savings to aid financial risk protection and resulted in less disposable income for food consumption.

  • Does Public Health Insurance Coverage Lead to Better Health Outcomes? Evidence From Chinese Adults:
    Inquiry : a journal of medical care organization provision and financing, 2019
    Co-Authors: Hongli Fan, Qingyue Yan, Peter C. Coyte
    Abstract:

    This article examines the impacts of Public Health Insurance on the Health of adults through use of data from the China Health and Nutrition Survey. We use the endogenous treatment effects model to infer the causal effects of Public Health Insurance on Health. We find that Public Health Insurance significantly improves the physical and mental Health status of Health Insurance beneficiaries after controlling for other covariates. Among the 2 types of voluntary Public Health Insurance, the Urban Resident Basic Medical Insurance has the greater impact in improving Health than the New Cooperative Medical Scheme. Moreover, the Health effect appears to be stronger for middle-aged individuals, the elderly, and those with lower incomes than for their counterparts. The positive Health effects may result from few channels, including the increase of Health care utilization, the improvement of Health-related behaviors, and the fact that individuals with Public Health Insurance are more likely to use higher level care providers. This study provides implications on reforming China's Health care system.