Department of Policy Analysis and Management
MVR Hall, Room 298
Ithaca, NY 14853
NBER Program Affiliations:
NBER Affiliation: Faculty Research Fellow
NBER Working Papers and Publications
|October 2018||The Impact of Insurance Expansions on the Already Insured: The Affordable Care Act and Medicare|
with Sarah Miller, Laura R. Wherry: w25153
Some states that have not adopted the Affordable Care Act (ACA) Medicaid expansions have stated concerns that the expansions may impair access to care and utilization for those who are already insured. We investigate such negative spillovers using a large panel of Medicare beneficiaries. Across many subgroups and outcomes, we find no evidence that the expansions reduced utilization among Medicare beneficiaries, and can rule out all but very small changes in utilization or spending. These results suggest that the expansions in Medicaid did not impair access to care or utilization for the Medicare population.
|February 2017||The Effect of Prescription Drug Monitoring Programs on Opioid Utilization in Medicare|
with Thomas C. Buchmueller: w23148
The misuse of prescription opioids has become a serious epidemic in the US. In response, states have implemented Prescription Drug Monitoring Programs (PDMPs), which record a patient's opioid prescribing history. While few providers participated in early systems, states have recently begun to require providers to access the PDMP under certain circumstances. We find that "must access" PDMPs significantly reduce measures of misuse in Medicare Part D. In contrast, we find that PDMPs without such provisions have no effect. We find stronger effects when providers are required to access the PDMP under broad circumstances, not only when they are suspicious.
Published: Thomas C. Buchmueller & Colleen Carey, 2018. "The Effect of Prescription Drug Monitoring Programs on Opioid Utilization in Medicare," American Economic Journal: Economic Policy, vol 10(1), pages 77-112. citation courtesy of