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Report
Did the Medicaid Expansion Crowd Out Other Payment Sources for Medications for Opioid Use Disorder? Evidence from Rhode Island
Using information from the all-payer claims database for Rhode Island covering more than three-quarters of health insurance enrollees in the state from April 2011 through May 2019, this paper offers new measures of the association between the Medicaid expansion and the rate of receipt of buprenorphine and methadone for opioid use disorder (OUD). These robust measures adjust for the extent to which new Medicaid payments for these medications that started in 2014 crowded out payments from either non-Medicaid insurance or from non-insurance subsidies for the treatment of opioid abuse. We find ...
Working Paper
Household Inflation Expectations and Consumer Spending: Evidence from Panel Data
Recent research offers mixed results concerning the relationship between inflation expectations and consumption, using qualitative measures of readiness to spend. We revisit this question using survey panel data from the United States of actual spending from 2009 through 2012 that also allow us to control for household heterogeneity. We find that durables spending increases with inflation expectations only for certain types of households, while nondurables spending does not respond to inflation expectations. Moreover, spending decreases with an expected increase in unemployment. These results ...
Working Paper
Informal Work and Official Employment Statistics: What’s Missing?
Using eight consecutive waves of the Survey of Informal Work Participation (SIWP) spanning 2015 through 2022, we investigate informal “gig” work participation in the United States— broadly defined to include online and offline activities—and its implications for the measurement of employment. Our results suggest that employment rates among US household heads were consistently understated in the Current Population Survey (CPS). Under conservative estimates, we find that the employment-to-population ratio would have been 0.25 to 1.1 percentage points higher over the 2015–2022 period ...
Working Paper
The distributional effects of contractual norms: the case of cropshare agreements
According to principal-agent theory, a share contract strikes an optimal balance between risk-sharing and incentive provision when it is difficult to gauge the agent's contribution. This theory predicts that the size of the share should vary with economic fundamentals. In practice, however, the share divisions that are specified often cluster around "usual and customary" levels ? even when there is substantial heterogeneity among principal - agent pairs. Using Illinois farm-level data observed between 1980 and 1994 that include soil productivity ratings, tenant net income, and crop yields, ...
Working Paper
Who counts as employed?: informal work, employment status, and labor market slack
Several recent studies find that as of 2015, a significant share of working-age adults in the United States participates in nonstandard work arrangements. Such arrangements tend to lack long-term employment contracts and are often referred to as ?gig economy? jobs. This paper investigates the implications of nonstandard or ?informal? work for the measurement of employment status and labor market slack. Using original survey data, we find that as of 2015 roughly 37 percent of nonretired U.S. adults participated in some type of informal work, and roughly 20 percent participated in informal ...
Using Inflation Expectations to Boost Consumer Spending Poses Policy Risks
Communication that raises inflation expectations has been suggested as a policy tool for central banks. Our research suggests that this policy tool has some limitations that central banks must manage when implementing it.
Working Paper
Did the Affordable Care Act Affect Access to Medications for Opioid Use Disorder among the Already Insured? Evidence from the Rhode Island All-payer Claims Database
Previous research suggests that state Medicaid expansions implemented under the Patient Protection and Affordable Care Act (ACA) helped large numbers of patients suffering from opioid use disorder (OUD) gain access to life-saving medications, including buprenorphine. However, Medicaid expansions could have impeded access to care among individuals already enrolled in Medicaid, as new enrollees would have placed added demands on a limited supply of buprenorphine providers. Using a panel data set of medical claims from Rhode Island, we estimate the causal effects of the state’s January 2014 ...
Report
The Medicaid Expansion and the Uptake of Medication-assisted Treatment for Opioid Use Disorder: Evidence from the Rhode Island All-payer Claims Database, 2012–2018
This article uses the all-payer claims database for the state of Rhode Island to assess recent progress in the state toward the goal of expanding access to medication-assisted treatment (MAT) for opioid use disorder (OUD). The analysis highlights the role played by the Affordable Care Act (ACA) and the associated Medicaid expansion in furthering that goal. Using measures that account for changes in health insurance enrollment, we find that the MAT rate per 100,000 enrollees in Rhode Island effectively doubled between 2012 and 2018, while the prevalence of OUD in the sample also doubled over ...
Report
Labor force participation in New England vs. the United States, 2007–2015: why was the regional decline more moderate?
This paper identifies the main forces that contributed to the decline in labor force participation in New England between 2007 and 2015, as well as the forces that moderated the region?s decline relative to that of the nation. This exercise contributes to an assessment of the outlook for participation in New England moving forward. Similar to previous findings pertaining to the United States as a whole, the single largest factor in the recent decline in labor force participation in New England was the shifting age composition of the region?s population. In particular, the share of New England ...
Working Paper
Geographic variations in a model of physician treatment choice with social interactions
Location-specific norms of behavior are a widespread phenomenon. In the case of medical practice, numerous studies have found that geographic location exerts a strong influence on the choice of treatments and procedures. This paper shows how the presence of social influence on treatment decisions can help to explain this phenomenon. We construct a theoretical model in which physicians' treatment choices depend on patients' characteristics and on the recent choices of nearby peers - either because there are local knowledge spillovers or because physicians want to conform to local practice ...