We are the first to document that Supplemental Nutrition Assistance Program (SNAP) caseworker behavior impacts program receipt, likely due to differing levels of helpfulness in navigating the complicated application process. We use the conditional random assignment of caseworkers as an...

This paper examines the tradeoffs of monitoring for wasteful public spending. By penalizing unnecessary spending, monitoring improves the quality of public expenditure and incentivizes firms to invest in compliance technology. I study a large Medicare program that monitored for unnecessary...

We estimate the role of firms in worker health care utilization. Using linked administrative data on Austrian workers from 1998-2018, we exploit mobility between firms to estimate how much a firm contributes to worker-level differences in utilization in a setting with non-employer provided...

Many public programs let individuals choose between publicly provided benefits and a subsidized private alternative. We investigate the determinants of health insurance choice in Medicare--a setting with vast geographic variation in the share of individuals selecting the public option versus...

The Medicare hospice program is intended to provide palliative care to terminal patients, but patients with long stays in hospice are highly profitable, motivating concerns about overuse among the Alzheimer's and Dementia (ADRD) population in the rapidly growing for-profit sector. We provide the...

The United States spends substantially more on health care than most developed countries, yet leaves a greater share of the population uninsured. We suggest that incremental insurance expansions focused on addressing market failures will propagate inefficiencies and are not likely to facilitate...

Health plans for the poor increasingly limit access to specialty hospitals. We investigate the role of adverse selection in generating this equilibrium among private plans in Medicaid. Studying a network change, we find that covering a top cancer hospital causes severe adverse selection,...

I describe several changes to Medicare in the 1990s, their rationale, and their likely effects. I focus principally on issues in the administered price systems Medicare uses to pay medical providers, especially those used for post-acute care providers, Health Maintenance Organizations (HMOs),...

This paper studies the accuracy of reported Medicaid coverage in the Survey of Income and Program Participation (SIPP) using a unique data set formed by matching SIPP survey responses to administrative records from the State of California. Overall, we estimate that the SIPP underestimates...

Competition and prospective payment systems have been widely used to attempt to control health care costs. Though much of the increase in medical costs over the past half-century has been concentrated among a few high-cost users of health care,prospective payment systems may provide incentives...