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By Audrey Kornkven
In October 2008, a provision of the Deficit Reduction Act of 2005 known as Medicare “Nonpayment” went into effect, eliminating reimbursement for the marginal costs of preventable hospital-acquired conditions in an effort to correct perverse incentives in hospitals and improve patient safety. This paper contributes to the existing debate surrounding Nonpayment’s efficacy by considering varying degrees of fiscal pressure among hospitals; potential impacts on healthcare utilization; and differences between Medicare and non-Medicare patient populations. It combines data on millions of hospital discharges in New York from 2006-2010 with hospital-, hospital referral region-, and county-level data to isolate the policy’s impact. Analysis exploits the quasi-experimental nature of Nonpayment via difference-in-differences with Mahalanobis matching and fuzzy regression discontinuity designs. In line with results from Lee et al. (2012), Schuller et al. (2013), and Vaz et al. (2015), this paper does not find evidence that Nonpayment reduced the likelihood that Medicare patients would develop a hospital-acquired condition, and concludes that the policy is not likely the success claimed by policymakers. Results also suggest that providers may select against unprofitable Medicare patients when possible, and are likely to vary in their responses to financial incentives. Specifically, private non-profit hospitals appear to have been most responsive to the policy. These findings have important implications for pay-for-performance initiatives in American healthcare.
Advisors: Professor Charles Becker, Professor Frank Sloan, Professor Grace Kim| JEL Codes: I1, I13, I18
The Impact of Access to Public Transportation on Residential Property Value: A Comparative Analysis of American Cities
By Moses Snow Wayne
This paper develops a consistent model for analyzing the impact of access to public transportation on property value applied to the four cities of Atlanta, Boston, New York, and San Francisco. This study finds a negative relationship between increasing distance to public transit and property value. Additionally, the elicited effects in each city generally align with geographic features and the degree to which a city is monocentric. This study also demonstrates the salience of using actual map-generated distances as proximity measures and characteristics of public
transit systems in modeling the relationship between public transportation and residential property value.
Advisors: Dr. Patrick Bayer and Kent Kimbrough | JEL Codes: C12, R14, R30, R41