CSMGEP Dissertation Session

Paper Session

Friday, Jan. 6, 2017 7:30 PM – 9:30 PM

Hyatt Regency Chicago, New Orleans
Hosted By: American Economic Association
  • Chair: Ebonya Washington, Yale University

Reference Pricing: The Case of Screening Colonoscopies

Marion Aouad
,
University of California-Berkeley
Timothy Brown
,
University of California-Berkeley
Christopher Whaley
,
University of California-Berkeley

Abstract

With concerns over growing health care spending, programs that increase patient cost-sharing have been used by both public and private agencies as a way to constrain medical spending. However, a better understanding of the mechanisms by which the cost savings are achieved and the related health consequences of such policies is needed. This analysis addresses these issues by examining the introduction of reference pricing, a health insurance reform, to the California Public Employees' Retirement System. Reference pricing changed patient cost-sharing on screening colonoscopies by setting a maximum reimbursable amount for screenings received at hospitals, while no maximum was set at ambulatory surgical centers. Making use of a unique medical claims dataset, we use Difference-in-Difference and Instrumental Variables estimators to analyze the change in the share of patients using ambulatory surgical centers (versus hospitals) and the cost savings associated with this facility switching. We find an approximately 10 percentage point increase in the share of patients who use an ambulatory surgical center. For those who switch, we estimate the mean reduction in total costs to be between $2300 to $1700. Additionally, we find an approximately 67% increase in the probability of total costs being below the reference price threshold for these facility switchers and do not find any effect on health outcomes.

Manufacturing Equal Pay: How Does Equal-Pay-for-Equal-Work Legislation Affect Manufacturers and Exporters?

Raffi Garcia
,
Brandeis University

Abstract

This paper provides new evidence on the effect of equal-pay for equal-work regulations on the employment of women in the manufacturing industry. Using the universe of Chilean manufacturing plants, I posit that characteristics of monopsonistic (oligopsonist) competition in the labor market contributed to the increase of female employment contrary to what classic economic theory of competitive labor markets and wage discrimination [Becker, 1957] would predict. The identification comes from a regression discontinuity (RD) design that exploits the quasi-experimental properties around the policy cutoff. I find that firms in the treated group (those with 200 employees or higher) increased female employment and their relative labor composition after the regulation was implemented. The results show that the impact was an increase of 3-5 percentage points higher than the control group.

Unpacking Policy Uncertainty: Evidence From European Firms

Sandile Hlatshwayo
,
University of California-Berkeley

Abstract

The intensifying nature of policy uncertainty makes it a popular explanation for recent weak economic performance and puzzles. However, the empirical literature is limited in its ability to make causal claims because it largely relies on macro-level measures of policy uncertainty and treats the concept as homogenous but indeterminate. This research addresses these limitations by exploiting variation in firms' exposure to external markets to construct a firm-level measure of policy uncertainty. The approach both highlights a new channel for policy uncertainty and allows for stronger causal identification of the effects of policy uncertainty on economic performance. As part of this effort, I refine prior approaches to measuring policy uncertainty and distinguish between generic, fiscal, monetary, and trade policy uncertainty. I find that firms with greater exposure to external markets tend to experience larger declines in investment, sales, profits, and employment when fiscal and monetary policy uncertainty increase. Unexpectedly, increases in trade policy uncertainty appear to have a positive impact on exports for exposed firms. Both sets of findings can be rationalized in a standard model of firm investment under uncertainty. In particular, I present evidence that exposed firms may perceive increased uncertainty around trade agreement negotiations as a signal that negative outcomes are less likely in the near-term, incentivizing immediate investments.

The Effect of State Party Affiliation on Higher Education: A Regression Discontinuity Analysis

Alberto Ortega
,
University of Florida

Abstract

Discussant(s)
Steven Davis
,
University of Chicago
Mark Duggan
,
Stanford University
Fernando Ferreira
,
University of Pennsylvania
Seema Jayachandran
,
Northwestern University
JEL Classifications
  • D0 - General
  • E0 - General