Becky Staiger, Laurence Baker, and Tina Hernandez-Boussard. "Provider Opioid Prescribing Behaviors and Opioid Use in Medicaid." Job Market Paper.
Abstract: Liberal prescription of opioids is widely believed to have contributed to the ongoing epidemic of opioid misuse and related harms within the United States and elsewhere. Policies aimed at curbing the epidemic have focused on encouraging providers to adopt stricter opioid prescribing behaviors. However, the extent to which the association between providers' opioid prescribing behaviors and their patients' opioid use reflects a causal influence of behavior versus patient-provider sorting is unclear. Using Medicaid claims data for three states from 2016-2021, we use provider exits from Medicaid to evaluate how enrollees with chronic pain are affected by a switch to a lower- or higher-prescribing provider. We find that among patients with prior opioid use, switching to lower intensity physicians leads to as much as a 75% decrease in opioid use, with evidence of increased hospitalizations. While we observe a 15% increase in opioid use among opioid-naive enrollees who switch to more intensely prescribing providers, the health effects are less clear. Our findings are similar when using an instrumental variables approach to correct for the potential endogeneity of the destination provider's prescribing intensity.
Ajin Lee, Maya Rossin-Slater, Becky Staiger, and Amanda Su. "Managed Care in Medicaid's Long-Term Services and Supports."
Abstract: The American healthcare system and care economy face growing demands from an aging population, raising important questions regarding the organization, delivery, and funding for services in these two sectors. Long-term services and supports (LTSS) include medical and personal care services for individuals requiring assistance with daily activities. Over the last two decades, state Medicaid programs--which pay for more than half of all LTSS delivery--have shifted away from traditional fee-for-service (FFS) payment models toward managed care systems in which private insurers cover LTSS in exchange for capitated payments from the state. We study the effects of the transition to managed LTSS (MLTSS) in Florida's and New York's Medicaid programs on healthcare utilization among dual-eligible Medicare-Medicaid beneficiaries aged 65 and older. Using administrative Medicare claims data, we leverage the county-by-county rollouts of MLTSS mandates in the two states in a stacked difference-in-differences design. We find that in both states, MLTSS leads to a reduction in the use of preventive care, including evaluation & management visits with primary care providers and specialists, and laboratory testing. We also observe reductions in the use of some prescription drugs and in outpatient emergency department (ED) visits. At the same time, we find increases in emergent hospitalizations and ED visits that result in inpatient stays. Since all of these healthcare utilization outcomes are covered by traditional fee-for-service Medicare, these effects can be interpreted as externalities of MLTSS on healthcare excluded from the managed care model. On net, we find that MLTSS reduces annual Medicare spending by 16 percent in Florida and 5 percent in New York.
Katja Hofmann, Caitlin Myers, Maya Rossin-Slater, and Becky Staiger. "Access to Abortion Care and Low-Income Women's Health: Evidence from Medicaid Beneficiaries."
Draft coming soon.
Becky Staiger, Esther E. Velasquez, Mathew V. Kiang, and Michael L. Barnett. "The Impact of Opioid Pharmaceutical Representative Interactions and Provider Prescribing Practices: Evidence from Purdue Detailing Records."
Draft coming soon.
Stacy Chen and Becky Staiger. "Medicaid Expansion Increased Income Among Newly-Eligible Adults." Health Affairs Scholar. 2025.
Becky Staiger*, Valentin Bolotnyy*, Sonya Borrero, Maya Rossin-Slater, Jessica Van Parys, Caitlin Myers. "Obstetrician and Gynecologist Physicians' Practice Locations Before and After the Dobbs Decision." JAMA Network Open. 2025.
Media coverage: CNN, The Hill (Op-Ed)
Joseph Doyle and Becky Staiger. "Physician Group Influences on Treatment Intensity and Health: Evidence from Physician Switchers." AEJ: Economic Policy. 2025.
Other versions: NBER Working Paper No. 29613
Becky Staiger, Maddie Helfer, and Jessica Van Parys. "The Effect of Medicaid Expansion on the Take-up of Disability Benefits by Race and Ethnicity." Health Economics. 2023.
Other versions: NBER Working Paper No. 31557.
Becky Staiger*, Anran Li*, Diane Alexander, and Molly Schnell. "Enrollment Brokers Did Not Increase Medicaid Enrollment, 2008-18." Health Affairs. 2022.
Becky Staiger. "Disruptions to the Patient-Provider Relationship and Patient Utilization and Outcomes: Evidence from Medicaid Managed Care." Journal of Health Economics. 2022.
*Indicates shared first authorship