Selected Research In Progress
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.
Joseph Doyle and Becky Staiger. "Physician Group Influences on Treatment Intensity and Health: Evidence from Physician Switchers." NBER Working Paper No. 29613.
Revisions requested, AEJ: Economic Policy.
Abstract: Treatment intensity varies remarkably across physicians, yet the key drivers are not well understood. Meanwhile, the organization of healthcare is undergoing a secular transformation as physicians increasingly work in groups. This paper tests whether physicians' group affiliation matters for practice styles and patient health. Using Medicare inpatient claims data, we compare these outcomes before and after physicians switch between groups of varying treatment intensity while remaining in the same hospital to control for practice setting. Event studies show that internists who join more-intensive groups immediately increase their own treatment intensity, with an elasticity of approximately 0.3; the opposite is found for internists who switch to groups that are less intensive. This change in Medicare spending largely stems from greater quantities of care provided, with some evidence of a change in coding behavior. We do not detect a change in health outcomes, suggesting that treatment intensity induced by group affiliation may not be productive.
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.
Zack Cooper, Olivia Stiegman, Chima D. Ndumele, Becky Staiger, and Jonathan Skinner. "Geographical Variation in Health Spending Across the US Among Privately Insured Individuals and Enrollees in Medicaid and Medicare." JAMA Network Open. 2022.
Katherine Piwnica-Worms, Becky Staiger, Joseph S. Ross, Marjorie S. Rosenthal, and Chima D. Ndumele. "Effects of Forced Disruption in Medicaid Managed Care on Children with Asthma." Health Services Research. 2021.
Chima D. Ndumele, Becky Staiger, Joseph S. Ross, and Mark J. Schlesinger. "Network Optimization and the Continuity of Physicians in Medicaid Managed Care." Health Affairs. 2018.
*Indicates shared first authorship