Research
Research
Job Market Paper:
The Dynamics of Health Behaviors, Pregnancies, and Birth Outcomes
Abstract: Women who smoke, use marijuana, and binge drink during pregnancy are significantly more likely to experience poor birth outcomes than those who don't. However, little is known about how these behaviors prior to pregnancy impact birth outcomes. Using data that chronicles annual behaviors and pregnancies of women from adolescence through their fecund years, I jointly estimate a set of multiple dynamic equations to examine the impact of health behavior histories on birth outcomes. I use the estimated parameters to simulate counterfactual scenarios consisting of different histories of health behaviors to quantify resulting changes in pregnancy, live birth, gestation length, and birth weight. I find that a woman's history of smoking increases her likelihood of having a low birth weight child after accounting for multiple sources of endogeneity bias associated with selection, simultaneity, and habitual behavior. Conversely, I find no evidence of marijuana use or binge drinking histories impacting birth outcomes beyond the negative impacts of use during or immediately prior to pregnancy.
Slides: Link
Biosimilar Entry and the Pricing of Biologic Drugs (with Josh Feng, Thomas Hwang, and Luca Maini) (Under Review)
Abstract: Unlike small-molecule drugs, biologics cannot be exactly replicated, and instead face post-exclusivity competition from inexact copies known as biosimilars. Under a stylized model, greater perceived differences between incumbent and entrant can cause incumbents to “fight” rather than “acquiesce.” Consistent with this prediction, we find that, in the U.S. market, biologics respond to biosimilar entry by reducing net-of-rebate prices to maintain volume, in contrast to the well-documented response of small-molecule drugs to generic entry. We exploit variation in biosimilar entry mechanisms created by the 2009 Biologics Price and Competition Act to provide further suggestive evidence that perceived differences drive the observed outcomes.
Slides: Link
The Impact of Including Drug Spending on Risk and Performance of Alternative Payment Models for Oncology Patients (with Mark Holmes and Luca Maini)
A New Approach to Missing Data with an Application to Pregnancy Data (with Donna Gilleskie, David Guilkey, and Chenxi Yu)
In addition to my academic work, I also have contributed to other reports through consulting with the Lewin Group (a subsidiary of UnitedHealth Group). Below I give a brief summary of two projects I worked on:
CMS Comprehensive Care for Joint Replacement Model Evaluation: The Comprehensive Care for Joint Replacement (CJR) model tests whether episode-basedpayment and quality measurement for lower extremity joint replacements (LEJR) can lower payments and improve quality. I contributed to this project in multiple ways that can be seen in the upcoming Annual Report (AR4) that will be posted sometime in Summer/Fall 2021. I wrote a chapter and was responsible for the analysis of a chapter looking at possible unintended consequences of the model. I also played a part in applying econometric methods to deal with the changing policy landscape during the model. (Link to come)
Health Literacy and Medicare Outcomes Briefing: In this project we looked at the relationship between community health literacy levels and Medicare outcomes. The final briefing made by the client was picked up by the CDC and is available to view here: https://www.cdc.gov/healthliteracy/learn/Understanding.html or here: https://www.unitedhealthgroup.com/content/dam/UHG/PDF/About/Health-Literacy-Brief.pdf