Self-Selection and Cross Subsidization in Medicare Advantage
This research examines issues related to who selects into Medicare Advantage from two different perspectives:
1) Individuals’ decisions to select Medicare Advantage during Medicare’s Initial Enrollment Eligibility Period upon turning 65 and the resulting impact on MA enrollees’ health care utilization and costs, and
2) Insurers’ ability to influence decisions to enroll in Medicare Advantage enrollment by reallocating capitation payments disproportionately to benefits with greater appeal to healthy patients.
Team: Moiz Bhai, Zhaowei She, Turgay Ayer, and Bilal Gokpinar
Publications:
M. Bhai, D.R. Hughes. 2026. “Estimating Self-Selection in Medicare Advantage,” Journal of Policy Analysis and Management, 45(2): e70090
HCEO Working Paper 2024-009
Z. She, T. Ayer, B. Kokpinar, D.R. Hughes. 2024. “Strategic Cross Subsidization in Healthcare Capitation Programs: Evidence from Medicare Advantage,” Manufacturing and Service Operations Management, 26(6): 2085-2101
Finalist for 2023 Pierskalla Award
Access and Barriers to Cancer Screening
This series of papers examine the many barriers that patients face to comply with USPSTF cancer screening guidelines, resulting health disparities in treatment, and ultimate effect on mortality and other health outcomes.
Team (Core): Richard Duszak, Chad Stecher, and Moiz Bhai
Publications:
B.V. Patel, R. Gurudu, G. Mazza, R.E. Sharpe, L. Mina, J. Fraker, J. Kling, K. Anderson, D.R. Hughes, B. Pockaj. 2024. “Patient-Reported Testing Burden of Screening Contrast Enhanced Mammography,” Journal of the American College of Radiology, 21(5): 789-794
D.R. Hughes, W. Espinoza, S. Fein, E.Y. Rula, G. McGinty. 2023. “Patient Cost-Sharing and the Utilization of Breast Cancer Diagnostic Imaging by Patients Undergoing Subsequent Testing After Undergoing a Screening Mammogram,” JAMA Network Open, 6(3): e234893
D.R. Hughes, J. Chen, A. Wallace, S. Santavicca, R. Duszak, E.Y. Rula, R. Smith. 2023. “Comparison of Lung Cancer Screening Eligibility and Use between Commercial, Medicare, and Medicare Advantage Enrollees,” Journal of the American College of Radiology, 20(4): 393-476
N. Chartrand, C. Stecher, S. Rajendra, A. Rosenkrantz, R. Duszak, D.R. Hughes. 2023. “Racial/Ethnic Disparities in the Use of Prostate MRI Following an Elevated Prostate-Specific Antigen Test,” Urology Practice, 10(6): 612-619
N. Abashidze, C. Stecher, A. Rosenkrantz, R. Duszak, D.R. Hughes. 2021. “Racial/Ethnic Disparities in the Use of Prostate MRI Following an Elevated Prostate-Specific Antigen Test,” JAMA Network Open, 4(11): e2132388
Nurse Practitioner and Certified Nurse Midwife Scope of Practice (SOP)
Many papers find expanding SOP is associated with improved endpoint outcomes, but what is the mechanism? This series of studies strive to unpack the black-box of “how” and “why” using detailed micro-level claims data.
Team: Moiz Bhai, Mitch Mitchell, Candice Filar (PhD student), Alexa Wallace (PhD student), and Mary Motolenich (PhD student)
Publications:
A. Wallace, M. Bhai, D.R. Hughes. 2025. “The Effect of Nurse Practitioner Scope of Practice Laws on Diabetic Health Care Costs,” Contemporary Economic Policy, 43(1): 93-115
M. Bhai, M. Motolenich, D.T. Mitchell, D.R. Hughes. 2025. “Advanced Practice Registered Nurse Involvement in Pregnancy Episodes: U.S. Trends From 2008-2014.” Journal of Nursing Regulation, 15(4): 51-59
D.R. Hughes, C. Filar, D.T. Mitchell. 2022. “Nurse Practitioner Scope of Practice and the Prevention of Foot Complications in Rural Diabetes Patients,” Journal of Rural Health, 38(4): 994-998
When Information Bridges the Care Gap: Online Physician Ratings and Reduced Healthcare Disruptions
We combine medical insurance claims with web-scraped physician review data to explore whether online review platforms reduce medical care interruptions for patients seeking a new physician because of physician retirement.
Team: Michael E. Kummer, Ulrich Laitenberger, Cyrus Rich (PhD Student), and Turgay Ayer
Previously distributed as ZEW Discussion Paper 21-075
Danny R Hughes 