Current Projects

Estimating Self-Selection in Medicare Advantage

Using linked MA and commercial insurance claims, we examine who selects into MA after Medicare’s Initial Enrollment Eligibility Period and the resulting impact on MA enrollees’ health care utilization and costs.

Team: Moiz Bhai

Update: HCEO Working Paper 2024-009

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

Barriers and Disparities in 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, Moiz Bhai, and Shubhsri Rajendra (PhD student)

Publications:

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

Strategic Cross Subsidization in Healthcare Capitation Programs: Evidence from Medicare Advantage

This study exploits an exogenous change on Medicare Advantage (MA) capitation payments to examine whether MA plans’ cause high-risk patients to cross-subsidize low-risk patients by reallocating capitation payments disproportionately to benefits with greater appeal to healthy patients.

Team: Zhaowei She, Turgay Ayer, and Bilal Gokpinar

Update: Finalist for 2023 Pierskalla Award

Publications:

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

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

Notes: Previously distributed as ZEW Discussion Paper 21-075