Kevin Stange

How does provider supply and regulation influence health care markets? Evidence from nurse practitioners and physician assistants

Nurse practitioners (NPs) and physician assistants (PAs) now outnumber family practice doctors in the United States and are the principal providers of primary care to many communities. Recent growth of these professions has occurred amidst considerable cross-state variation in their regulation, with some states permitting autonomous practice and others mandating extensive physician oversight. I find that expanded NP and PA supply has had minimal impact on the office-based healthcare market overall, but utilization has been modestly more responsive to supply increases in states permitting greater autonomy. Results suggest the importance of laws impacting the division of labor, not just its quantity.

A Longitudinal Analysis of the Relationship Between Fertility Timing and Schooling

This article quantifies the contribution of pre-treatment dynamic selection to the relationship between fertility timing and postsecondary attainment, after controlling for a rich set of predetermined characteristics. Eventual mothers and nonmothers are matched using their predicted birth hazard rate, which shares the desirable properties of a propensity score but in a multivalued treatment setting. I find that eventual mothers and matched nonmothers enter college at the same rate, but their educational paths diverge well before the former become pregnant. This pre-pregnancy divergence creates substantial differences in ultimate educational attainment that cannot possibly be due to the childbirth itself. Controls for predetermined characteristics and fixed effects do not address this form of dynamic selection bias. A dynamic model of the simultaneous childbirth-education sequencing decision is necessary to address it.

A New Measure of College Quality to Study the Effects of College Sector and Peers on Degree Attainment

Students starting at a two-year college are much less likely to graduate than similar students who start at a four-year college, but the sources of this attainment gap are largely unexplained. This paper investigates the attainment consequences of sector choice and peer quality among recent high school graduates. Using data on all Preliminary SAT (PSAT) test-takers between 2004 and 2006, we develop a novel measure of peer ability for most two-year and four-year colleges in the United States—the average PSAT of enrolled students. We document substantial variation in this measure of peer quality across two-year colleges and nontrivial overlap between the two-year and four-year sectors. We find that half the gap in bachelors degree attainment rates across sectors is explained by differences in peers, leaving room for structural barriers to transferring between institutions to also play an important role.

Vocational and Career Tech Education in American High Schools: The Value of Depth over Breadth

Vocational education is a large part of the high school curriculum, yet we have little understanding of what drives vocational enrollment or whether these courses help or harm early careers. To address this we develop a framework for curriculum choice, taking into account ability and preferences for academic and vocational work. We test model predictions using detailed transcript and earnings information from the NLSY97. Our results are two-fold. First, students positively sort into vocational courses, suggesting the belief that low ability students are funneled into vocational coursework is unlikely true. Second, we find higher earnings among students taking more upper-level vocational courses – a nearly 2% wage premium for each additional year, yet we find no gain from introductory vocational courses. These results suggest (a) policies limiting students’ ability to take vocational courses may not be welfare enhancing, and (b) the benefits of vocational coursework accrue to those who focus on depth over breadth.