Melissa McInerney

Physician responses to rising local unemployment rates: Healthcare provision to Medicare and privately insured patients

Prior studies suggest that hospital care is countercyclical among Medicare beneficiaries, and if anything, procyclical among the non-elderly. In this paper, we provide the first physician-level analysis of changes in healthcare provision to Medicare and privately insured patients across the business cycle. Using Florida discharge data aggregated to the physician level, we find that as county unemployment rates increase, physicians treat fewer privately insured patients in both inpatient and outpatient settings. In contrast, physicians who are more exposed to income losses during recessions provide more care to Medicare patients as the unemployment rate rises. Further analysis suggests that easing capacity constraints may contribute to this rise in Medicare volume; however, even in areas that are not capacity constrained, care provided to Medicare patients remains countercyclical among physicians with a large share of privately insured patients. This pattern is consistent with demand inducement in response to a negative income shock.

What determines employer accommodation of injured workers? The influence of workers' compensation costs, state policies, and case characteristics

Despite a recent dramatic increase in the rate of employer accommodation of injured workers, the extant literature provides little evidence on the determinants of accommodation or the reasons for this upward trend. In this study, the authors take a comprehensive approach to estimating the determinants of workplace accommodation, assessing the influence of employer workers’ compensation (WC) costs; WC market features and state WC laws; and characteristics of firms, injured workers, and their injuries. Using state-level data from the BLS, they find that employer WC costs, WC market features, and state return-to-work (RTW) policies all have an impact on accommodation, but the effects are small and explain only one-fifth of the increase in restricted work. With data on injured workers from the NLSY79 and HRS, the authors study case-specific determinants of accommodation. Results suggest that employer and injury characteristics matter most, and these results are consistent with accommodation occurring mostly at large, experience-rated employers.