The economics of intense exercise, by David O. Meltzer and Anupam B. Jena
Despite the well-known benefits of exercise, the time required for exercise is widely understood as a major reason for low levels of exercise in the US. Intensity of exercise can change the time required for a given amount of total exercise but has never been studied from an economic perspective. We present a simple model of exercise behavior which suggests that the intensity of exercise should increase relative to time spent exercising as wages increase, holding other determinants of exercise constant. Our empirical results identify an association between income and exercise intensity that is consistent with the hypothesis that people respond to increased time costs of exercise by increasing intensity. More generally, our results suggest that time costs may be an important determinant of exercise patterns and that factors that can influence the time costs of exercise, such as intensity, may be important concerns in designing interventions to promote exercise.
We investigate whether the removal of high-cost individuals from private insurance markets leads to greater coverage for individuals who are similar but not as high cost. Using data on insurance coverage from the Panel Study of Income Dynamics, we estimate the effect of the extension of Medicare to the disabled on the private insurance coverage of non-disabled individuals. We find that the insurance coverage of individuals who had a health condition that limited their ability to work increased significantly in states with high versus low rates of disability.
Structuring Payment For Medical Homes, by Katie Merrell and Robert A. Berenson
Despite widespread interest in the medical home model, there has been a lack of careful assessment of alternative methods to pay practices that serve as medical homes. This paper examines four specific payment approaches: enhanced fee-for-service payments for evaluation and management; additional codes for medical home activities within fee-for-service payments; per patient per month medical home payments to augment fee-for-service visit payments; and risk-adjusted, comprehensive per patient per month payments. Payment policies selected will affect both the adoption of the model and its longer-term evaluation. Evaluations of ongoing demonstrations should focus on payment design as well as on care—and cost.
The concept of accountable care organizations (ACOs) has been set forth in recently enacted national health reform legislation as a strategy to address current shortcomings in the U.S. health care system. This paper focuses on implementation issues related to these organizations, building on some initial examples. We seek to clarify definitions and key principles, provide an update on implementation in the context of other reforms, and address emerging issues that will affect the organizations’ success. Finally, building on the initial experience of several organizations that are implementing accountable care and complementary reforms, we propose a national strategy to identify and expand successful approaches to accountable care implementation.
[book] Mostly Harmless Econometrics: An Empiricist’s Companion, by Joshua D. Angrist & Jörn-Steffen Pischke. The following summary is from Princeton University Press.
The core methods in today’s econometric toolkit are linear regression for statistical control, instrumental variables methods for the analysis of natural experiments, and differences-in-differences methods that exploit policy changes. In the modern experimentalist paradigm, these techniques address clear causal questions such as: Do smaller classes increase learning? Should wife batterers be arrested? How much does education raise wages? Mostly Harmless Econometrics shows how the basic tools of applied econometrics allow the data to speak.
In addition to econometric essentials, Mostly Harmless Econometrics covers important new extensions–regression-discontinuity designs and quantile regression–as well as how to get standard errors right. Joshua Angrist and Jörn-Steffen Pischke explain why fancier econometric techniques are typically unnecessary and even dangerous. The applied econometric methods emphasized in this book are easy to use and relevant for many areas of contemporary social science.
