Published in Refereed Journals

Unspecified Firearm Type for Firearm Suicides in the National Vital Statistics System (NVSS): A County-Level Analysis (with Emma Gause, Ali Rowhani-Rahbar, Frederick Rivara)
Forthcoming at the American Journal of Preventive Medicine

Can Malpractice Pressure Compel a Physician to Relocate?  (with Justin Robertson)
Link to Publication at the International Law and Economic Review

Abstract: This analysis measures the effect of malpractice pressure on negative defensive medicine. Existing literature considers the effect of tort reforms on physician supply. However, some avoidance behaviors may not be observable at the aggregate level. Using a panel dataset which follows a random sample of 28,227 family medicine physicians in the United States from 1992-2007, this paper evaluates one of these avoidance behaviors by asking whether changes in malpractice premiums impact a physician’s decision to relocate their practice. Results indicate that group and hospital practice physicians are more likely to relocate to another state when premiums are high compared to solo and partnership practice physicians. Our findings also suggest that even large premium growth has only minor implications on the physician relocation decision. Generally, these results suggest that family medicine physicians do not use relocation as a strategy to avoid malpractice pressure.

Pony Distress: Using ESPN's 30FOR30 Films to Teach Cartel Theory (with Franklin G. Mixon)
Link to Publication at the Journal of Economics and Finance Education 

Abstract: This study provides a roadmap for economics instructors to use a graphical model along with various clips from ESPN’s critically-acclaimed 30FOR30 films series in order to complement classroom discussion of cartel theory, particularly the story of the National Collegiate Athletics Association as a cartel. The two films used here are Thaddeus D. Matula’s Pony Excess (2010) and Jonathan Hock’s The Best that Never Was (2010). Each chronicles the rampant rules-breaking, or cartel cheating, in college football during the 1970s and 1980s, culminating in the “Death Penalty” at SMU and the collapse of the Southwest Conference cartel. 
Note: Published under maiden name - Alice M. Crisp

Lincoln's Wartime Incumbency Network: Vertical Trust, Informal Payments, and the U.S. Presidential Election of 1864 (with Franklin G. Mixon)
Journal of Public Finance and Public Choice

Abstract: Public choice interpretations of historical events represent a growing literature in economics. This particular study follows in, and builds upon, this tradition by examining, through the public choice lens, events leading up to the U.S. presidential election of 1864. We posit that the modern theory of bureaucracy, as described in Breton and Wintrobe [1982], perhaps best explains the way in which Abraham Lincoln's subordinates assisted, sometimes even manipulating the gears of the federal (Union) government in doing so, in his re-election effort. That bureaucracy, which we refer to herein as Lincoln's wartime incumbency network, was based on a system of vertical trust, and included an incentive structure wherein subordinates provided Lincoln with informal services related to his re-election in 1864, and were provided in return with informal payments, which often consisted of ex ante/ex post promotions and/or nominations for other government positions. 
Note: Published under maiden name - Alice M. Crisp

Working Papers

The Prescription Drug Paradox: Pipeline Pressure and Rising Prices 
​(with Anirban Basu)
Revise and Resubmit at Health Economics
Link to NBER working paper 

Abstract:  Economic literature has extensively studied how prices for incumbent firms respond to competition after entry, especially in prescription drug markets following generic entry. However, less attention has been paid to firm behavior prior to entry. We contribute to this gap in the literature by both developing a model of pricing strategies for incumbent drug manufacturers under health insurance and empirically assessing pricing adjustments for incumbent firms, using the insulin market as a natural experiment. We consider the price strategy of incumbent firms among branded, horizontally-differentiated drugs under tiered insurance, which predicts rising prices for incumbent drugs for a range of elasticities as the likelihood of entry increases. Empirically, we exploit exogenous variation in a potential entrant's completion of clinical trials to identify the effect of drug pipeline pressure on the prices of incumbent drugs. Results suggest that pipeline pressure significantly increases the prices of incumbent drugs, and potential biosimilar entry may drive this effect. 

Flipping the Script: Evaluating the Policy Effects and Restrictiveness of PDMPs on Opioid Prescribing Behavior
(with Jevay Grooms and Alberto Ortega)
Under Review 
Link to working paper

Abstract: Over the past decade, federal and state governments have implemented a variety of policies to address the debilitating effects of the opioid epidemic. One of the most effective tools has been mandatory access Prescription Drug Monitoring Programs (MA-PDMPs), which aim to curb the epidemic at a common point of initiation of use, the prescription. However, there is a recent concern as to whether these opioid specific policies have been too restrictive and reduced appropriate access to patients with the most need for these pharmaceuticals. To answer this question we assess the effect of this mandatory component on specialty-specific opioid prescribing behavior using the CMS Medicare Part D Public Use Files. Our findings suggest that requiring providers to query a PDMP database, prior to prescribing an opioid drug, differentially affects opioid prescribing across provider specialty. As in other studies, we find an overall decrease in prescribing as a result of implementing a MA-PDMP, but find that this decrease is largely driven primarily by primary care and inpatient care providers. Interestingly, we also find increases in prescribing for oncology and palliative care providers after a MA-PDMP is implemented. Our results indicate that MA-PDMPs may help close provider-patient informational gaps while retaining a provider’s ability to supply these drugs to patients with a need for opioids (e.g. end of life care).

A flexible Bayesian framework to assess the impact of state-level firearm permit-to-purchase requirements on county-level firearm suicide: advancements and challenges
(with Tim Wolock, Emma Gause and Ali Rowhani-Rahbar)
Under Review 

Abstract: Despite suicides accounting for approximately 60% of firearm deaths annually in the United States, relatively little is known about the effect of firearm sale regulation on firearm suicide. Previous state-level research suggests that permit-to-purchase (PTP) requirements might reduce population-level suicide mortality, but the topic has not been assessed robustly at the county level. We used a Bayesian hierarchical regression framework to estimate the effect of PTP on county-level firearm suicide mortality and three negative control outcomes. By estimating the effects of independent PTP policy-time indicators, we allowed the effect of the policy to vary post-implementation. Further, by conducting four parallel analyses (one of firearm suicide and three of negative control outcomes), we were able to assess the presence of unmeasured confounding more robustly than other studies. We observed significant, temporally plausible associations between PTP and all four outcome variables, suggesting the presence of unmeasured confounding that varied systematically over policy-time. Our results do not allow us to comment on the relationship between PTP and county-level firearm suicide rates with confidence, but they do illustrate the importance of negative control outcomes, as well a number of methodological improvements that can be applied widely in ecological and multi-level firearm policy research.

Abstract: 

Works in Progress

"Initiation of digital dating abuse and patterns of co-occurrence" (with Avanti Adhia, Vivian Lyons, and Frederick Rivara)

"Expanding autonomy: scope of practice laws and opioid prescribing behavior" (with Alberto Ortega and Jevay Grooms)

"School shootings and stress-related emergency department visits in CA" with Kritee Gujral, Ali Rowhani-Rahbar, Frederick Rivara)

"Deaths of Despair" (with Emma Gause and Ali Rowhani-Rahbar)

"The Effect of Police Institutions and Resources on the Use of Force" (with Brian Meehan)

"Not quite a pill mill: effects of PDMPs on overprescribing providers" (with Jevay Grooms and Alberto Ortega)
​
"Switching the script: Post-PDMP Pain Prescribing Substitution Effects" (with Alberto Ortega and Jevay Grooms)

Unpublished Manuscripts

"The Clinical and Economic Impact of Washington State's Oral Anticancer Treatment Parity Law"
​(with Anirban Basu)

Abstract: Several states have implemented legislation in recent years to control the rising cost of oral chemotherapy drugs. This study examines the impact of Washington State’s oral chemotherapy parity law on access to cancer treatment options and two aspects of treatment costs, patient out-of-pocket spending and health plan spending. We consider about 22,000 patients with newly diagnosed cancer about 4 years before and 3.5 years after the parity law took effect in 2012 by linking claims and enrollment data to the Washington State SEER cancer registry data. About half of the patients were in fully insured plans that are subject to the parity law (treatment group) and the other half were in self-insured plans that are exempt from the law (control group). Using an interrupted time series approach, we compare changes across these two groups following the implementation of the parity law. The analyses will also investigate differential impacts by type of cancer.