Institutional Affiliation: Michigan State University
|What to Expect When It Gets Hotter: The Impacts of Prenatal Exposure to Extreme Heat on Maternal Health|
with , : w26384
We use temperature variation within narrowly-defined geographic and demographic cells to show that exposure to extreme heat increases the risk of maternal hospitalization during pregnancy for potentially life-threatening causes. We find that this effect is driven by women residing in historically cooler rather than hotter counties, suggesting that adaptation plays a role in mitigating the health impacts of weather shocks. We also find that the heat-induced deterioration in maternal pregnancy health is larger for black than for white mothers, suggesting that projected increases in extreme heat over the next century may further exacerbate the black-white maternal health gap.
|Medicare Payment to Skilled Nursing Facilities: The Consequences of the Three-Day Rule|
with , : w25017
Medicare does not pay for a skilled nursing facility (SNF) unless a fee-for-service patient has stayed in the hospital for at least three days. Discharges after the three-day cutoff consistently result in more transfers to SNFs. Using the three-day rule as an instrument, we find that SNF discharges decrease hospital readmission for patients with comorbidities. However, for knee and hip replacement patients, we find significant increases in readmission. This perverse effect is more severe when local SNFs have lower quality. Back-of-the-envelope calculations suggest that the three-day rule may have generated extra Medicare payments to SNFs by $100-447 million per year.