Sure, WSJ. Shame on me for worrying about patient access to care and taxpayer spending over for profit companies. As long as the system works for the wealthy it must be fine with you. Enjoying the comments on the piece, though.

Trouble With MedPAC - WSJ share.google/M9VyVAt9V255...

More immigration into the US raises the number of health care workers and saves the lives of older Americans, from David C. Grabowski, Jonathan Gruber, and Brian E. McGarry www.nber.org/papers/w34791

“We measure the impact of increased immigration on mortality among elderly Americans, who rely on the immigrant-intensive [health care] sectors… [we find] striking effects on mortality: a 25% increase in the steady state flow of immigrants to the US would result in 5,000 fewer deaths nationwide.”

Immigrants save Americans' lives: "...a 25% increase in the steady state flow of immigrants to the US would result in 5,000 fewer deaths nationwide. We identify reduced use of nursing homes as a key mechanism driving this result."
www.nber.org/papers/w34791

Major news outlets: Please consider prominently reporting what this all-star team of researchers has found.
www.nber.org/papers/w34791

SNF capacity is the bottleneck that keeps people waiting in ER hallways and make-shift hospital rooms. SNF beds are crucial to our health system. Since 2020, capacity is down 5%, with less slack, due to staffing shortages.

@jamainternalmed.com @mlbarnett.bsky.social: jamanetwork.com/journals/jam...

Skilled nursing facility operating capacity in the US declined by 5% since 2019, with the largest losses in rural counties and areas reporting staff shortages, impacting hospital discharge and access to facility-based postacute care. ja.ma/49LZK1E

More on dementia & finances: similar to credit outcomes, we see declines on asset side start about 6 years before dementia onset, patterns are consistent with mistakes driving declines, not healthcare spending or spenddown

New work from @mlbarnett.bsky.social, Andrew Wilcock, Ashvin Gandhi, Fangli Geng, David Grabowski, & me in @jamainternalmed.com documenting declines in SNF capacity in the aftermath of the Covid-19 pandemic
jamanetwork.com/journals/jam...

Nursing home effort fluctuates with the inspection cycle, affecting patient survival. Unpredictable inspection schedules may boost effort and save lives, from Ashvin Gandhi, Andrew Olenski, and Maggie Shi www.nber.org/papers/w34491

Medicaid “spend down” — how we force individuals to impoverish themselves to qualify for Medicaid coverage of long-term care — is one of the most messed up things I’ve learned about the US health care system

In a new paper, we look at how often spend-down happens in nursing homes specifically

Next up at @SHESG2025, Katherine Wen presents work on employment and vaccine mandates. Katherine and her colleagues study the impact of vaccinations mandates surrounding COVID. You may remember that there was significant push-back from workers about the mandates at the time.

Excited this paper is out. Medicare Advantage is driving longer hospital lengths of stay, especially for patients discharged to SNFs. This has important implications for patients' access to post-acute care and hospital patient flows as MA becomes dominant type of Medicare coverage

Eric Roberts and @joefigs.bsky.social led a groundbreaking new study on Medicaid and Medicare, out today in NEJM. I’m lucky to have been a part of it.

Medicare saves lives. But is it enough to save lives of the most vulnerable Americans? The study suggests no; Medicaid still matters. (1/11)

Placing a "soft" spending limit on physical therapy reduces unnecessary care, but also introduces inequities based on how well providers can navigate paperwork requirements, from Ashvin Gandhi and Maggie Shi https://www.nber.org/papers/w33722

We are hiring! HSR, health policy, health Econ

jobs.academyhealth.org/jobs/view/as...

Happy to chat!

#econsky #policysky

A key problem is there's a Hotel California aspect to MA: once you're in, it's hard to leave.

In nearly every state, after your initial eligibility period @65, you can't revert to traditional Medicare without facing medical underwriting for Medigap plan that cover your out-of-pocket obligations.

As the baby boom generation enters its prime years for long-term care needs, its difficult to come up with a more challenging backdrop than an immigration system about to be cut off at its knees (think: nursing home aides) and states having to fill in funding gaps from Medicaid spending shortfalls.