Working papers

Abstract: This paper documents maternal wage dynamics around childbirth and its heterogeneity by education using German administrative data. Women with low education experience a smaller drop and a faster recovery of their wages than women with higher levels of education. These differences are largely explained by the fact that women with low education have their first child at a younger age. To investigate whether public policies can influence these wage dynamics, I exploit a paid family leave policy change in 2007 to set up a differences-in-regression-discontinuities design. The policy change shortened the duration of monthly benefit receipt, increased the amount of monthly transfers, and encouraged secondary caregivers to spend at least two months on leave. I find suggestive evidence that the policy did not have an effect on wage loss after childbirth for women with high education. Women with low education earn a larger share of their pre-birth wage in the second year after childbirth under the new policy regime. This is most likely because they returned to work faster. My results suggest that the policy change only influenced labor market behavior of mothers with economic constraints.

Access to child care: Novel insights using distance traveled for care as an indicator

(Revise and Resubmit at Early Childhood Research Quarterly)


Abstract: This paper provides novel insights into early childhood education (ECE) access by using a new indicator: distance traveled for child care. It documents trends in how far families travel to access care in the United States by neighborhood income using geographic mobility data for 2019 for n = 106,916 child care programs. The findings indicate that distance traveled follows an inverted U-shaped pattern. Families who live in the lowest and highest income neighborhoods tend to travel less for child care than families in the middle of the income distribution. In a case study examining the state of Illinois, the pattern is consistent with the physical availability of child care. Findings are discussed in terms of how distance traveled as an indicator can help define the child care market and its implications for early childhood policy.

Journal articles

Trends in High- and Low-Value Cardiovascular Diagnostic Testing in Fee-For-Service Medicare, 1999-2016 

Vinay, K, Virágh, T H, Magid, D J, Masoudi, F A, Moghtaderi, A, and Black, B S

JAMA Network Open, 2019, 2(10): e1913070.

Abstract:

Question  Are changes in annual rates of diagnostic cardiovascular tests associated with changes in rates of high- and low-value testing?

Findings  In this cohort study of a 5% national sample of Medicare beneficiaries, annual rates of overall testing appeared to increase from 2000 to 2008 and then declined until 2016. Rates of low-value tests (preoperative stress testing and routine stress testing after coronary revascularization) appeared to have increased and then decreased, whereas rates of high-value tests (assessing left ventricular systolic function among patients hospitalized with acute myocardial infarction and heart failure) appeared to increase throughout the study period.

Meaning  Payment changes intended to reduce spending on overall testing may not have adversely affected testing recommended by guidelines.


Trends in Medicare Payment Rates for Noninvasive Cardiac Tests and Association with Testing Location

Masoudi, F A, Virágh, T H, Magid, D J, Moghtaderi, A, Schilsky, S, Sage, W M, Goodrich, G, Newton, K M, Smith, D H, and Black, B S

JAMA Internal Medicine, 2019, 179(12)


Abstract:

Question  What are the trends in Medicare payment rates for outpatient noninvasive cardiovascular tests, and are payment rates for hospital-based outpatient testing vs provider-based office testing associated with testing location?

Findings  In this study using the total number of Medicare claims from 1999 to 2015 (mean of 1.72 million patient-years annually), the hospital-based outpatient testing to provider-based office testing payment ratio for noninvasive cardiac tests increased from 1.05 in 2005 to 2.32 in 2015, an increase that was associated with the subsequent proportion of hospital-based testing in Medicare fee-for-service organizations but not in a comparison group of 3 health maintenance organizations (mean of 142 230 patient-years annually).

Meaning  In settings in which reimbursement depends on test location, higher hospital-based vs practice-based payments were associated with greater proportions of outpatient noninvasive cardiac tests performed in hospital-based locations.

Policy briefs

Child Care in the Time of COVID: How Illinois Resourced Programs to Support (Re)opening

Sabol, T J, Virágh, T H, Healy, O J, Nerella, A. 

Institute for Policy Research Rapid Research Report, 2020

Works in progress

Revisiting Family Stress Theory: A Case Study from the Head Start Impact Study 

Virágh, T H, Sabol, T J