Brent Fulton, Associate Director

Closed (1) Health Economics Research (Please Note: Only Project E is open during the extended application phase)

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There are five distinct studies that the student could be involved in (see below). I plan to work with 2-4 students. Please state which study(s) you are interested in.

A. Health behaviors, such as smoking, weight (bmi), etc. account for approximately 25% of health outcomes. This study will examine the share of these behaviors that is based on free choice versus genetic and environmental factors that influence free choice. Study will be of interest to those interested in determinism versus free choice debate.

B. Approximately 20,000 people are hospitalized each year in the United States for encephalitis. Isolating its cause can be challenging, because the infection’s source may be viral, bacterial, parasitic, or fungal. Next-generation DNA sequencing technologies using cerebrospinal fluid can identify the infectious agent. My portion of the study will estimate the cost impact and cost effectiveness of different entry criteria for the next-generation DNA sequencing technology to be used as a diagnostic test for meningitis and encephalitis cases. The cost effectiveness per quality-adjusted life year will be estimated using a decision tree, either deterministically or stochastically, to allow for random components. The overall study is located at UCSF. For more information, see

C. Federal health insurance premium tax credits (i.e., subsidies) in the Affordable Care Act Health Insurance Marketplaces are not adjusted for cost-of-living differences across the United States. This study will estimate the number of additional people who could be insured for the same aggregate subsidy budget, if individual subsidies were adjusted for cost-of-living differences.

D. The Centers for Medicare and Medicaid Services’ State Innovation Model (SIM) Initiative aims to stimulate a comprehensive approach to transforming states’ health care delivery systems. The study will estimate the impact of those reforms on preventing and managing diabetes. For more information, see

E. This study will estimate the healthcare cost savings from Medicare funding healthcare services and prevention programs that are not emphasized by commercial insurers for the near elderly (e.g., aged 50-64), because the breakeven points do not occur for several years. Commercial insurers do not have a financial incentive to invest in an intervention when the breakeven point is beyond a few years, because of the high turnover among their enrollees. However, Medicare has an incentive, because if people aged 65 enroll in Medicare at a lower health risk, their lifetime healthcare spending is lower (Rula et al., 2011). This study will include three important findings: (1) Medicare's estimated savings, which would improve its dire long-term fiscal situation; (2) the estimated reduction in employer-sponsored and individual market heath insurance premiums from commercial insurers being able to tap Medicare funding for particular interventions; and (3) the estimated impact on the culture of health (e.g., how many people with pre-diabetes would be able to enroll in a diabetes prevention program, because of the Medicare funding).
Citation: Rula, Elizabeth Y., James E. Pope, and Joel C. Hoffman. "Potential Medicare savings through prevention and risk reduction." Population Health Management 14.S1 (2011): S-35.

The student will search for and summarize existing studies, and depending on skill level, do analyses and create tables and figures using excel.

The student's key learning outcome will be gaining a better understanding on how empirical research is conducted within health economics.

Qualifications: Required skills include the following: strong writing skills, proficiency in searching publication databases (e.g., PubMed, Google Scholar, etc.), proficiency in Microsoft Office. Desirable but not essential skills include the following: background in U.S. healthcare system and health economics, Endnote, Excel. Hours per week is 9-12, but would consider 6-9.

Weekly Hours: 9-12 hrs

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