Urban Institute

About: Urban Institute is a nonprofit organization based out in Washington D.C., District of Columbia, United States. It is known for research contribution in the topics: Medicaid & Population. The organization has 927 authors who have published 2330 publications receiving 86426 citations.

Hospitals’ Geographic Expansion In Quest Of Well-Insured Patients: Will The Outcome Be Better Care, More Cost, Or Both?

Abstract: The emphasis that hospitals place on cutting-edge technology and niche specialty services to attract physicians and patients has set the stage for health care’s most recent competitive trend: an increased level of targeted, geographic service expansion to “capture” well-insured patients. We conducted interviews in twelve US communities in 2010 and found that many hospital systems—some with facilities in geographically undesirable areas—have expanded to compete for better-insured patients by building or buying facilities and physician practices in nearby, more affluent communities. Along with extending services to new markets, these hospital outposts often serve to pull well-insured patients to flagship facilities. The acceleration and expansion of such geographically competitive strategies by hospitals has implications for cost and access. Although payers and competitors contend such strategies will lead to higher costs, hospitals assert the expansions will increase efficiency, increase access, and improv...

The Taxation of Retirement Saving: Choosing Between Front-Loaded and Back-Loaded Options

Abstract: We examine retirement savers' choices between front- and back-loaded tax incentives, such as traditional and Roth IRAs, respectively With equal dollar contribution limits, back-loaded plans shelter more funds than front-loaded plans This implies that Roth IRAs can be the preferred choice even for investors who expect their tax rates to fall in retirement Empirically, we examine how marginal tax rates have varied between 1982 and 1995 for a sample of taxpayers and calculate both ex ante and ex post effective tax rates on front-loaded IRAs The average effective tax rate on traditional IRA contributions made in 1982 and withdrawn in 1995 was negative 30 percent Changes in tax law after 1982 reduced tax rates considerably Holding tax law constant, the average effective tax rate on IRAs was about negative 11 percent These results occur because the tax rate in retirement is lower for most people than the rate while working In contrast, the effective tax rate on Roth IRAs is always zero Despite the lower average effective tax rate on traditional IRAs, many taxpayers in the sample would have benefited from contributing to a Roth IRA instead of a traditional IRA, due to the difference in effective contribution limits

Explaining trends in health insurance coverage between 1988 and 1991.

Abstract: This paper uses regression-based decompositions to examine the downward trend in insurance coverage between 1988 and 1991. I find that falling family incomes account for much of the decline in overall insurance coverage, while a secular decline in insurance coverage across all industries, firm sizes, employment statuses, income levels, and demographic groups accounts for most of the decline in employer-sponsored insurance among workers. Rising unemployment and changing patterns of industrial employment explain little of the decline in coverage across the entire population. Taken together, these results suggest that fewer employers are offering health coverage, workers are finding it difficult to pay their share of the premiums, and those without access to employer-sponsored plans are finding it harder to purchase nongroup insurance. Thus, it appears that the rising cost of health insurance coupled with falling incomes and profits during the recession account for the fall in health insurance coverage between 1988 and 1991.

For whom does a transitional jobs program work

Abstract: Each year, more than 700,000 individuals are released from prisons nationwide (Sabol, West, and Cooper, 2009). Many former prisoners have lengthy criminal backgrounds and struggle to avoid recidivating while reintegrating into the communities to which they return. A person’s criminal history, age, and gender all contribute to the likelihood of future crime (Gendreau, Little, and Goggin 2006; Levinson, 2002). Among released prisoners, younger males with extensive criminal histories are often at greatest risk of future recidivism (Langan and Levin, 2002).1