PhD, Economics, Princeton University, 2018
Economist Molly Schnell examines how incentives and constraints facing both medical providers and consumers influence healthcare access, health behaviors, and health outcomes. Her research encompasses the causes and consequences of provider behavior, and much of her work focuses on the provision of pharmaceuticals in markets across the United States.
Schnell spent 2018–19 as a postdoctoral fellow at Stanford University, after receiving her PhD in economics from Princeton. She has written policy briefs on the recent opioid crisis for the Harvard Business Review, Brookings Institute, and Stanford Institute for Economic Policy Research. Her research has been published in the Quarterly Journal of Economics, Journal of Health Economics, and Journal of Public Economics, among others. Media outlets including The Economist, The New York Times, and The Atlantic have featured her work.
The Impacts of Physician Payments on Patient Access, Use, and Health. In this project, Schnell and economist Diane Alexander of the Federal Reserve Bank of Chicago examine how increasing Medicaid payments to physicians affects their willingness to accept new Medicaid patients. They also study whether changes in access influence patient’s use of healthcare and their subsequent health. By comparing states that increased Medicaid payments by varying degrees, they find that closing the gap in payments between public and private insurers would reduce disparities in access among adults by two-thirds and eliminate them among children. Improving access to doctors for Medicaid patients led to more office visits, better self-reported health, and reduced school absenteeism for children. The researchers’ results demonstrate that financial incentives for physicians are significant in determining patient access to care, and that they hold important implications for patient health.
Physician Behavior in the Presence of a Secondary Market: The Case of Prescription Opioids. In this working paper, IPR economist Molly Schnell examines how the entwined nature of legal and illegal drug markets has affected the U.S. opioid epidemic. Schnell designs and estimates a supply-and-demand model of how physicians’ prescribing behavior changes when they know patients have access to an illegal secondary market. Her model allows physicians to be motivated both by concern for patient health and their own financial gain. She identifies that spectrum of motivation by observing which doctors were altruistically motivated, and more or less likely to prescribe a new opioid that was less addictive, but also less profitable. The research shows that physicians decrease the number of opioid prescriptions they write to account for the secondary market, with more altruistic providers adjusting their prescribing the most. Despite this reduction in prescriptions, she finds that the total amount of opioid prescriptions is still too high. Her estimates suggest that feedback between legal and illegal markets limits the effectiveness of policies aimed at curbing abuse. To address the crisis, it will be key to target both the initial flow of medications from providers in the legal market as well as the exchange of medications across patients on the illegal market.
Alexander, D., J. Currie, and M. Schnell. Forthcoming. Check up before you check out: The impact of retail clinic expansion on emergency room use. Journal of Public Economics.
Allcott, H., R. Diamond, J.-P. Dubé, J. Handbury, I. Rahkovsky, and M. Schnell. Forthcoming. Food deserts and the causes of nutritional inequality. Quarterly Journal of Economics.
Alexander, D. and M. Schnell. 2019. Just what the nurse practitioner ordered: Independent prescriptive authority and population mental health. Journal of Health Economics 66:145–62.
Currie, J., J. Jin, and M. Schnell. 2019. U.S. employment and opioids: Is there a connection? In Health and Labor Markets (Research in Labor Economics, Vol. 47), ed. S. Polachek and K. Tatsiramos, 253–80. Bingley, U.K.: Emerald Publishing.
Schnell, M. and J. Currie. 2018. Addressing the opioid epidemic: Is there a role for physician education? American Journal of Health Economics 4(3): 383–410.