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Aims: We examined the effects of a statewide New York (NY) care management (CM) program for substance use disorder (SUD), Managed Addiction Treatment Services (MATS), on SUD treatment services' utilization and spending among patients with a recent history of high Medicaid spending and among those for whom a predictive algorithm indicates a higher probability of outlier spending in the following year. Methods: We applied difference-in-difference analyses with propensity score matching using NY Medicaid claims data and a state registry of SUD-treatment episodes from 2006 to 2009. A total of 1263 CM enrollees with high SUD treatment spending (>$10K) in the prior year and a matched comparison group were included in the analysis. Crisis care utilization for SUD (detoxification and hospitalizations), outpatient SUD treatment, and Medicaid spending were examined over 12 months among both groups. CM effects among predicted high-future-spending patients (HFS) were also analyzed. Results: CM increased outpatient SUD treatment visits by approximately 10.5 days (95% CI = 0.9, 20.0). CM crisis care and spending outcomes were not statistically different from comparison since both conditions had comparable pre-post declines. Conversely, CM significantly reduced SUD treatment spending by approximately $955 (95% CI = −1518, −391) and reduced days of detox utilization by about 1.0 days (95% CI = −1.9, −0.1) among HFS. Conclusion: Findings suggest that CM can reduce SUD treatment spending and utilization when targeted at patients with a greater likelihood of high future spending, indicating the potential value of predictive models to select CM patients. [ABSTRACT FROM AUTHOR]

AIMS: We examined the effects of a statewide New York (NY) care management (CM) program for substance use disorder (SUD), Managed Addiction Treatment Services (MATS), on SUD treatment services' utilization and spending among patients with a recent history of high Medicaid spending and among those for whom a predictive algorithm indicates a higher probability of outlier spending in the following year. METHODS: We applied difference-in-difference analyses with propensity score matching using NY Medicaid claims data and a state registry of SUD-treatment episodes from 2006 to 2009. A total of 1263 CM enrollees with high SUD treatment spending (>$10K) in the prior year and a matched comparison group were included in the analysis. Crisis care utilization for SUD (detoxification and hospitalizations), outpatient SUD treatment, and Medicaid spending were examined over 12 months among both groups. CM effects among predicted high-future-spending patients (HFS) were also analyzed. RESULTS: CM increased outpatient SUD treatment visits by approximately 10.5 days (95% CI = 0.9, 20.0). CM crisis care and spending outcomes were not statistically different from comparison since both conditions had comparable pre-post declines. Conversely, CM significantly reduced SUD treatment spending by approximately $955 (95% CI = -1518, -391) and reduced days of detox utilization by about 1.0 days (95% CI = -1.9, -0.1) among HFS. CONCLUSION: Findings suggest that CM can reduce SUD treatment spending and utilization when targeted at patients with a greater likelihood of high future spending, indicating the potential value of predictive models to select CM patients. [ABSTRACT FROM AUTHOR]

The New York Independent System Operator (NYISO) has developed a carbon-pricing proposal to reduce carbon intensive electricity generation in anticipation of future clean energy goals in the state. The proposed measure is a so-called 'carbon adder' on CO2 emissions from the power sector that targets the social cost of carbon amidst existing overlapping policies. The carbon adder is set as the difference between the targeted social cost of carbon and the prevailing RGGI price for CO2 emission allowances. We investigate the economic and environmental impacts from the imposition of a carbon adder on New York's power sector. Our analysis indicates that the carbon adder gives the 'right' price signal for New York's power generation to turn into a greener one and is shown to be more cost-effective than clean energy standards. Requirements for permit price floors in the RGGI market induces carbon permit retirements across RGGI states leading to small reductions in region- and country-wide emissions levels.The proposed border carbon adjustments on electricity trade are shown to further mitigate emission leakage. Key policy insights NYISO's proposed carbon adder provides strong incentives for decarbonization and renewable power generation in the New York region. The carbon adder is shown to be more cost-effective than New York's clean energy standard measures in achieving an equivalent level of emissions reductions. This is because the carbon adder targets energy carriers by their specific CO2 emissions while the clean energy standard implicitly targets energy carriers by their specific CO2 emissions while the clean energy standard implicitly provides a uniform subsidy to all clean energy carriers. The existing RGGI price floor mechanism assures that NYISO's unilateral use of carbon adder is environmentally effective by generating overall emission reductions in the RGGI region in order to maintain the existing price floor. Border carbon adjustments on the embodied carbon of electricity imports to New York, and an emission containment reserve, which dynamically adjusts RGGI cap as a response to RGGI price change, will likely mitigate leakage further and improve competitiveness of the New York's energy sector. [ABSTRACT FROM AUTHOR]

Future conventional and renewable energy production will predominantly occur on farmland, resulting in economic gains as well as potential negative externalities for farmland owners and rural communities. However there is limited research on the economic impact of energy production that takes place on farmland. This study uses the discrete change in expectations caused by the 2008 New York State moratorium on hydraulic fracturing to investigate the net impact of shale gas development on farmland values. We use a difference-in-differences empirical design with a hedonic pricing model. We find that the moratorium led to net economic losses for rural landowners in New York's Southern tier, as reflected in farmland values declining approximately $1,400/acre. [ABSTRACT FROM AUTHOR]

A solar energetic particle (SEP) event generates a shower of secondary generated particles in the Earth's atmosphere down to lower altitudes to cause an atmospheric radiation storm (ARS). The high-energy secondary particles cause additional radiation dose at altitudes where aircraft flies. The space weather information provided by the International Civil Aviation Organization (ICAO) designated space weather centers includes advisories on the solar radiation storm. The Warning System for AVIation Exposure to Solar energetic particle (WASAVIES), we can estimate the effective dose rate (EDR) along the flight path of the aircraft. However, it has not been well established how the operators of aircraft should react with the space weather advisories on the solar radiation storm. By using a flight trajectory generation algorithm and the global EDR distribution, the economic impacts of ARS associated with SEP events on aircraft operation, namely the flight path length, flight time, and fuel consumption, are estimated. The conditions of the peak of the ARS event on 20 January 2005 are used. The economic impacts for a flight route from New York, US to Tokyo, Japan, are estimated with constraints in flight routes to avoid the hazard of radiation and compared with those of the reference case without the ARS effects. The fuel consumption is shown to increase by 39–69 tons (33–58%) for a twin-engine, wide-body jet passenger aircraft, when a constraint is imposed on the flight altitude only. When the constraints are set on the aircraft altitude and the latitude, the flight time and the fuel consumption are both increased by 2.2–2.8 h (17–20%) and 32–48 tons (27–41%), respectively. If the ARS event duration is limited for 3 h, the increase in the fuel consumption is about 7.6–14 tons (6.4–12%). This economic impact may be reduced, if the space weather nowcast and forecast for the ARS and an optimal flight trajectory generation algorithm are used together. Setting more flexible constraints on the flight route and generating optimal flight trajectories with minimal economic impacts by fully utilizing the global EDR distribution is the next step. [ABSTRACT FROM AUTHOR]

• Farm-to-School (FTS) programs are often supported by public policies and funds. • The gross and net economic impacts of a new state-funded FTS initiative are estimated. • Detailed data on food products, production location, and type of seller are analyzed. • Results show positive net economic impacts of the policy for a large school district. • Net benefits depend on extent of food production and processing industry expansion. Farm-to-school projects have been widely supported by policy makers with funding provided at state and federal levels. Still, many of the outcomes of this inflow of policy and funding remain unclear, often due to insufficient data to examine them. In 2018, New York State (USA) announced the 30% NY Initiative that substantially increases school lunch reimbursements if school districts purchase at least 30% of their ingredients as New York food products. With detailed food purchasing data from the second largest school district in the state and the largest to qualify for enhanced reimbursement, we estimate the gross and net economic impacts of the policy through a customized input–output model. We observe clear shifts in food spending categories that suggest changes in what and where foods were purchased. Results demonstrate net positive value added impacts of the policy even when a negative impact is applied to account for the cost of the policy to taxpayers. For every dollar in gross domestic product lost in the state to support the program, $1.06 of gross domestic product is expected to be added. However, the results are only true to the extent that the increase in local food spending is commensurate with an expansion of the related farm and food product industries to meet that demand. Specifically, at least 67% of the growth in local food spending must contribute to new aggregate demand for the related food product industries, rather than reallocation from other local marketing channels. [ABSTRACT FROM AUTHOR]

Objectives The main objective of this study was to estimate effects of dementia on Medicaid expenditures in an ethnically diverse community. Methods The sample included 1,211 Medicare beneficiaries who did not have any Medicaid coverage and 568 who additionally had full Medicaid coverage enrolled in the Washington Heights-Inwood Columbia Aging Project (WHICAP), a multiethnic, population-based, prospective study of cognitive aging in northern Manhattan (1999–2010). Individuals' dementia status was determined using a rigorous clinical protocol. Relationship between dementia and Medicaid coverage and expenditures were estimated using a two-part model. Results In participants who had full Medicaid coverage, average annual Medicaid expenditures were substantially higher for those with dementia than those without dementia ($50,270 vs. $21,966, p <.001), but Medicare expenditures did not differ by dementia status ($8,458 vs. $9,324, p =.19). In participants who did not have any Medicaid coverage, average annual Medicare expenditures were substantially higher for those with dementia than those without dementia ($12,408 vs. $8,113, p =.02). In adjusted models, dementia was associated with a $6,278 increase in annual Medicaid spending per person after controlling for other characteristics. Discussion Results highlight Medicaid's contribution to covering the cost of dementia care in addition to Medicare. Studies that do not include Medicaid are unlikely to accurately reflect the true cost of dementia. [ABSTRACT FROM AUTHOR]

Objective: To examine within-hospital racial and ethnic disparities in severe maternal morbidity rates and determine whether they are associated with differences in types of medical insurance.Methods: We conducted a population-based, cross-sectional study using linked 2010-2014 New York City discharge and birth certificate data sets (N=591,455 deliveries) to examine within-hospital black-white, Latina-white, and Medicaid-commercially insured differences in severe maternal morbidity. We used logistic regression to produce risk-adjusted rates of severe maternal morbidity for patients with commercial and Medicaid insurance and for black, Latina, and white patients within each hospital. We compared these within-hospital adjusted rates using paired t-tests and conditional logit models.Results: Severe maternal morbidity was higher among black and Latina women than white women (4.2% and 2.9% vs 1.5%, respectively, P<.001) and among women insured by Medicaid than those commercially insured (2.8% vs 2.0%, P<.001). Women insured by Medicaid compared with those with commercial insurance had similar risk for severe maternal morbidity within the same hospital (P=.54). In contrast, black women compared with white women had significantly higher risk for severe maternal morbidity within the same hospital (P<.001), as did Latina women (P<.001). Conditional logit analyses confirmed these findings, with black and Latina women compared with white women having higher risk for severe maternal morbidity (adjusted odds ratio [aOR] 1.52; 95% CI 1.46-1.62 and aOR 1.44; 95% CI 1.36-1.53, respectively) and women insured by Medicaid compared with those commercially insured having similar risk.Conclusion: Within hospitals in New York City, black and Latina women are at higher risk of severe maternal morbidity than white women; this is not associated with differences in types of insurance. [ABSTRACT FROM AUTHOR]

Objective: To determine whether Medicare's Nonpayment Program was associated with decline in venous thromboembolism (VTE) following hip and knee replacements; and whether the decline was greater among hospitals at risk of larger financial losses from the Program.Data Sources: State Inpatient Database for New York (NY) from 2005 to 2013.Study Design: The primary outcome was an occurrence of VTE. Medicare Utilization Ratio (MUR), which is the proportion of inpatient days in a hospital that is financed by Medicare, represented a hospital's financial sensitivity. We used hierarchical logistic regressions with difference-in-differences estimation to study the Program effects.Principal Findings: A total of 98,729 hip replacement and 111,361 knee replacement stays were identified. For hip replacement, the Program was associated with significant reduction (Range: 44% to 53%) in VTE incidence among hospitals in MUR quartiles 2 to 4. For knee replacement, the Program was associated with significant reduction (47%) in VTE incidence only among quartile 2 hospitals.Conclusion: Implementation of the Program was associated with a reduction in VTE, especially for hip replacements, in higher MUR hospitals. Payment reforms such as Medicare's Nonpayment Program that withhold payments for complications are effective and should be continued. [ABSTRACT FROM AUTHOR]

Persons living in communities with limited resources are at heightened risk of posttraumatic stress (PTS) after disasters, especially if they were highly exposed. The support deterrence desistence model and the conservation of resources theory suggest that this risk might increase in the longer-term aftermath of disasters. In the present study, we aimed to test this hypothesis. Two population-based samples of New York City residents in communities affected by Hurricane Sandy were surveyed at either 13-16 months (Time 1; n = 421) or 25-28 months (Time 2; n = 420) postdisaster. Participants reported on their exposure to disaster-related stressors and PTS. The percentage of residents who were unemployed in participants' census tracts was collected from the 2008-2012 American Community Survey. Multilevel models found that disaster-related stressors were more strongly associated with PTS for participants living in communities with high unemployment, but only at Time 2 (Est. = .58, SE = .21, p = .006). Mapping of community unemployment and disaster-related stressors suggested that communities in southern Brooklyn and Queens, and northeastern Staten Island were at particularly high risk for PTS at Time 2. The results suggest the need for ongoing support to economically disadvantaged communities in which residents have endured disaster-related stressors. [ABSTRACT FROM AUTHOR]

Objective: We examined the magnitude and related costs of potentially avoidable hospitalizations including re-hospitalizations for long-stay residents in nursing homes.Design: We conducted our investigation as a retrospective cohort study where the cohort comprised individuals who were eligible for Medicare and had spent at least 120 uninterrupted days in a nursing home in New York State between 2004 and 2007. To conduct the study, we linked the Minimum Data Set, Medicare Provider Assessment File and Provider of Service File.Measurements: We defined a potentially avoidable hospitalization as one where a resident was admitted to a hospital for which the principle diagnosis was 1 of 15 ambulatory care sensitive (ACS) conditions.Results: Although the percentage of total hospitalizations for ACS conditions declined during the study period, 20% or more of annual hospitalizations were for ACS conditions entailing Medicare payments in excess of $450 million. Approximately 40% of the residents who were hospitalized once for an ACS condition were re-hospitalized during the study period for the same or different ACS condition.Conclusion: During the study period, potentially avoidable hospitalizations from nursing homes were a common occurrence in New York. A substantial percentage of such hospitalizations involved residents who had been previously hospitalized, in some cases multiple times, for an ACS condition. Although the observed decline in ACS-related hospitalizations suggests improvements in nursing home care, various policy and managerial-level initiatives may be needed to ensure that nursing home residents are not exposed to a substantial risk of avoidable hospitalizations in the future. [ABSTRACT FROM AUTHOR]

Abstract: This paper empirically investigates the economic effects of government regulation in a regulated taxicab market. We use a cointegration model with structural breaks to test the hypothesis that government regulation increases the price of the regulated good and/or causes the monopoly price. We examine the New York taxicab market and argue that regulation brings about artificial rents by increasing medallion prices, and an increase in medallion prices gives rises to upward pressure on taxi fares. The evidence presented shows that regulation of the New York taxicab market increases medallion prices, and this increase in medallion prices pressures on taxi fares. [Copyright &y& Elsevier]

Patients facing serious or life-threatening illnesses account for a disproportionately large share of Medicaid spending. We examined 2004-07 data to determine the effect on hospital costs of palliative care team consultations for patients enrolled in Medicaid at four New York State hospitals. On average, patients who received palliative care incurred $6,900 less in hospital costs during a given admission than a matched group of patients who received usual care. These reductions included $4,098 in hospital costs per admission for patients discharged alive, and $7,563 for patients who died in the hospital. Consistent with the goals of a majority of patients and their families, palliative care recipients spent less time in intensive care, were less likely to die in intensive care units, and were more likely to receive hospice referrals than the matched usual care patients. We estimate that the reductions in Medicaid hospital spending in New York State could eventually range from $84 million to $252 million annually (assuming that 2 percent and 6 percent of Medicaid patients discharged from the hospital received palliative care, respectively), if every hospital with 150 or more beds had a fully operational palliative care consultation team. [ABSTRACT FROM AUTHOR]

Background: Inpatient treatment of pneumonia produces significant costs to the health care system. In an effort to improve quality of care, decrease length of stay, and decrease drug costs associated with treating pneumonia, on October 1, 2006, the Veterans Affairs New York Harbor Healthcare System (VANYHHS) implemented guidelines for treating hospitalized patients with pneumonia. These guidelines included specific criteria for initial selection of an antimicrobial agent based on patient risk factors, conversion from intravenous (IV) to oral antibiotics, and selection of an appropriate oral agent for conversion. The primary objective of this study was assessment of the economic impact of implementing pneumonia treatment guidelines at the VANYHHS. Methods: Retrospective analysis of 100 patients admitted to the VANYHHS for treatment of pneumonia was completed before implementation of the guidelines, and then those data were compared with similar data from a group of 100 patients admitted to the hospital for treatment of pneumonia after implementation of the guidelines. Electronic medical records were reviewed for (1) initial antibiotic therapy administered, (2) time needed for conversion from IV to oral antibiotics after becoming eligible for the switch based on implemented guidelines, and (3) length of hospital stay. Results: Data from the preguideline group demonstrated that it took an additional 2.31 days to convert patients from IV to oral antibiotics after they were eligible for the switch to oral therapy. The mean length of stay was 9.2 days. Data from the postguideline group illustrated that the time needed to convert patients from IV to oral therapy was decreased to 1.09 days (P = 0.002) and the mean length of stay was decreased to 8.76 days (P -- 0.677) when compared with the preguideline group data. The estimated annual cost savings from implementing pneumonia treatment guidelines based on the decrease in mean length of stay was $290,482.20 annually. Conclusion: Implementing pneumonia treatment guidelines was associated with decreased length of stay and, thus, a decrease in the costs associated with treating pneumonia in an institutional setting. It is estimated that the VANYHHS could save nearly $300,000 annually as a result of the implementation of the treatment guidelines for pneumonia. [ABSTRACT FROM AUTHOR]

• The paper describes our recent research and study activities for a joint project with New York Power Authority (NYPA) and New York State Energy Research and Development Authority (NYSERDA). • One goal of the project is to use closed-loop control device, multi-band power system stabilizers (MBPSS), in the New York power grid (NYPG) to improve its dynamic stability performance including primary frequency and inter-area oscillatory control. • This paper is primarily focused on the frequency control. • The study results show that with a small number of selected controllable assets only operated by NYPA, including WGs, MBPSS effectively improves the dynamic performance of NYPG and even of the Eastern Interconnection as a whole. This paper provides a very detail-oriented study to prepare a full pathway for applying the technology of multi-band power system stabilizers (MBPSS) to a large industrial interconnection-level power system, the Eastern Interconnection network, with a few selected controllable assets of New York Power Authority (NYPA), including wind generations to improve dynamic stability performance with the emphasis on primary frequency control. The detailed methodology to identify the most effective control devices is outlined. Coordinated tuning of MBPSS is performed. The impact of different wind generation levels on the frequency control is demonstrated. The results show that the technology of the advanced closed-loop control with a limited number of NYPA assets improves the dynamic stability performance of the New York power grid and even of the Eastern Interconnection as a whole. Evaluation of the economic benefit from frequency improvement is analyzed. [ABSTRACT FROM AUTHOR]

The article presents the author's observations on the changes in the eating lifestyle in New York. The author imparts how the economic meltdown brought a gloomy effect on restaurants, especially on their customers. The author shares how she and her friends reminisce the past wherein food allowances are provided when employees are working late and more options are given when they are eating out. Meanwhile, the author also finds out the rarity of bring your own wine (BYO) restaurants in Manhattan.

The article discusses the authors' views about the potential use of value-based pricing strategies and state reform measures to control prescription drug prices in the U.S., and it mentions America's Medicaid health insurance program. The New York State government's authorization of limits on prescription drug costs in 2017 is examined, along with state drug price legislation and Medicaid rebates for brand-name medications.

The article offers information on the report by Appleseed on the impact of the Brookhaven National Laboratory on the economy of Long Island, New York and on the state itself. It says that the report covers fiscal data from October 1, 2008 to September 30, 2009, in which Brookhaven generated 704 million dollars for the state and created 5,400 jobs. Furthermore, it is estimated that the laboratory will generate an income of 947 million dollars in an average annual basis from 2010 to 2014.

Understanding the effectiveness of a school closure in limiting social interaction and the economic impact of school closure on households is critical when developing guidelines to prevent spread of pandemic influenza. A New York City survey conducted in June 2009 in 554 households affected by the 2009 pandemic influenza H1N1–related school closures showed that, during closure, 30% of students visited at least 1 locale outside their homes. If all the adults in the home were employed, an ill child was less likely to leave home. In 17% of the households, at least 1 adult missed some work because of the closure. If all adults in the home were employed, someone was more likely to take time off work. If other children were in the household, it was less likely that an adult took time off work. The findings of our study will be important when developing future pandemic school-closure guidance. [ABSTRACT FROM PUBLISHER]

Reports on the plan of the New York City state government to decrease Medicaid spending. Plan to sell three public hospitals.