Leonard Davis Institute for Health Economics

Since 1967, the Leonard Davis Institute of Health Economics (LDI) has been the leading university institute dedicated to data-driven, policy-focused research that improves our nation’s health and health care. Originally founded to bridge the gap between scholars in business (Wharton) and medicine at the University of Pennsylvania, LDI now connects all of Penn’s schools and the Children’s Hospital of Philadelphia through its more than 240 Senior Fellows. LDI’s research focuses on the key themes of insurance reform, health care delivery, healthy behaviors, and vulnerable populations.


Search results

Now showing 1 - 10 of 235
  • Publication
    Could a Public Health Insurance Option Lead to More Competitive Markets?
    (2019-12-10) Pauly, Mark V.
    Calls for the establishment of a “public option,” which emerged during the debate on the Affordable Care Act, have reemerged in this election season. Some proposals base the public option on Medicare, while others on Medicaid. In this article, Wharton professor and LDI Senior Fellow Mark Pauly discusses the likely effects of a public option on private markets, using experience in Medicare Advantage as a guide. Will the public option become the preferred one, sweeping away the private market? Or can the public and private options peacefully coexist?
  • Publication
    Affirmative Action Bans and Health Risk Behaviors
    (2019-07-19) Venkataramani, Atheendar S.; Cook, Erin; O'Brien, Rourke L.; Kawachi, Ichiro; Jena, Anupam B.; Tsai, Alexander C.
    College affirmative action bans were associated with higher rates of smoking and drinking in underrepresented minority 11th and 12th graders, and these students continued to smoke at higher rates into young adulthood. Policymakers should consider unintended public health consequences of proposals, such as affirmative action bans, that may limit socioeconomic opportunities.
  • Publication
    Substance Use Disorder in America: Research to Practice, and Back Again
    (2017-08-01) Miclette, Matthew; Cuan, Isabella; Meisel, Zachary F.
    These proceedings summarize the insights shared by nationally renowned panels of experts and overall themes discussed throughout a substance use disorder conference held at the University of Pennsylvania. The conference included experts from academia and public and private sectors, who came together to discuss the gaps in evidence-based substance use policy and practice, with particular emphasis on the opioid epidemic. The day concluded with an interactive session focused on the exchange of ideas and solutions to curb the opioid epidemic. Those ideas are included in these proceedings
  • Publication
    Lower Health Care Use Among Elderly Patients Residing with Another Adult
    (2019-06-11) Carlin, Caroline; David, Guy
  • Publication
    Transforming Mental Health Care Through Implementation of Evidence-Based Practices
    (2020-05-21) Glickman, Aaron; Weiner, Janet; Beidas, Rinad
    Changing clinical practice is hard, and changing practices within larger organizations is even harder. Increasingly, policymakers are looking to implementation science—the study of why some changes prove more durable than others—to understand the dynamics of successful transformation. In this brief, we summarize the results of an ongoing community-academicpartnership to increase the uptake of evidence-based practices in Philadelphia’s public behavioral health care system. Over five years, researchers found that widescale initiatives did successfully change the way care was delivered, albeit modestly and slowly. The evidence suggests that organizational factors, such as a proficient work culture, are more important than individual therapist factors, like openness in change, in influencing successful practice change. Furthermore, organizations must address staff turnover and burnout, and employees must feel supported in general in order for managers to expect them to change. In short, while practice transformation is possible—even in highly stressed and under-resourced public health settings—it requires focusing on underlying problems within organizations as well as championing new policies.
  • Publication
    Contributors to Post-Injury Mental Health In Urban Black Men With Serious Injuries
    (2019-06-05) Richmond, Therese S.; Wiebe, Douglas J.; Reilly, Patrick M.; Rich, John; Shults, Justine; Kassam-Adams, Nancy
  • Publication
    Opportunities for Precision Cancer: Reflections from the Gant Consortium
    (2018-09-20) Glickman, Aaron; Weiner, Janet
    There is substantial interest in targeted cancer therapies, spurred by recent biomedical research in genomics and oncology. Targeted cancer therapies, in which prevention and treatment of cancer are based on genomic and biologic analyses, hold promise for cancer care. However, the rising costs of such therapies may threaten that promise. In an effort to meet the future challenges of targeted cancer medicine head-on, the University of Pennsylvania convened the Gant Family Precision Cancer Medicine Consortium, a multidisciplinary work group of experts from health care economics, policy, law, regulation, cancer research and medicine, patient advocacy, and the pharmaceutical and insurance industry. The Gant Consortium sought answers to a central question: what approaches should stakeholders take to foster the economic viability and sustainability of targeted cancer drugs? The Consortium literature review was conducted from August through November 2016. The expert committee met regularly from October 2016 to May 2017 to identify points of contention and consensus, outline the issues at the core of sustainable targeted cancer medicine, and inform potential policy recommendations. The literature presented in this report does not include therapies developed afterwards, such as CAR-T. The views expressed in this White Paper reflect the discussions of the Gant Consortium but do not necessarily represent the views of either any individual member or of the Consortium as a whole.
  • Publication
    Supply of Primary Care Providers and Appointment Availability for Philadelphia's Medicaid Population
    (2018-10-23) Candon, Molly; Andreyeva, Elena; Rosenquist, Rebecka; Grande, David
    This brief analyzes the supply of primary care providers serving the Medicaid population in Philadelphia, and the geographic variability of this measure across the city. It also examines important measures of access – appointment availability and wait time for an initial appointment – that highlight challenges faced by Medicaid patients.
  • Publication
    Health Inequity in the United States: A Primer
    (2020-01-06) Escarce, José
    By any measure, the United States has a level of health inequity rarely seen among developed nations. The roots of this inequity are deep and complex, and are a function of differences in income, education, race and segregation, and place. In this primer, we provide an overview of these distinctly American problems, and discuss programs and policies that might promote greater health equity in the population.
  • Publication
    Evaluating A State Opioid Prescribing Limit and Electronic Medical Record Alert
    (2019-10-11) Lowenstein, Margaret; Hossain, Erik; Yang, Wei; Perrone, Jeanmarie; Neuman, Mark D.; Ashburn, Michael; Delgado, M. Kit
    Because long-term opioid use has been linked to the length and strength of an initial prescription, 33 states, Medicare, and some private insurers have set limits on the duration of new opioid prescriptions. In May 2017, New Jersey implemented a statewide 5-day limit on new opioid prescriptions and Penn Medicine implemented an Electronic Medical Record (EMR) alert to notify prescribers when a prescription exceeded the limit and provide compliant prescription orders. This study compared outcomes in Penn Medicine outpatient practices in New Jersey with its practices in Pennsylvania not subject to the law. Outcomes included total opioid dose and number of tablets per prescription as well as rates of prescription refills, health care visits, and telephone calls within 30 days to account for potential unintended consequences.