Megdalynn Fisher

Megdalynn Fisher

PhD Candidate

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Workshop Preview

Adobe-based newsletter created to promote the Health Policy Workshop’s Spring semester

publications

The Hope of Mankind

Published in The Journal of Student Leadership

In the inaugural edition of the Journal of Student Leadership we pause to ponder what student leadership is and what students can contribute toward the future of leadership and leadership studies.

Recommended citation: Fisher, Megdalynn. (2017). "The Hope of Mankind." The Journal of Student Leadership. 1(1). https://journals.uvu.edu/index.php/jsl/issue/view/1

talks

The Hope of Mankind

Published:

Fisher, Megdalynn. “The Hope of Mankind,” Oral recitation at the celebration of the inaugural edition of The Journal of Student Leadership, Orem, Utah, April 20, 2017.

An Advocacy Coalition Framework Approach to Section 340B

Published:

The Section 340B Drug Pricing program is often criticized and defended by various stakeholders. As a program with a nuanced history, growing footprint, poor targeting, and unintended consequences, I explore the program’s development, implementation, and evaluation using an Advocacy Coalition Framework to conceptualize the public policy process.

Tribal Self-Governance and COVID-19 Outcomes

Published:

Does tribal self governance improve COVID-19 outcomes among Native American and Indigenous American populations? I present early findings on collaborative work with Patrick Carlin.

Hospital Competition, Quality, and Municipal Debt: Do Non-Profit Hospitals Utilize Municipal Market Credit Access to Fund Competition on Quality

Published:

Using the variation of municipal governments’ credit ratings, I examine associations between Hospital Compare quality ratings, market concentration, and nonprofit hospital municipal market bond issuance to identify the effects of hospital quality measures on bond issuance. Findings include higher bond issuance in counties with lower reported hospital quality.

Public Reporting of Nursing Home Antipsychotic Use: Changes in the Reporting of Exclusionary Diagnoses?

Published:

Following the public reporting of Antipsychotic Medication (APM) use in nursing homes, we document an increase in prevalence of schizophrenia diagnos, a diagnosis which excludes facilities from the public reporting requirement for these residents. Public reporting is designed to reduce off-label use of APMs, increases in schizophrenia diagnosis are an unintended consequence of the policy that may be attributed to either more accurate diagnosis or upcoding.

Racial and Ethnic Segregation in Nursing Homes

Published:

In this presentation, we discuss our upcoming contribution to the literature measuring and understanding drivers of racial and ethnic sorting (segregation) in the health care setting by constructing dissimilarity indices (DI) for nursing homes. The dissimilarity index, a commonly used measure in residential segregation studies, ranges from 0 to 1 and in our context describes the share of patients in a health care market who would have to switch homes in order for there to be evenness (no segregation) across the providers in that market. Prior work has computed the DI in healthcare settings but provides limited evidence on how the DI varies across geographic areas and/or is based on data more than a decade old. We combine administrative data on all certified nursing homes in the U.S. with health assessments of long-term stay patients residing in those homes for the years 2011 and 2017. Geographically, we define a nursing home market to be a county.

teaching

Public Management Economics, MPA-612

Graduate Teaching Assistant, Brigham Young University, Romney Institute of Public Service and Ethics

Course support, lab direction and tutoring, assignment grading for Dr. Andrew Heiss. By the end of this course, you will (1) be literate in fundamental economic principles, (2) understand the limits of economic theory and free markets, (3) justify government and nonprofit intervention in the economy, and (4) make informed policy recommendations by analyzing and evaluating public sector policies.
MPA-612

Contemporary Economic Issues in Public Affairs, SPEA-V202

Associate Instructor (Instructor of Record), Indiana University, O'Neill School of Public and Environmental Affairs

Spring Semester (3 cr.)
This course reinforces and deepens economic skills by applying basic microeconomic concepts and models to a variety of policy areas. Using economic models, students in the course will examine the motivation for intervention in the economy, the types of intervention, and the predicted effects of policies.
Policy areas covered will include tax, social, health, regulatory, environmental, and trade policy, among others. To better understand these issues, the course will first briefly discuss some of the institutional details of the policy area, and then use economic models to examine impact of policy on behavior and market outcomes.

wip

End of Life Inpatient Spending and Hospital Advertising

Work in Progress: under review

Does hospital advertising inform patient choice or represent ‘cheap talk’? We investigate the hospital advertising at the market level, establishing a correlation with end-of-life inpatient spending, a proxy for geographical differences in hospital spending on care with a uniform outcome.

Recommended citation: Freedman, Seth, Victoria Perez, Megdalynn Fisher. "End of Life Inpatient Spending and Hospital Advertising" under review .

Antipsychotic Medication Use Among Nursing Home Residents with Alzheimer’s Disease and Related Dementias: Ownership Structures and Racial Disparities

Work in Progress: working paper

Are nursing home residents with Alzheimer’s disease and related dementias (ADRD) receive antipyschotic medications more often than residents with other severe mental illnesses? What disparities in treatment through antipsychotic medications are present in nursing homes? We explore the relationships between race, payment, dementia, serious mental illness, and ADRD.

Recommended citation: Bowblis, John, Megdalynn Fisher, Shruthi Jayashankar, Judith Lucas, Kosali Simon. "Antipsychotic Medication Use Among Nursing Home Residents with Alzheimer's Disease and Related Dementias: Ownership Structures and Racial Disparities." work in progress.

Nursing Home Use of Antipsychotics: Does Public Reporting Incentivize Gaming?

Work in Progress: working paper

The number of nursing home residents with schizophrenia has increased due to their exemption from the requirement for antipsychotic medication quality reporting. Since public reporting incentivizes either more accurate diagnosis or upcoding, we examine these effects at the reporting threshold based on number of residents in the facility.

Recommended citation: Bowblis, John, Megdalynn Fisher, Kosali Simon. "Nursing Home Use of Antipsychotics: Does Public Reporting Incentivize Gaming?" work in progress.

Government Intervention in Nursing Homes: Assessing Ownership Dynamics and Quality of Care Under Non-State Government Owned Supplemental Payment Programs

Work in Progress: working paper

Do subsidies through Non-State Government Owned nursing facility supplemental payment programs spur government acquisitions and do the subsidies translate to fewer deficiencies and better quality?

Recommended citation: Fisher, Megdalynn. "Is Government Acquisition of Nursing Homes an Improvement? Medicaid Supplemental Payments to Non-State Government-Owned Nursing Facilities, Quality, and Enforcement" work in progress.

Racial Sorting Among Nursing Home Residents

Work in Progress: working paper

We contribute to the literature measuring segregation in the health care setting by constructing dissimilarity indices (DI) for nursing homes and counties to examine relationships with income inequality, reliance on Medicaid, urbanicity, and quality.

Recommended citation: Bowblis, John, Megdalynn Fisher, and Kosali Simon. "Racial Sorting Among Nursing Home Residents" work in progress.