YU-CHU SHEN. Naval Postgraduate School Office: (831) Dyer Road, Code GB

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1 YU-CHU SHEN Naval Postgraduate School Office: (831) Dyer Road, Code GB Monterey, CA Web: EDUCATION Harvard University Ph.D. in Health Policy (field: Health Economics), 2001 Harvard University A.B. with magna cum laude in Applied Mathematics (field: Decision and Control), 1996 PROFESSIONAL EXPERIENCES 2015 present Professor of Economics, Graduate School of Business and Public Policy, Naval Postgraduate School, Monterey, CA Associate Professor of Economics (with tenure), Graduate School of Business and Public Policy, Naval Postgraduate School, Monterey, CA Assistant Professor of Economics, Graduate School of Business and Public Policy, Naval Postgraduate School, Monterey, CA 2004 present Faculty Research Fellow, National Bureau of Economic Research, Cambridge, MA Research Associate, Health Policy Center, the Urban Institute, Washington, DC RESEARCH INTEREST Dr. Shen s research expertise can be summarized in three broad areas in the field of health economics and health policy: (1) analyzing system-level factors that affect access and health outcomes in health care; (2) examining how organizational changes and financial incentives in the health care markets affect provider behaviors. (3) evaluating service-specific risk factors and programs that affect mental health readiness in the U.S. military. PUBLICATIONS IN PEER-REVIEWED JOURNALS 1. Wu, V., Shen, Y., Yun, M-S, and Melnick, G Decomposition of the drivers of the US Hospital spending growth, BMC Health Services Research, 14:230 (DOI: / ). Available at 2. Wu, V. and Shen, Y Long-term impact of Medicare payment reductions on patient outcomes. Health Services Research, 49(5): Previous version: NBER Working Paper # Arkes, J. and Shen Y For better or for worse, but what about a recession? Contemporary Economic Policy, 32(2): Previous version: NBER Working Paper # Howard, D. and Shen, Y Trends in PCI Volume after negative results from a comparative effectiveness research trial. Health Services Research, 49 (1, Part I): Mohan, A., Fazel, R., Huang, P., Shen, Y., and Howard, D Changes in geographic variation in percutaneous coronary intervention (PCI) for stable ischemic heart disease following publication of the COURAGE Trial. Circulation: Cardiovascular Quality and Outcomes, 7: updated 3/2015 1

2 6. Shen, Y. and Wu, V Reductions in Medicare payments and patient outcomes: An analysis of five leading Medicare conditions. Medical Care, 51(11): Wu, V., Shen, Y., and Melnick, G Competitive market forces and trends in U.S. hospital spending, Health, 5(7): Shen, Y., Sim, W., Caughey, A. B., Howard, D. H Can major systematic reviews influence practice patterns? A case study of episiotomy trends. Archives of Gynecology and Obstetrics, 288 (6): Shen, Y., Arkes, J., and Williams, T. V Effects of Iraq/Afghanistan deployments on major depression and substance use disorder: Analysis of active duty personnel in U.S. military. American Journal of Public Health, 102 (March, S1): S80-S Shen, Y. and Hsia, R. Y Does decreased access to emergency departments affect patient outcomes? Analysis of AMI population Health Services Research, 47(1, Part 1): Previous version: NBER Working Paper # Hsia, R. Y. and Shen, Y Rising closures of hospital trauma centers disproportionately burden vulnerable populations. Health Affairs, 30 (10): Melnick, G., Shen, Y., and Wu, V The increased concentration of health plan markets can benefit consumers through lower hospital prices. Health Affairs, 30 (9): Shen, Y. and Hsia, R. Y Association between ambulance diversion and survival of patients with acute myocardial infarction. JAMA, 305 (23): Hsia, R. Y., Kellermann, A., and Shen, Y Factors associated with closures of emergency departments in the United States. JAMA, 305 (19): Hsia, R. Y. and Shen, Y Are there geographical barriers to trauma center access for underserved patients in the United States? An analysis of urban and rural communities. Archives of Surgery, 146(1): Eggleston, K. and Shen, Y Soft budget constraints and ownership: Empirical evidence from U.S. hospitals. Economics Letters, 110 (1): Shen, Y., Arkes, J., Kwan, B., Tan, L. and Williams, T. V Effects of Iraq/Afghanistan deployments on PTSD diagnoses for still active personnel in all four services. Military Medicine, 175 (10): Previous version: NBER Working Paper # Shen, Y. and Hsia, R. Y Changes in emergency department access between 2001 and 2005: Are vulnerable populations more at risk for declines in access? American Journal of Public Health, 100 (8): Shen, Y., Wu, V., and Melnick, G Trends in hospital cost and revenue, : How are they related to HMO penetration, concentration and for-profit ownership. Health Services Research, 45 (1): Previous version: NBER Working Paper # Shen, Y., Hsia, R. Y., and Kuzma, K Understanding the risk factors of trauma center closures: Do financial pressure and community characteristics matter? Medical Care, 47(9): Shen, Y. and Eggleston, K The effect of soft budget constraints on access and quality in hospital care. International Journal of Healthcare Finance and Economics, 9(2): Previous version: NBER Working Paper # Eggleston, K., Shen, Y., Lu, M., Li, C., Wang, J., Yang, Z., and Zhang, J Soft budget constraints in China: Evidence from the Guangdong Hospital Industry. International Journal of Healthcare Finance and Economics, 9(2): updated 3/2015 2

3 23. Shen, Y., Arkes, J., and Pilgrim, J The effects of deployment intensity on post-traumatic stress disorder: Military Medicine, 174 (3): Shen, Y Do HMO and its for-profit expansion jeopardize the survival of hospital safety net services? Health Economics, 18(3): Previous version: NBER Working Paper # Eggleston, K., Shen, Y., Schmid, C., Lau, J., and Chan, J Hospital ownership and quality of care: What explains the different results in the literature? Health Economics, 17(12): Previous version: NBER Working Paper # Shen, Y. and Melnick, G. A Is managed care still an effective cost containment device? Forum for Health Economics & Policy: Vol. 9: Iss. 1 (Frontiers in Health Policy Research), Article 3. pkqdow&result=1 27. Shen, Y., Eggleston, K., Schmid, C., and Lau, J Hospital ownership and financial performance: What explains the different empirical literature findings? Inquiry, 44 (1): Previous version: NBER Working Paper # Shen, Y. and Long, S What s driving the downward trend in employer sponsored health insurance? Health Services Research, 41(6): Shen, Y. and McFeeters, J Out-of-pocket health spending between low- and high-income populations: Who is at risk of having high expenses and financial burdens? Medical Care 44(3): Previous version: NBER Working Paper # Coughlin, T., Long, S., and Shen, Y Assessing access to care under Medicaid: Evidence for the nation and thirteen states. Health Affairs 24 (4): Shen, Y. and Zuckerman, S The effect of Medicaid payment generosity on access and use among Medicaid beneficiaries. Health Services Research 40(3): Shen, Y. and Melnick, G. A The effects of HMO ownership on hospital costs and revenues: Is there a difference between for-profit and not-for-profit plan? Inquiry 41(3): Long, S. and Shen, Y Low-income workers with employer-sponsored insurance: Who s at risk when employers drop coverage? Medical Care Research and Review 61(4): Zuckerman, S. and Shen, Y Characteristics of occasional and frequent emergency department users: Do insurance coverage and access to care matter? Medical Care 42(2): Shen, Y Changes in hospital performance after ownership conversions. Inquiry 40 (3): Holahan, J., Nichols, L. M., Blumberg, L. J., and Shen, Y A new approach to risk spreading via coverage expansion subsidies. American Economic Review 93 (2): Shen, Y The effect of financial pressure on the quality of care in hospitals. Journal of Health Economics 22 (2): Shen, Y. and Zuckerman, S Why is there state variations in employer-sponsored insurance? Health Affairs 22 (1): Shen, Y The effect of ownership choice on patient outcomes after treatment for acute myocardial infarction. Journal of Health Economics 21 (5): Barnett, R. and Shen, Y Gender, high- low-schedule-control household tasks and psychological distress: A study of dual-earner couples. Journal of Family Issues 18 (4): updated 3/2015 3

4 PEER-REVIEWED BOOK CHAPTERS 41. Howard, D. and Shen, Y Comparative effectiveness research, technological abandonment, and health care spending. Advances in Health Economics and Health Services Research, Volume 23: Chosen as an Outstanding Author Contribution Award Winner at the Literati Network Awards for Excellence Eggleston, K. and Shen, Y Ownership and performance of health service organizations: Evidence from hospitals. Global Forum Update on Research for Health, 3rd annual volume: TECHNICAL REPORTS, OTHER MANUSCRIPTS AND POLICY PAPERS 43. Wu, V. Y. and Shen, Y Evaluation of the Impact of Medicare Payment Cuts on Treatment Process and Outcomes for Medicare Patients. Technical Report to Medicare Trustee. Office of Actuary, Centers for Medicare and Medicaid Services. 44. Wu, V. Y. and Shen, Y Evaluation of long-term effects of 1997 Balanced Budget Act inpatient Medicare payment cuts. Technical Report to Medicare Trustee. Office of Actuary, Centers for Medicare and Medicaid Services. 45. Howard, D. and Shen, Y Comparative effectiveness research, COURAGE, and technological abandonment. NBER Working Paper # Shen, Y. and Arkes, J Effects of OEF/OIF deployment intensity on PTSD diagnoses among still active population: Analysis of enlisted and officer population NPS Technical Report, NPS-GSBPP Lin, K. and Shen, Y A game-theoretic model for jamming radio controlled improvised explosive devices. NPS Technical Report, NPS-OR Shen, Y., Waidmann, T., and Zuckerman, S What explains racial and ethnic disparities in insurance coverage and access to care? Manuscript. 49. Zuckerman, S. and Shen, Y Did recent payment rate increases improve access and use among Medi-Cal beneficiaries? Policy Report to the California HealthCare Foundation. 50. Blumberg, L. J. and Shen, Y The effects of introducing federally licensed association health plans in California: A quantitative analysis. Policy Report to the California HealthCare Foundation. Available Shen, Y., Liu, K., Kramer, A., Maxwell, S., Garrett, A. B., and Wissoker, D What explains therapy cost in skilled nursing facilities? The feasibility of using clinical characteristics in a payment system. Interim Analysis Report to the Centers of Medicare & Medicaid Services (CMS). 52. Blumberg, L. J. and Shen, Y Using the Urban Institute s Health Insurance Reform Simulation Model (HIRSM) to produce state-specific results. Report to Robert Wood Johnson Foundation. 53. Blumberg, L. J., Shen, Y., Nichols, L. M., Buettgens, M., Dubay, L. C., and McMorrow, S The Health Insurance Reform Simulation Model (HIRSM): Methodological detail and prototypical simulation results. Final Report to the U.S. Department of Labor, PWBA, July Available at UNDER REVIEW AT ACADEMIC JOURNALS updated 3/2015 4

5 54. Hsia, R. Y. and Shen, Y Access to percutaneous coronary intervention in the United States and risk factors for untimely access (R&R at Health Services Research). 55. Shen, Y. and Hsia, R Ambulance diversion is associated with decreased access to technology, reduced likelihood of intervention, and increased mortality for cardiac patients (R&R at Health Affairs) 56. Cunha, J., Arkes, J., Lester, PB, and Shen, Y. Association between mental resilience and psychological health and attrition from military service (corresponding author). OTHER WORKING PAPERS 57. Shen, Y. and Hsia, R Association between ambulance diversion and racial disparities in access, treatment, and outcomes among patients with acute myocardial infarction. 58. Shen, Y. and Wu, V Readmission rates diverge between hospitals facing small and large payment cuts from Medicare, but the gap closes in recent years. CONFERENCE PRESENTATIONS AND INVITED TALKS 1. Impact of Medicare payment cuts on treatment process and outcomes for Medicare patients, presented at the Center for Medicare and Medicaid Services, Baltimore MD, September Effect of Medicare payment reductions on hospital quality: an analysis of 30-day readmission among five leading Medicare conditions, presented at the Academy Health Annual Research Conference, San Diego CA, June Does decreased access to emergency departments affect patient outcomes? Analysis of AMI population presented at the 4 th biennial conference of the America Society of Health Economists, Minneapolis MN, June The long-term impact of Medicare payment reductions on patient outcomes, presented at the National Bureau of Economic Research Health Care Meeting, Cambridge MA, March Association between ambulance diversion and survival of patients with acute myocardial infarction, presented at the Academy Health Annual Research Conference, Seattle WA, June Effects of Iraq/Afghanistan deployments on major depression and substance abuse: analysis of still active personnel in U.S. military, presented at the Navy Workforce Research and Analysis Conference, Arlington VA, May Effects of decreased emergency department access on AMI health outcomes, presented at the Academy Health Annual Research Conference, Boston MA, June Effects of decreased emergency department access on AMI health outcomes, invited talk at the National Yang Ming University, Taipei Taiwan, June Brief introduction to the U.S. health insurance market and health policy research topics, invited talk at the National Yang Ming University, Taipei Taiwan, June Brief introduction to the U.S. health insurance market, invited talk at the Silicon Valley Taiwanese American Industrial Technology Association 2010 Annual Conference, San Jose CA, May Effects of Iraq/Afghanistan deployments on PTSD diagnoses for still active personnel in all four services, presented at the Navy Workforce Research and Analysis Conference, Arlington VA, May Analysis of system-level risk factors for hospital trauma center closures: , presented at the Academy Health Annual Research Conference, Seattle, WA, June Can managed care depress hospital price? An analysis of HMO market structure , updated 3/2015 5

6 presented at the Academy Health Annual Research Conference, Seattle, WA, June The changing effect of HMO market structure: an analysis of penetration, concentration, and ownership between , presented at the Academy Health Annual Research Conference, Seattle, WA, June From ideas to publications: How to develop and execute a research project in health policy and health economics," presented at the National Yang Ming University, Taipei Taiwan, April The changing effect of HMO market structure: an analysis of penetration, concentration, and ownership between , presented at the National Yang Ming University, Taipei Taiwan, April Do HMO and its for-profit expansion jeopardize the survival of hospital safety net services? presented at the annual INFORMS conference, Seattle, WA, November Effect of soft budget constraints on the survival of hospital safety net services, presented at Stanford University, RIP seminar, October Managed care and cost containment, presented at the National Yang Ming University, Taipei Taiwan, May Financial pressure and the continuity of safety net services, presented at the National Yang Ming University, Taipei Taiwan, October Applications of the propensity score methods in health policy studies, guest lecture at the National Yang Ming University, Taipei, Taiwan, October The effects of managed care and its for-profit expansion on the survival of specialized hospital services. presented at the Stanford Research-in-progress seminar, Stanford CA, October Systematic review of hospital ownership and quality of care: what explains the different results in the literature? presented at the Academy Health Annual Research Conference, Seattle, WA, June Hospital ownership and performance: a quantitative review. presented at the American Society of Health Economists 2006 Conference, Madison, WI, June Is managed care still an effective cost containment device? presented at the Ninth Annual Frontiers in Health Policy Research Meeting, Cambridge, MA, November Is managed care still an effective cost containment device? presented at the Research-in-Progress seminar, Stanford University. Stanford, CA. September Hospital ownership and financial performance: an integrative research review, presented at the Academy Health Annual Research Conference, Boston, MA, June Hospital ownership and performance: an integrative research review, presented at the Research-in- Progress Seminar, Stanford University. Stanford, CA. May What explains racial and ethnic disparity in health insurance coverage and access to care? presented at the American Public Health Association (APHA) Annual Meeting, Washington, DC, November 8, The effects of financial incentives on health care access and quality. Invited talk at the Bureau of National Health Insurance, Taipei Taiwan, March Welfare implications of hospital ownership conversions to for-profit status. Invited talk at the National Health Research Institute, Taipei Taiwan, March Low-income workers with employer-sponsored insurance: Who is at risk when employers drop coverage? presented at the Association for Public Policy Analysis and Management (APPAM) Annual Research Conference, Washington DC, November Welfare implication of hospital ownership conversion to for-profit status, presented at the American Economics Association (AEA) 2003 Annual Meeting, Washington DC, January updated 3/2015 6

7 34. Do insurance coverage and access to care influence emergency room use? presented at the U.S. General Accounting Office seminar series, Washington DC, November Changes in hospital performance after ownership conversions: an application of the propensity score method, presented at the Urban Institute Modeling Group seminar, April The effect of financial pressure on the quality of care in hospitals: evidence from patient outcomes after treatment for acute myocardial infarction, presented at the poster session of NRSA Conference, Los Angeles CA, June TEACHING Graduate School of Business and Public Policy, Naval Postgraduate School. Instructor Economics in the Global Defense Environment (GB3070) Economics for Defense Managers (GE3070) Multivariate Data Analysis I (MN4110) National Yang Ming University, Taipei Taiwan. Instructor Intensive Course on Applied Econometrics for Health Care Data December 2012 Kennedy School of Government, Harvard University. Teaching fellow Regulation and Management in the Health Care System Quantitative Analysis and Empirical Methods SPONSORED RESEARCH National Institute of Health, 1R56HL A1. The Impact of Cardiac Care Regionalization on Access, Treatment, and Outcomes. 9/2014-8/2015. Co-Investigator Navy, Chief of Naval Personnel. Analysis of Suicide Evolution in the Navy Population. 10/2014-9/2015. Principal Investigator. Center for Medicare and Medicaid Services, Office of Actuary. HHSM P. Evaluation of Long Term Impacts of Medicare Payment Cuts Phase II. 9/2013-9/2014. Co-Principal Investigator (with Vivian Wu, USC). National Institute of Health, 1R01HL Effect of Emergency Care Availability on Racial Disparities in Access & Outcomes. 8/2012-4/2016. Principal Investigator. Army, Office of the Deputy Chief of Staff. Evaluation of Army Comprehensive Soldier and Family Fitness Program. 8/2012-9/2015. Principal Investigator. American Heart Association National Clinical Research Program Award. Does ED Access Block Contribute to the Widening of Disparities in Outcomes for Cardiovascular Disease? 01/ /2014. Co-Investigator Center for Medicare and Medicaid Services, Office of Actuary. HHSM P. Evaluation of Long Term Impacts of Medicare Payment Cuts. 10/2011-9/2012. Co-Principal Investigator (with Vivian Wu, USC). Navy Manpower, Personnel, Training and Education Organization (N1 MPT&E). The Effect of updated 3/2015 7

8 Combat Exposure on Reenlistment and Attrition. 10/ /2011. Principal Investigator. Navy Manpower, Personnel, Training and Education Organization (N1 MPT&E). The Effect of Deployment Intensity on the Prevalence of Depression and Substance Abuse incidences in the Active Duty Population: / /2010. Principal Investigator. Navy Manpower, Personnel, Training and Education Organization (N1 MPT&E). Economic Analysis of Post-Traumatic Stress Disorder in the GWOT Environment. 2/2009-9/2009. Principal Investigator. The Joint IED Defeat Organization. Game-Theoretic Models for Jamming RCIEDs and Red Teaming. 1/2008-6/2009. Co-Principal Investigator (with Kyle Lin, NPS). Robert Wood Johnson Foundation (HCFO), # Effects of Decreased Emergency Department Access on Patient Outcomes. 4/ /2010. Principal Investigator. UCSF, grant #UL1 RR Socioeconomics Disparities in Access to Emergency and Trauma Care. 6/2008-6/2009. Co-Investigator. Naval Postgraduate School GSBPP Direct Funded Research Program. Economic Analysis of Post- Traumatic Stress Disorder in the GWOT Environment. Principal Investigator. Robert Wood Johnson Foundation (HCFO), # The Effect of Health Plan Concentration on Hospital Prices, Costs, Capacity, Charity Care and Outcomes. 2/2006-1/2008. Co-Principal Investigator (with Glenn Melnick, USC). Naval Postgraduate School Research Initiative Program. Effects of Organizational and Market Changes on Hospital Behavior. 10/2004 9/2006. Principal Investigator. Robert Wood Johnson Foundation (HCFO), # Hospital Ownership and Performances: An Integrative Research Review. 6/ /2005. Co-Principal Investigator (with Karen Eggleston, Tufts). University of Southern California, # Analysis of Hospital Data. 1/2002-8/2004. Principal Investigator. PROFESSIONAL ACTIVITIES NPS 2011 present 2011 present 2012 present Academic Associate, Manpower System Analysis Curriculum GSBPP Faculty Instruction Committee GSBPP Faculty Development Committee REFEREE Journal of Health Economics, Health Economics, Inquiry, Health Services Research, Journal of American Medical Association, Health Affairs, Health Policy, Contemporary Economic Policy, Journal of Health Care for the Poor and Underserved, Southern Economic Journal, Forum for Health Economics & Policy, Health Economics, International Journal for Equity in Health, Journal of Economics and Management Strategy, Social Science & Medicine, Medical Care CONFERENCE COMMITTEE updated 3/2015 8

9 2008 Abstract review committee, Academy Health Annual Research Conference 2005 Session Chair: Health Disparity and Access to Care. International Conference on Health Policy Research, sponsored by the American Statistical Association. FELLOWSHIPS & HONORS PERSONAL 2014 Naval Postgraduate School Menneken Faculty Award for Excellence in Scientific Research 2011, 2014 Naval Postgraduate School GSBPP Special Act Award 2008 Naval Postgraduate School GSBPP Significant Contributor Award Hauser Center Fellowship for Doctoral Studies in the Nonprofit Sector 1999 Harvard Graduate Society Fellowships, Term-Time Dissertation Fellowship Alfred P. Sloan Foundation Fellowship 1998 Harvard Graduate Society Fellowships, Summer Awards Harvard Ph.D. Program in Health Policy Fellowship Female; Fluent in English and Mandarin; US citizen. updated 3/2015 9