Publications
“Anti-Maintenance of Certification Laws and Older Physician Supply” with Shishir Shakya, Edward Timmons, Manu Mathew, Economics Letters, 2024 Download
“Impact of Physician Assistant Scope of Practice Laws on Interstate Mobility and Retentions” with Shishir Shakya, Journal of Labor Research, 2025 Download
Working Papers
Job Market Paper: The Impact of Syringe Service Programs (SSPs) on Bloodborne Diseases and Opioid Mortality: Evidence from States’ Legalization of SSPs between 2008-2023 (with Andrew Hussey)
"The United States has experienced a dramatic increase in drug-related deaths since 2014, along with rising hepatitis C (HCV) infections linked to injection drug use. Meanwhile, HIV transmission among people who inject drugs (PWID) has remained stable over the last few decades. To address these issues, several states have legalized Syringe Service Programs (SSPs) as a harm reduction strategy, but causal evidence on their effectiveness remains limited. This study evaluates the impact of the legalization of SSPs on opioid-related mortality, illicit drug overdose deaths, and HIV and HCV diagnoses using state-level data from 2008 to 2023. Applying an imputation-based staggered difference-in-differences design and dynamic event study methods, we find that SSPs reduce opioid and illicit opioid-related deaths by about 3 per 100,000 adults, with stronger effects among men and African American populations. While the primary estimates for HCV and HIV diagnoses show no impact of SSPs, alternative specifications suggest a decrease in HIV diagnoses among PWID. Robustness checks confirm these findings. Evidence indicates that increased naloxone distribution and improved access to substance use disorder treatment for PWID are likely mechanisms behind the mortality reductions. The findings of the study suggest that the legalization of SSPs can be an effective tool for states to reduce overdose mortality and prevent HIV transmission amidst the opioid crisis.”
Greater Autonomy, Better Access? The Causal Effect of Physician Associate Scope-of-Practice Expansions on Healthcare Access and Cost Barriers (with Han Yu )
"This paper examines the causal effects of expanded scope-of-practice laws for physician associates on healthcare access and utilization among working-age individuals in the United States. We measure treatment as the cumulative count of practice act elements adopted by each state, capturing the intensity and incremental nature of reforms that binary indicators cannot. Using the staggered difference-in-differences estimator of De Chaisemartin and d’Haultfoeuille (2024) and nationally representative individual-level data from the Behavioral Risk Factor Surveillance System (BRFSS) spanning 2012 to 2024, we find that each additional element of PA practice authority reduces the probability of forgoing care due to cost by 0.3 percentage points, with more pronounced effects in urban areas. We find no significant effects on routine checkups, having a personal healthcare provider, or emergency department and outpatient visits. Expanded PA autonomy also leaves malpractice payment records unchanged, providing no evidence of deterioration in care quality. Taken together, these findings suggest that supply-side deregulation through PA scope-of-practice expansion can alleviate financial barriers to care without compromising quality, pointing to its potential as a consumer welfare-enhancing health policy tool.”
More Access, Same Workforce: Evidence from the Physical Therapy Compact (with Shishir Shakya)
"We evaluate the impact of the Physical Therapy compact, an interstate agreement designed to reduce licensure barriers and enhance workforce mobility for physical therapists. We leverage states' staggered adoption of the compact and individual-level geo-coded data on physical therapist practice locations from 2013 to 2025. We find that the compact does not significantly affect state-level aggregates or individual decisions related to entry, exit, or changes in practice location, whether across or within states. However, it improves access, adding approximately 1.4 physical therapists per 10,000 population when measured using car driving duration-adjusted spatial accessibility, with gains concentrated in non-rural areas (1.4 per 10,000) compared to the full sample (0.9 per 10,000). Our findings suggest that the compact enhances service reach without expanding the workforce, while also underscoring the need for complementary policies to address persistent rural access gaps”
Research in Progress
Workplace Violence Prevention Laws in Healthcare Facilities: Impact on Violence Against Healthcare Workers, Physician Supply, and Nurse Migration
New Doctors at Your Door: Can Unmatched Medical Graduates Improve Access to Healthcare in Missouri?
Easing Housing Burdens for Home-Based Childcare Providers: A Path to Affordable Childcare Services
Do Telehealth Payment Parity Laws Improve Labor Market Outcomes for Healthcare Providers? Evidence from State-Level Reforms in the U.S.
Full Practice Authority and Cancer Screening: Evidence from Staggered Adoption of Nurse Practitioner Scope-of-Practice Laws
Expanding Dental Hygienists' Scope of Practice and Preventive Dental Care Utilization: Evidence from North Carolina
The Impact of Medicaid Institutions for Mental Disease (IMD) Exclusion Waivers on Substance Use Mortality
Selected Workshop Presentations
“Impact of Physician Assistant Scope of Practice Laws on Interstate Mobility and Retentions” (with Shishir Shakya), Institute for Human Studies (George Mason University) and Knee Regulatory Center, (West Virginia University), Morgantown, May 2024
“More Access, Same Workforce: Evidence from the Physical Therapy Compact” (with Shishir Shakya), Institute for Human Studies (George Mason University) and Knee Regulatory Center, (West Virginia University), Seattle, Aug 2025
“The Impact of Syringe Service Programs (SSPs) on Bloodborne Diseases and Opioid Mortality: Evidence from States’ Implementation of SSPs between 2008-2023” (with Andrew Hussey), CATO Institute, Washington, DC, Oct 2025, forthcoming
Conference Presentations
“Impact of Physician Assistant Scope-of-Practice Laws on Access to Healthcare in the US” (with Han Yu), 94th SEA, Washington, DC, Nov 2024
“Workplace Violence Prevention Laws in Healthcare Facilities: Impact on Violence Against Healthcare Workers, Physician Supply, and Nurse Migration”, 14th ASHEcon Conference, Nashville, TN, June 2025
“The Impact of Syringe Service Programs (SSPs) on Bloodborne Diseases and Opioid Mortality: Evidence from States’ Implementation of SSPs between 2008-2023” (with Andrew Hussey), 95th SEA Annual Conference, Tampa, FL, Nov 2025, forthcoming
Professional Services
Reviewed 13 conference papers for the 18th South Asian Economics Students’ Meet (Kathmandu, Nepal) 2020 and 2023
Abstracts reviews: ASHEcon 2026
Referee: Journal of Labor Economics (2026)
Research Work Before Joining the PhD Program
“Status of Nepali Migrant Workers in the Destination Countries: Prospects of Earnings and Working Environment” Bikas Udhyami 2019 Download
“Exploring the Avenues for Plastic Waste Management”, United Nations Development Programme (UNDP) 2020 Download
“Behavioral Insights and Impact Study on Pocket Park” , United Nations Development Programme (UNDP) 2021 Download