Molly Schnell
Assistant Professor of Economics
IPR Fellow - On leave Fall 2024
PhD, Economics, Princeton University, 2018
Economist Molly Schnell examines how incentives and constraints facing both medical providers and consumers influence healthcare access, health behaviors, and health outcomes. Her research encompasses the causes and consequences of provider behavior, and much of her work focuses on the provision of pharmaceuticals in markets across the United States.
Schnell spent 2018–19 as a postdoctoral fellow at Stanford University, after receiving her PhD in economics from Princeton. She has written policy briefs on the opioid crisis for the Harvard Business Review, Brookings Institute, and Stanford Institute for Economic Policy Research. Her research has been published in the Quarterly Journal of Economics, Proceedings of the National Academy of Sciences, Journal of Public Economics, and American Economic Journal: Applied Economics, among others. Media outlets including the Economist, New York Times, Washington Post, and Atlantic have featured her work.
Current Research
The Effects of Competition on Physician Prescribing. In this working paper, Schnell and economists Anran Li and Janet Currie ask how competition influences the prescribing practices of physicians. Law changes granting nurse practitioners (NPs) the ability to prescribe controlled substances without physician collaboration or oversight generate exogenous variation in competition. In response, the researchers find that general practice physicians (GPs) significantly increase their prescribing of controlled substances such as opioids and controlled anti-anxiety medications. GPs also increase their co-prescribing of opioids and benzodiazepines, a practice that goes against prescribing guidelines. These effects are more pronounced in areas with more NPs per GP at baseline and are concentrated in physician specialties that compete most directly with NPs. The authors’ findings are consistent with a simple model of physician behavior in which competition for patients leads physicians to move toward the preferences of marginal patients. These results demonstrate that more competition will not always lead to improvements in patient care and can instead lead to excessive service provision.
Drivers of Racial Differences in C-Sections. In this working paper, Schnell examines why Black mothers are more likely to deliver by C-section than white mothers in the United States. Using data covering over 500,000 births over the course of a decade, Schnell and economists Adriana Corredor-Waldron and Janet Currie show that Black mothers with unscheduled deliveries are 25 percent more likely to deliver by Csection than non-Hispanic white mothers. The gap is highest for mothers with the lowest risk and is reduced by only four percentage points when controlling for observed medical risk factors, sociodemographic characteristics, hospital, and doctor or medical practice group. Remarkably, the gap disappears when the costs of ordering an unscheduled C-section are higher due to the unscheduled delivery occurring at the same time as a scheduled C-section. This finding is consistent with provider discretion—rather than differences in unobserved medical risk—accounting for persistent racial disparities in delivery method. The authors further find that additional C-sections that take place for low-risk women when hospitals are unconstrained negatively impact maternal and infant health.
Selected Publications
Alexander, D. and M. Schnell. 2024. The Impacts of Physician Payments on Patient Access, Use, and Health. American Economic Journal: Applied Economics 16(3): 142–77.
Staiger, B., A. Li, D. Alexander, and M. Schnell. 2022. Enrollment brokers did not increase Medicaid enrollment, 2008–18. Health Affairs 41(9): 1333–41.
Currie, J., M. Schnell, H. Schwandt, and J. Zhang. 2021. Prescribing of opioid analgesics and buprenorphine for opioid use disorder during the COVID-19 pandemic. JAMA Network Open 4(4): e216147.
Rossin-Slater, M., M. Schnell, H. Schwandt, S. Trejo, and L. Uniat. 2020. Local exposure to school shootings and youth antidepressant use. Proceedings of the National Academy of Sciences 117(38): 23484–9.
Alexander, D., J. Currie, and M. Schnell. 2019. Check up before you check out: The impact of retail clinic expansion on emergency room use. Journal of Public Economics 178: 104050.
Allcott, H., R. Diamond, J.-P. Dubé, J. Handbury, I. Rahkovsky, and M. Schnell. 2019. Food deserts and the causes of nutritional inequality. Quarterly Journal of Economics 134(4): 1793–844.
Alexander, D. and M. Schnell. 2019. Just what the nurse practitioner ordered: Independent prescriptive authority and population mental health. Journal of Health Economics 66: 145–62.
Currie, J., J. Jin, and M. Schnell. 2019. U.S. employment and opioids: Is there a connection? In Health and Labor Markets: Research in Labor Economics, 47: 253–80, eds. S. Polachek and K. Tatsiramos (Bingley, U.K.: Emerald Publishing).
