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Reducing Frictions in Healthcare Access: The ActionHealth NYC Experiment for Undocumented Immigrants

Author

Listed:
  • Jonathan Gruber
  • Adrienne Sabety
  • Rishi Sood
  • Jin Yung Bae

Abstract

In 2016, New York City designed and implemented an intervention reducing frictions in accessing safety-net care: randomly making initial primary care appointments for 2,428 undocumented immigrants. We leverage a novel survey-administrative data linkage to show that the program resulted in a more efficient allocation of care. The program increased self-reported access to primary care, leading to a 21% fall in emergency department (ED) use. This effect was driven by high-risk individuals whose ED visits fell by 42% on average. Among those visiting sponsored clinics, chronic condition diagnoses and preventive screens increased, positively affecting long-run health.

Suggested Citation

  • Jonathan Gruber & Adrienne Sabety & Rishi Sood & Jin Yung Bae, 2022. "Reducing Frictions in Healthcare Access: The ActionHealth NYC Experiment for Undocumented Immigrants," NBER Working Papers 29838, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:29838
    Note: CH EH LS PE
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    Cited by:

    1. He, Chengxu & Liang, Yinhe & Wang, Gefei, 2025. "Reshaping Migrant-Native Health Disparities: evidence from the hukou reform in China," World Development, Elsevier, vol. 195(C).
    2. Andrea Bernini & Navid Sabet, 2025. "Climbing the Political Ladder with Legal Status: Evidence from the Immigration Reform and Control Act," CESifo Working Paper Series 12081, CESifo.
    3. Anders Anell & Margareta Dackehag & Jens Dietrichson & Lina Maria Ellegård & Gustav Kjellsson, 2025. "Better off by risk adjustment? Socioeconomic disparities in care utilization in Sweden following a payment reform," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 44(3), pages 836-868, June.
    4. Bancalari, Antonella & Bernal, Pedro & Celhay, Pablo & Martinez, Sebastian & Sánchez, Maria Deni, 2023. "An Ounce of Prevention for a Pound of Cure: Efficiency of Community-Based Healthcare," IZA Discussion Papers 16350, Institute of Labor Economics (IZA).
    5. Sabety, Adrienne, 2023. "The value of relationships in healthcare," Journal of Public Economics, Elsevier, vol. 225(C).

    More about this item

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J15 - Labor and Demographic Economics - - Demographic Economics - - - Economics of Minorities, Races, Indigenous Peoples, and Immigrants; Non-labor Discrimination
    • J61 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Geographic Labor Mobility; Immigrant Workers

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