Reducing Frictions in Health Care Access: The ActionHealthNYC Experiment for Undocumented Immigrants

Abstract

In 2016, New York City designed and implemented an intervention to reduce 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 increased self-reported access to primary care, leading to 23 percent fewer emergency department (ED) visits. High-risk individuals’ ED visits fell by 32 percent on average, driving the aggregate effect. Preventive care also increased among individuals visiting sponsored clinics. (JEL H75, I11, I12, I13, I14, I18, J15)