Research

 Abstract: How does FDA regulation affect innovation and market concentration? I examine this question by exploiting FDA deregulation events that affected certain medical device types but not others. I collect comprehensive data on medical device innovation, device safety, firm entry, prices, and regulatory changes and enhance these data using text analysis methods. My analysis of these data reveals three key findings. First, deregulation events significantly increased the quantity and quality of new technologies in affected medical device types relative to controls. These increases are particularly strong among small and inexperienced firms. Second, these events increased firm entry and reduced prices for medical procedures that utilize affected medical device types. Finally, rates of serious injuries and deaths attributable to defective devices did not significantly increase following these events. Interestingly, deregulating certain device types was associated with reduced adverse event rates, possibly due to firms increasing their emphasis on product safety in response to increased litigation risk.

Abstract: We investigate the effects of substantial Medicare price reductions in the medical device industry, which amounted to a  61% decrease over 10 years for certain device types. Analyzing over 20 years of administrative and proprietary data, we find these price cuts led to a 25% decline in new product introductions and a 75% decrease in patent filings, indicating significant reductions in innovation activity. Manufacturers decreased market entry and increased outsourcing to foreign producers, associated with higher rates of product defects. Our calculations suggest the value of lost innovation may offset the direct cost savings from the price cuts. We propose that better-targeted pricing reforms could mitigate these negative effects. These findings underscore the need to balance cost containment with incentives for innovation and quality in policy design.

 Abstract: We analyze wartime prosthetic device patents to investigate how procurement policy affects the cost, quality, and quantity of medical innovation.  Analyzing whether inventions emphasize cost and/or quality requires generating new data.  We do this by first hand-coding the economic traits emphasized in 1,200 patent documents.  We then train a machine learning algorithm and apply the trained models to a century's worth of medical and mechanical patents that form our analysis sample.  In our analysis of these new data, we find that the relatively stingy, fixed-price contracts of the Civil War era led inventors to focus broadly on reducing costs, while the less cost-conscious procurement contracts of World War I did not.  We provide a conceptual framework that highlights the economic forces that drive this key finding. We also find that inventors emphasized dimensions of product quality (e.g., a prosthetic's appearance or comfort) that aligned with differences in buyers' preferences across wars.   Finally, we find that the Civil War and World War I procurement shocks led to substantial increases in the quantity of prosthetic device patenting relative to patenting in other medical and mechanical technology classes.  We conclude that procurement environments can significantly shape the scientific problems with which inventors engage, including the choice to innovate on quality or cost.

Abstract: In a California field experiment, I investigated the impact of a Facebook outreach campaign aimed at increasing enrollment in the Supplemental Nutrition Assistance Program (SNAP). The campaign used a promising marketing strategy known as "retargeting," where ads were delivered to a randomly selected subset of over 16,000 eligible non-participants who had nearly completed the SNAP application process, while a control group remained unaffected. Despite leveraging ad content developed in collaboration with non-profit and government partners, the campaign did not produce statistically or economically significant increases in enrollment, even when considering the extreme values of estimated confidence intervals.

Research Question: Are there ways to embed economics into AI models used in health care settings? Our research takes a cost-benefit approach to optimize the use of an AI algorithm that alerts healthcare providers to sepsis cases within a specific diagnostic group, such as heart disease. Our simulations show potential cost savings of $4.6 billion and higher accuracy using our implementation.

Overview: Private equity now plays a major role in health care, but most evidence focuses on providers—not the upstream medical device firms where much of the deal activity occurs. This project provides new causal evidence on how PE ownership affects medical device innovation, with early results showing sizable declines concentrated in highly leveraged buyouts (not growth equity or minority stakes). Ongoing work extends the analysis to device safety and firm performance to understand the broader consequences of PE ownership for medical technology markets.

Overview: U.S. FDA rules often function as de facto global regulation in medical devices, since firms worldwide innovate and produce to access the world’s largest market. This project uses FDA device reclassifications as quasi-experimental shocks to trace how U.S. regulatory loosening propagates internationally—shifting patenting, trade flows, and inventor mobility across countries and global value chains. Early results show large innovation responses in both the U.S. and major foreign jurisdictions, stronger effects for countries more tightly linked to the U.S. via trade, and increased foreign inventor inflows to the U.S.; ongoing work examines how these inflows reshape the direction of R&D and the global availability and safety of new technologies.

Overview: Entry regulation is a first-order determinant of market structure in health care, yet we know much less about how upstream entry barriers reshape negotiated prices and surplus throughout vertically linked markets. This project exploits a major FDA policy change in 2016 that eliminated premarket clearance requirements for ~250 device types to trace how a drop in entry costs propagates from manufacturers to hospitals, insurers, and patients. Early results show sharply higher manufacturer entry, large declines in negotiated device prices, and meaningful pass-through to procedure reimbursements and patient out-of-pocket spending; ongoing work builds a structural entry-and-bargaining model to quantify entry costs and evaluate counterfactual regulatory and consolidation policies.