Impeding Access or Promoting Efficiency? Effects of Rural Hospital Closure on the Cost and Quality of Care. Submitted.
Abstract: Over 15% of hospitals have closed in the past three decades. Hospital closure may improve welfare by reducing costs or reallocating patients to higher-quality hospitals, but may also delay treatment and erode health. This paper considers the efficiency of hospital closure and the efficacy of a federal program designed to limit closures through public subsidies. I study rural closures, where travel costs may induce large health effects. Using a difference-in-differences analysis, I show that closure leads to decreased spending and increased mortality. Hospital subsidies successfully forestalled closure, but inframarginal costs of the program were substantial relative to its health benefits.
How do Physicians Respond to Malpractice Allegations? Evidence from Florida Emergency Departments. Submitted.
(with David Cutler and Anupam Jena)
NBER Working Paper #28330. Ungated Manuscript.
Abstract: The general deterrence effects of malpractice laws on physician behavior have been extensively studied but may lack salience for physicians. We study the role of specific deterrence in malpractice by examining how physicians respond to being accused of malpractice. With the universe of data on patient care and malpractice complaints for Florida emergency physicians, we find that physicians oversee 9% fewer discharges after allegations and treat each discharge 4% more expensively. Effects are similar for paid claims and dropped accusations. Increases in treatment are generalized, i.e., not limited to conditions similar to what the physician is reported for.
Featured in NBER Bulletin on Aging and Health (non-technical summary)
Promoting Access To Hospital Care In Rural Areas: Current Approaches And Ongoing Challenges
(with Tori Berquist and Michael Chernew)
Health Affairs, 2024
Obstetric Care Access at Rural and Urban Hospitals in the United States, 2010-2022
(with Katy Kozhimannil, Julia Interrante, Emily Sheffield, Allysa Fritz, Alecia McGregor and Sara Handley)
JAMA, 2024
Selected Media Coverage: New York Times, ABC News, US News & World Report
Playing by the Rules? Tracking U.S. Hospitals’ Responses to Federal Price Transparency Regulation
(with Sayeh Nikpay, Ezra Golberstein and Jean Abraham)
Journal of Healthcare Management
(with Julia Interrante and Katy Kozhimannil)
Health Affairs Scholar, 2023
Hospital Survival in Rural Markets: Closure, Merger and Profitability
(with Rhiannon Euhus, Nancy Beaulieu and Michael Chernew)
Health Affairs, 2023
Adoption of Innovative Therapies Across Oncology Practices—Evidence From Immunotherapy
(with Mary Beth Landrum, Alexi Wright and Nancy Keating)
JAMA Oncology, 2023
(with Julia Interrante, Lindsay Admon, Carrie Henning-Smith, Phoebe Chastain and Katy Kozhimannil)
JAMA Health Forum, 2022
Reimagining and Reinvesting in Rural Hospital Markets
(with Arrianna Planey and Katy Kozhimannil)
Health Services Research, 2022
COVID-19 Hospitalization Trends in Rural Versus Urban Areas in the United States
(with Yi Zhu, Khoa Vu, Soumya Sen, Archelle Georgiou and Pinar Karaca-Mandic)
Medical Care Research and Review, 2022
Association between Medicaid Expansion and Loss of Hospital-Based Obstetric Services
(with Julia Interrante, Jamie Daw and Katy Kozhimannil)
Health Affairs, 2022
Taking the Pulse of Hospitals’ Response to the New Price Transparency Rule
(with Sayeh Nikpay, Ezra Golberstein, Hannah Neprash and Jean Abraham)
Medical Care Research and Review, 2021.
(with Michael Chernew, A. Mark Fendrick, Joseph Thompson and Sherri Rose)
Journal of Health Economics, 2018
NBER Working Paper #23926. Ungated Manuscript.
Featured in NBER Bulletin on Aging and Health (non-technical summary)
(with Lisa Clemans-Cope, Genevieve Kenney, Matthew Buettgens and Fredric Blavin)
Health Affairs, 2012
Public Investment and Health Care Quality: Evidence from Rural Hospital Subsidies
Effect of System Affiliation on Hospital Choice: Evidence from Rural Markets (with Olivia Moore, Nancy Beaulieu and Michael Chernew)
Spillover Effects of Hospital Closure on Commercial Prices at Surviving Hospitals (with Jessica Chang). Revised and Resubmitted.
Obstetric Care Access Continues to Decline at Rural and Urban Hospitals across U.S. States, 2010-2022 (with Katy Kozhimannil, Julia Interrante, Emily Sheffield, Allysa Fritz, Alecia McGregor and Sara Handley). Submitted.