Research

Tradeoffs in Managed Medicaid scoring auctions

Work in progress.
Awards: Snavely Best Dissertation Proposal Award (2026)
Presentations: UVA Economics Research Colloquium (May 2026), UVA Labor-Public workshop (April 2026)

Abstract: Trillions of U.S. government dollars are allocated through competitive procurements. Many procurements depart from traditional auction designs, awarding on a score (not price) or awarding multiple winners. How does the design of scored auctions shape bidder offerings? I study this question in the context of Managed Medicaid, a publicly funded but privately administered health insurance program. I leverage a novel dataset of over 2,000 bids for Medicaid contracts (2010–2025). I develop a structural model of Medicaid insurer bidding by adapting the standard first-price auction model to a setting with scored awards, multiple winners,  heterogenous bids, and ex-post competition. I characterize how bids would change in counterfactual auctions (fewer winners or alternative scoring rules), and quantify corresponding welfare effects for downstream Medicaid enrollees. Finally, I consider implications of adverse selection. 

Costs of better bidders in competitive procurements: evidence from Managed Medicaid

Work in progress.
Awards: Snavely Distinguished Second Year Paper Prize (2025)
Presentations: ASHEcon Annual Meeting (June 2026), UVA Labor-Public workshop (October 2025)

Abstract: Medicaid programs spend billions of dollars each year providing coverage through contracted health insurers. Yet little is known about whether competition among insurers impacts the costliness or quality of the program. I exploit the 2020 merger of two nationwide Medicaid insurers for plausibly exogenous variation in competition for Medicaid contracts in different geographies. Using a comprehensive, novel dataset of over 2,000 bids for Medicaid contracts (2010–2025), I find that merger-treated geographies attracted one fewer bidder post-merger. Instrumental variables estimates indicate that losing one bidder decreases Medicaid program costs by approximately 12% per year. However, one fewer competing bidder also causes lower-scoring winners (by two percentage points) and reduced prescription drug use among enrollees (by 0.35 filled prescriptions per-person per-year). These results provide new evidence for a cost-quality tradeoff in scored procurement markets: stronger bidder competition may increase quality, but can also increase public program costs.