Hi there!

I'm an Assistant Professor of Economics at the School of Business and Economics of Universidad de los Andes, Chile.

My research focuses on health care and industrial organizations.

Working Papers

Network Tiering and Hospital Prices: Evidence from Chile's Individual Health Insurance Market (draft available upon request)

(previously titled Equilibrium Effects of Health Insurance Selection on the Hospital Market)

Abstract. How does patient cost sharing shape hospital prices negotiated by private insurers? Using 2012–2025 administrative data covering all private insurers in Chile's individual market, I show that tiered provider networks are prevalent and inpatient prices vary substantially across insurers within hospitals: insurers offering greater coverage pay lower prices, especially at expensive hospitals. An event study provides within-insurer evidence: several years after one insurer was acquired, its coverage profile converged toward industry-standard tiering; at high-priced hospitals, coverage fell and relative inpatient prices rose nearly 50 log points, with no outpatient counterpart. I estimate hospital demand and use the implied derivatives to quantify three forces governing negotiated prices: patient demand, insurer cost exposure, and the pass-through of consumer welfare into insurer revenue. With inpatient demand inelastic and pass-through estimated at zero for corporate insurers, cost exposure is the principal link between coverage and negotiated prices: lower coverage makes price increases less costly to insurers, weakening downward price pressure. The model reproduces the acquired insurer's price-schedule rotation relative to its competitors. At non-preferred hospitals, out-of-pocket spending rises steeply with resource intensity. Lower-income patients requiring resource-intensive care are therefore more likely to substitute toward cheaper providers, consistent with income-dependent access to highly valued hospitals and a mismatch between hospital quality and medical needs in this market.

Sorting on Survival Gains under Cost Exposure [PDF][appendix]

with Dominique Araya Vergara

Abstract. This paper examines whether patients choose private care based on expected health benefits when government-sponsored health care is capacity constrained and access to private providers entails cost exposure. Using individual-level hospital discharge data linked to death records from Chile, we estimate marginal treatment effects of private surgical care on mortality, exploiting a continuous instrument to identify how treatment effects vary with patients' unobserved resistance to private care. We find negative sorting on gains: patients with the largest potential mortality reductions are also the least likely to access private care. Our findings suggest that cost exposure can undermine the efficient allocation of life-saving medical capacity by deterring precisely those patients who stand to benefit most.

Work in Progress

Personalized Childbirth Care and Cesarean Delivery: Evidence from Chile's PAD Program

Summary. Chile has one of the highest cesarean section rates among OECD countries, with especially high rates in the private sector, despite equal reimbursement rates for natural birth and cesarean section. This paper shows that the public-private gap in cesarean delivery is largely attributable to a defining feature of private-style childbirth care: the ability to choose a personalized medical team. The empirical setting is the gradual adoption by Chilean hospitals of Fonasa’s Pago Asociado a un Diagnostico (PAD), a fixed-price bundled payment that allows publicly insured patients to receive childbirth care in participating providers with financial certainty about the final charge. In traditional public hospitals, patients are treated by the medical team on shift. Under PAD, patients can choose their medical team and receive upgraded accommodation. An event-study with staggered difference-in-differences shows that PAD adoption increased cesarean section rates among publicly insured patients in public hospitals by 14.5 percentage points.

The Waiting and Matching Quality Trade-off in Kidney Transplants

Summary. This paper leverages a particular policy in Chile that permits private hospitals that procure deceased donor organs from remote areas to retain one of the two kidneys they receive, prioritizing their own patients. As a result, patients in need of kidney transplantation face different waiting times and matching quality between public and private hospitals: the national list has a longer wait time but better matching quality due to a greater market "thickness" for available kidneys and transplant candidates, whereas the private hospital list has a shorter wait time but lower matching quality. I quantify the tradeoff by comparing the life-years from transplantation between the two sectors, using distance to dialysis centers as an instrumental variable for the binary choice between dialysis and transplantation.