Research

Working Papers

When Transparency Works: Service Shoppability, Contracting Depth, and the Price Effects of Hospital Disclosure (Job Market Paper)

Abstract: Does publishing negotiated hospital prices lower them? The 2021 CMS Hospital Price Transparency Rule required every U.S. hospital to post them. Using data on 3,723 hospitals and 738 clinical services, I instrument local peer disclosure with the out-of-market rollout timing of health systems present in each market. For shoppable services, whose scope is known before delivery, negotiated prices fall 3.3 to 3.9% per additional local hospital already posting. Nonshoppable services, such as emergency care and surgery, show no response. Price comparability, the mechanism I expected, does not explain this gap. Instead, price declines shrink with contracting depth, the number of insurers with which a service is negotiated. Self-pay cash prices, the posted prices patients act on directly, do not fall, pointing to an effect that travels through the insurer bargaining channel rather than patient shopping.

“The Shadow of Regulation: How Neighboring Inspections and Violations Impact Industrial Air Emissions”

Abstract: Does enforcement at one power plant change behavior at its neighbors? Regulators inspect only a fraction of facilities each year, so activity at one site may shift nearby firms' expectations of scrutiny. Using continuous emissions monitoring data for roughly 1,600 fossil-fuel power plants from 2011 to 2019, linked to federal and state inspections, violations, enforcement actions, and penalties, I use local projections to trace emissions after changes in nearby regulatory activity. I separate total emissions into heat input, a proxy for generation, and the emission rate, which captures pollution intensity. On-site inspections at neighboring plants lower SO₂ and NOₓ emission rates with little change in heat input, suggesting plants operate existing controls more intensively rather than cut generation. Violations, enforcement actions, and penalties instead operate through heat input. The inspection response fades with distance, concentrates in the first four months, and is stronger within the same regulatory jurisdiction. Spillovers depend on the intensity and recurrence of regional enforcement.