Gautam Gowrisankaran

University of Arizona | UA · Department of Economics

We study healthcare operations of emergency departments (EDs) by examining the practice styles and skills of ED physicians. Our data include all residents of Montreal, Canada, with an initial ED visit in Montreal during a nine-month period. For each visit, our data record the initial treating hospital, ED physician, ED billed expenditures, and all...

The 2010 Affordable Care Act (ACA) instituted incumbent regulation policies in the small group market, where existing health plans could choose to defer compliance with ACA regulations. This created incentives for employers with lower expected healthcare costs and greater uncertainty to not immediately become ACA compliant. We use unique national d...

A “Nash equilibrium in Nash bargains” has become a workhorse bargaining model in applied analyses of bilateral oligopoly. This paper proposes a noncooperative foundation for “Nash-in-Nash” bargaining that extends Rubinstein’s alternating offers model to multiple upstream and downstream firms. We provide conditions on firms’ marginal contributions u...

A key problem with solar energy is intermittency: solar generators produce only when the sun is shining, adding to social costs and requiring electricity system operators to reoptimize key decisions.We develop a method to quantify the economic value of large-scale renewable energy. We estimate the model for southeastern Arizona. Not accounting for...

Many policy makers believe that health status would be improved and health care spending reduced if people managed their health better. This study examined the effectiveness of a program put in place by BJC HealthCare, a hospital system based in St. Louis, Missouri, that tied employees' eligibility to participate in the system's most generous healt...

In healthcare and other bilateral oligopoly markets, prices are often negotiated by the contracting parties. Many hospitals have merged in recent years in part to gain bargaining leverage with managed care organizations (MCOs), leading to several antitrust trials. We specify and estimate a bargaining model of competition between hospitals and MCOs...

This paper seeks to understand the impact of the Medicare Rural Hospital Flexibility (Flex) Program on rural resident hospital choice and welfare. The Flex program created a new class of hospital, the Critical Access Hospital (CAH), which receives more generous reimbursement in return for limits on capacity and length of stay. A hospital that conve...

This amicus brief was filed in Federal Trade Commission v. Phoebe Putney Health System, Inc., in which the FTC has obtained review of an 11th Circuit decision that insulated a merger of two nonprofit hospitals from antitrust scrutiny. We make two arguments in the amicus brief. First, there is no compelling theoretical basis for an antitrust exempti...

This paper develops new econometric methods to estimate hospital quality and other models with discrete dependent variables and non-random selection. Mortality rates in patient discharge records are widely used to infer hospital quality. However, hospital admission is not random and some hospitals may attract patients with greater unobserved severi...

The check clearing and electronic payments systems market are regulated and dominated to various degrees by the Federal Reserve System. This article examines the theoretical and empirical implications of a potential deregulation of this market within the context of three broad effects: price discrimination, network externalities, and anticompetitiv...

This paper seeks to understand the impact of the Medicare Rural Hospital Flexibility (Flex) Program on rural resident hospital choice. The program created a new class of hospital, the Critical Access Hospital (CAH), which receives more generous reimbursement in return for limiting its beds and services. The program's goal is to maintain access to h...

A key problem with renewable energy is intermittency. This paper develops a method to quantify the social costs of large-scale renewable energy generation. The method is based on a theoretical model of electricity system operations that allows for endogenous choices of generation capacity investment, reserve operations, and demand-side management....

We estimate a structural equilibrium model of the automatic teller machine market (ATM) to evaluate the implications of regulating ATM surcharges. We use data on bank characteristics, potential and actual ATM locations, and consumer locations; identify the model parameters with a regression discontinuity design; and develop methods to estimate the...

Abstract This paper comments on “The Price Effects of Hospital Mergers: A Case Study of Sutter–Summit Transaction” by Steven Tenn. I exposit a simple model of differentiated products competition and consider the implications of Tenn’s findings in the context of this model. I find that Tenn provides compelling evidence that the merger led to a price...

We evaluate the impact of the Medicare HMO program and prescription drug coverage on elderly mortality using data from 1993 to 2000. We specify a model of plan entry and benefit choice and Medicare enrollee plan choice and health outcomes. We derive an estimator that is consistent with endogenous plan selection by using the quasi-experimental varia...

This paper seeks to understand the impact of the Medicare Rural Hospital Flexibility (Flex) Program. The goal of this program is to maintain access to hospital care for rural residents. Like many other government policies, the Flex program targets the underlying supply infrastructure, in this case by providing more generous cost-plus reimbursement...

This paper proposes methods for identifying indirect network effects with dynamically optimizing consumers purchasing a durable hardware good and associated software. We apply this model to a data drawn from the DVD player and titles markets. We observe model-level prices, sales and characteristics of DVD players and sales and availability of DVDs...

This paper proposes methods for identifying indirect network effects with dynamically optimizing consumers purchasing a durable hardware good and associated software. We apply this model to data drawn from the DVD player and titles markets. We observe model-level prices, sales and characteristics of DVD players and sales and availability of DVDs at...

This paper develops a framework to analyze the value of information in the context of health plan choice. We use a Bayesian learning model to estimate the impact and value of information using data from a large employer, which started distributing health plan ratings to its employees in 1997. We estimate the parameters of the model with simulated m...

Since 1914, the U.S. Senate has been elected and incumbent senators allowed to run for reelection without limit. This differs from several other elected offices in the U.S., which impose term limits on incumbents. Term limits may harm the electorate if tenure is beneficial or if they force high quality candidates to retire but may also benefit the...

This paper specifies and estimates a dynamic model of consumer preferences for new durable goods with persistent heterogeneous consumer tastes, rational expectations about future products and repeat purchases over time. Most new consumer durable goods, particularly consumer electronics, are characterized by relatively high initial prices followed b...

We seek to determine the causes and magnitudes of network externalities for the automated clearing house (ACH) electronic payments system.We construct an equilibrium model of customer and bank adoption of ACH.We structurally estimate the parameters of the model using an indirect inference procedure and panel data. The parameters are identified from...

In this paper we attempt to distinguish between two popular causal explanations for the volume-outcome relationship—learning-by-doing and selective referral. We perform the analysis for three procedures: The Whipple procedure, Coronary Artery Bypass Graft (CABG) and abdominal aortic aneurysm (AAA) using hospital discharge data from Florida and Cali...

The proliferation of ATMs and the pricing schemes that accompany them have attracted a great deal of attention from research economists, because they shed light on how banks compete against each other in the current environment. By studying the pattern of entry of ATMs in certain markets we can gain insight into the potential welfare consequences o...

Since 1914, incumbent U.S. senators running for reelection have won almost 80% of the time. We investigate why incumbents win so often. We allow for three potential explanations for the incumbency advantage: selection, tenure, and challenger quality, which are separately identified using histories of election outcomes following an open seat electio...

We analyze the extent of network externalities for the automated clearinghouse (ACH) electronic payments system using a panel dataset on bank adoption and usage of ACH. We develop three methods. The first examines the clustering of ACH adoption. The second examines the impact of market concentration and the size of competitors on ACH adoption. The...

We seek to understand the relationship between employer decisions regarding which health plans firms choose to offer to their employees and the performance of those plans. We measure performance using data from the Health Plan Employer Data Information Set (HEDIS) and the Consumer Assessment of Health Plan Survey (CAHPS). We use a unique data set t...

To what extent will an industry in which mergers are feasible tend toward monopoly? We analyze this question using a dynamic dominant-firm model with rational agents, endogenous mergers, and constant returns to scale production. We find that long-run industry concentration depends upon the initial concentration. A monopolistic industry will remain...

We estimate a structural model of the market for automatic teller machines (ATMs) in order to evaluate the implications of regulating ATM surcharges on ATM entry and consumer and producer surplus. We estimate the model using data on firm and consumer locations, and identify the parameters of the model by exploiting a source of local quasi–experimen...

This chapter presents the econometric methods that are used in health economics to model individuals health care costs. These methods are used for prediction, projection and forecasting, in the context of risk adjustment, resource allocation, technology assessment and policy evaluation. The chapter reviews the literature on the comparative performa...

To estimate the effects of competition for both Medicare and HMO patients on the quality decisions of hospitals in Southern California. Secondary discharge data from the Office of Statewide Health Planning and Development for the State of California for the period 1989-1993. Outcome variables are the risk-adjusted hospital mortality rates for pneum...

This paper develops new econometric methods to infer hospital quality in a model with discrete dependent variables and nonrandom selection. Mortality rates in patient discharge records are widely used to infer hospital quality. However, hospital admission is not random and some hospitals may attract patients with greater unobserved severity of illn...

In an effort to produce interoperable products, firms frequently participate in Standard Setting Organizations (SSOs) to collaboratively set technical standards for products used by networks of consumers. Some SSO members say they suffer from a type of holdup: after they sink technology-specific investments in developing and implementing a standard...

Will an industry with no antitrust policy converge to monopoly, competition, or somewhere in between? We analyze this question using a dynamic dominant firm model with rational agents, endogenous mergers, and constant returns to scale production. We find that perfect competition and monopoly are always steady states of this model, and that there ma...

The objective of this study is to estimate the effects of competition for both Medicare and HMO patients on the quality decisions of hospitals in Southern California. We use discharge data from the State of California for the period 1989-1993. The outcome variables are the risk-adjusted hospital mortality rates for pneumonia (estimated by the autho...

In this paper, we estimate the returns associated with the provision of coronary artery bypass graft (CABG) surgery, by payer type (Medicare, HMO, etc.). Because reliable measures of prices and treatment costs are often unobserved, we seek to infer returns from hospital entry behavior. We estimate a model of patient flows for CABG patients that pro...

We estimate a Bayesian learning model in order to assess the value of health plan performance information and the extent to which the explicit provision of information about product quality alters consumer behavior. We take advantage of a natural experiment in which health plan performance information for HMOs was released to employees of a Fortune...

I modify the uniform-price auction rules in allowing the seller to ration bidders. This allows me to provide a strategic foundation for underpricing when the seller has an interest in ownership dispersion. Moreover, many of the so-called "collusive-seeming" equilibria disappear.

This paper presents the structural estimation of a statistical discrimination model. Although the model is capable of displaying multiple equilibria, an estimation strategy that identifies both the parameters of the model and the equilibrium chosen by the economic agents is developed and empirically implemented. A comparison between the equilibria...

We seek to estimate the causes and magnitudes of network externalities for the automated clearinghouse (ACH) electronic payments system, using a panel data set on individual bank usage of ACH. We construct an equilibrium model of consumer and bank adoption of ACH in the presence of a network. The model identifies network externalities from correlat...

This paper develops new econometric methods to estimate hospital quality and other models with discrete dependent variables and non-random selection. Mortality rates in patient discharge records are widely used to infer hospital quality. However, hospital admission is not random and some hospitals may attract patients with greater unobserved severi...

We seek to estimate the effects of competition for both Medicare and HMO patients on the quality decisions of hospitals in Southern California. We find that increases in the degree of competition for HMO patients decrease risk-adjusted hospital mortality rates. Conversely, increases in competition for Medicare enrollees are associated with increase...

Mortality rates are a widely used measure of hospital quality. A central problem with this measure is selection bias: simply put, severely ill patients may choose high quality hospitals. We control for severity of illness with an instrumental variables (IV) framework using geographic location data. We use IV to examine the quality of pneumonia care...

This paper provides a survey on studies that analyze the macroeconomic effects of intellectual property rights (IPR). The first part of this paper introduces different patent policy instruments and reviews their effects on R&D and economic growth. This part also discusses the distortionary effects and distributional consequences of IPR protection a...

I develop a dynamic model of mergers, where mergers, investment, entry, and exit are endogenous variables rationally chosen by firms to maximize expected future profits. This model differs from previous analyses in that it incorporates dynamics and endogenizes the merger process. The model generates reasonable predictions: allowing for mergers has...

Corruption in the public sector erodes tax compliance and leads to higher tax evasion. Moreover, corrupt public officials abuse their public power to extort bribes from the private agents. In both types of interaction with the public sector, the private agents are bound to face uncertainty with respect to their disposable incomes. To analyse effect...

We briefly review the rationale behind technological alliances and provide a snapshot of their role in global competition, especially insofar as it is based around intellectual capital. They nicely illustrate the increased importance of horizontal agreements and thus establish the relevance of the topic. We move on to discuss the organisation of in...

We present a dynamic model of the hospital industry in which nonprofit and for-profit hospitals coexist and compete and are differentiated by their objective functions, investment technologies, and taxation rates. In our model, patients differ by income and type of insurance coverage, and choose admission to their preferred hospital, while hospital...

Many important economic problems require computation over state spaces that are not hypercubes. Examples include industry models of multi-product differentiated product firms, Bayesian learning problems with noisy signals and real business cycle models with heterogeneous agents. These problems have not been analyzed partly because of the difficulty...

For many products the average price paid by consumers during peak demand periods is lower than traditional economic theory would predict. We use digital camcorder sales data to investigate supply-side and demand-side behavior to analyze the low average price phenomenon. This analysis is done on a consumer electronic good, which is extremely seasona...

Many durable consumer goods are characterized by relatively high ini- tial prices followed by rapid declines in prices during the first few years. One possible explanation for this phenomenon is dynamic price discrimi- nation, wherein firms price high early in order to extract surplus from high value consumers, and then gradually lower price. This...