I am an Assistant Professor in the Division of Health Economics and Policy of the Department of Population Health Sciences at Augusta University.
I am an applied micro economist. My research agenda focuses on health and health care. It consists of experiments that advance the science of economics and identify implementable policy to contain health care costs and maximize the value of money spent on health care. I have a particular interest in investigating health disparities, and heterogeneity of health behaviors across different subgroups. My work examines both the supply and demand sides as well as the market institutions that shape how they meet. While my general focus is on health and health care, much of my work has implications on other areas, such as labor, finance and environment and broader policy.
Laboratory experiments offer the control of exogenous variation without confounding factors, so are an invaluable tool for testing policy, particularly in an area like health where it can take decades to realize outcomes of investments and prevention efforts. Informed by observational studies, and proceeding expensive and lengthily field experiments, laboratory experiments are a valuable complement to other research modalities. The laboratory also offers the ability to control and manipulate variables, so can be very useful in testing which attributes or mechanisms drive health disparities, when group differ in many ways, in observational data. By analyzing human subjects' responses, we gain insight into how policy is perceived, and better simulate long-term impacts. This saves time, money and lives when impacts are uncertain. For a research program with collaborators at the Economic Science Institute, I helped create a laboratory environment modeling the intertemporal tradeoffs people face when making health decisions. One of the most immediate priorities was to test the benefits and drawbacks of cost sharing in insurance. An Experimental Investigation of Health Insurance Policy and Behavior (PLoS, 2021), we test offering actuarially fair insurance to offering employer-based insurance. We find the latter performs better than predicted because, while it suffers the expected moral hazard, it largely alleviates the need for long-term planning which subjects cannot do well. Moral hazard costs are also smaller than predicted, because subjects in the actuarial treatment did not respond to price incentives to improve health behaviors. We plan to utilize the environment to tests many more policies and theories. We have already run some sessions for Determinates of Effort to Prevent Chronic Disease, a Laboratory Experiment in which we introduce chronic disease, and increasing (vs. flat) income. We have also piloted Measuring Real Effort and Estimating Marginal Value for Daily Life Activities, a "hybrid" (field and lab) experiment in which subjects' health decisions are no longer stated, but actually exercise as measured by accelerometers (Fitbits). We are planning to explore the impact of non-financial incentives, including but not limited to social and cultural factors.
My research agenda aims to illuminate how behavioral economic principles, such as framing, impact behavior in markets and market outcomes. A Reassessment of the Potential for Loss-Framed Incentive Contracts to Increase Productivity: a Meta-Analysis and Real-Effort Experiment is a refinement and continuation of research in my dissertation. In our meta analysis we find that loss framing has a much larger effect in laboratory experiments than in field experiments. We find evidence consistent with publication bias, particularly for the laboratory studies. In a high-powered laboratory experiment, we find an effect that is only 0.1 SD, much smaller than the 0.4 SD from the meta-analysis of lab studies. However, the estimate from our experimenter is consistent with the trim and fill estimate, which attempts to correct for publication bias. I have similar work in progress examining default nudges. Although this research is framed as a labor market experiment, the insights it offers about behavioral nudges and their limitations have implications for the potential to apply loss-framing as part of health and environment policy, or any setting in which incentives are used to induce effort.
One line of my research agenda explores how conflicts of interest impact market outcomes and what is helpful in mitigating any bias. Keeping a Clean Reputation: More Evidence on the Perverse Effects of Disclosure was peer-reviewed and accepted into The Center for Growth and Opportunity at Utah State University working paper series, and has been submitted to the American Law and Economics Review. The paper expands upon my dissertation, investigating issues regarding gifts to prescribers with laboratory experiment. However, the model generalizes to most situations in which advice is sought from an expert with a conflict of interest, e.g., a consumer seeks advice from a professional (doctor, lawyer, financial advisor) who might have greater profit if a particular course of action is taken. Our experiment tests how market competition and reputation’s ability to discipline experts who have incentives to give biased advice. We find that even when experts (agents) have conflicts of interest within a competitive environment, consumers use ratings to select agents and punish dishonest agents, resulting in unbiased advise. In contrast, within the same environment, disclosure of the conflict of interest produces biased advice. Additionally, we find that when conflicts of interest are endogenous, consumers use only ratings, and not disclosure of potential conflicts, to select agents.
My research pipeline has projects in various states of development. I have a paper on overconfidence, which we are close to circulating a draft. We elicited overconfidence regarding outcomes of rock-paper-scissors games. I hope to build upon the findings and examine how overconfidence manifest itself in health behaviors. I also hope to develop life-cycle environments that utilize Fitbit data as an input for simulated health. I have just developed software to elicit social norms and test how well they predict behavior in principal-agent scenarios with punishment. I am also interested in how social norms impact health decisions and how these norms could be leveraged to achieve healthier behaviors. I am designing experiments to test how team incentives and communication could encourage healthier behavior, and whether messaging persist after incentives are removed. The ultimate goal of my research agenda is to provide innovative and scientifically-based policy recommendations that can be piloted and implemented. I am excited by the possibilities a new institution presents to expand my network of collaborators and to incorporate new perspectives into my research.