- Health Economics
- Industrial Organization
Ashvin Gandhi conducts his research predominantly at the intersection of industrial organization and health economics. He is particularly interested in how firm strategy interacts with health care policy and regulation.
One of his recent projects investigates whether health care providers pick their patients. He uses patient-level administrative data on skilled nursing facilities in California to identify and analyze discriminatory admission practices in the nursing home industry. Gandhi finds evidence of selective admission practices that disproportionately harm Medicaid-eligible patients with lengthy anticipated stays, in spite of anti-discrimination laws. He explores the potential effects of proposed policies intended to mitigate these discriminatory practices.
His current work with Shoshana Vasserman and Pierre Dubois asks what would happen if the United States were to regulate pharmaceutical prices to be lower than in other countries. They find that the dominant effect of such a reference pricing policy could influence pharmaceutical companies to raise prices in other countries rather than substantially lower their U.S. prices. They also find that the structure of such a policy plays an important role in its potential effects.
Other recent work of his with Prabhava Upadrashta and YoungJun Song investigates the impact of private equity (PE) ownership in the healthcare industry. They study PE acquisitions of US nursing homes and find that PE owners are more sensitive to competition than non-PE owners. As a result, PE ownership is neither uniformly good nor uniformly bad for patients: when competition is strong, PE owners improve quality relative to non-PE owners, while when competition is weak, PE owners take advantage of their market power by reducing quality. Their findings suggest that concerned regulators should pay particularly close attention to competitive incentives in the markets where PE acquisitions occur.
During the COVID-19 pandemic, Gandhi studied the impact of COVID-19 on nursing homes. His work was some of the first to identify factors associated with nursing home outbreaks, such as facility size, staff size, surveillance testing rates, and staff vaccination rates. His work also measured the degree to which federal data undercounts the number of COVID-19 cases and deaths at nursing homes.
Ph.D. Economics, 2019, Harvard University
B.A. Mathematics and Economics, 2013, Pomona College
"Picking Your Patients: Selective Admissions in the Nursing Home Industry"
- Media Mentions: Anderson Review
"Bargaining and International Reference Pricing in the Pharmaceutical Industry" (with Pierre Dubois and Shoshana Vasserman)
"Private Equity, Consumers, and Competition" (with Prabhava Updrashta and YoungJun Song)
- Media Mentions: Anderson Review, Bloomberg Law
- Related Quotes: AARP
"Have Private Equity Owned Nursing Homes Fared Worse Under COVID-19?" (with YoungJun Song and Prabhava Upadrashta)
- Media Mentions: Bloomberg Law, Freakonomics Radio
"Minimum Wages and Employment Composition" (with Krista Ruffini)
"Healthcare Provider Bankruptcies" (with Samuel Antill, Jessica Bai, and Adrienne Sabety). Preliminary draft available on request.
"The Welfare Consequences of Fake Reviews" (with Brett Hollenbeck). Preliminary draft available on request.
"Beliefs that Entertain" (with Paola Giuliano, Quinn Keefer, Chase McDonald, Michaela Pagel, and Joshua Tasoff). Preliminary draft available on request.
"Employer Vaccine Mandates" (with Katherine Wen, Brian McGarry, Huizi Yu, Maggie Syme, Sarah Berry, Elizabeth White, Vincent Mor, and Ian Larkin). Under Review. Clinical journal embargo. Draft available on request.
"Healthcare Staff Turnover and Quality of Care at Nursing Homes" (with Karen Shen and Brian McGarry). Under Review. Clinical journal embargo. Draft available on request.
“The Effect of COVID-positive Admissions to Nursing Homes” (with Brian McGarry, Mah-Afroze Chughtai, and Michael Barnett). Clinical journal embargo. Draft available on request.
"Covid-19 Surveillance Testing and Resident Outcomes in Nursing Homes" (with Brian McGarry and Michael Barnett). 2023. New England Journal of Medicine.
- Media Mentions: National Institutes of Health, Washington Post, McKnight's
"Can better leadership reduce nursing home staff turnover?" (with Jessica Williams, Jamie Collins, Huizi Yu, Leslie Boden, Jeffrey Katz, Gregory Wagner, and Glorian Sorensen). Forthcoming. Journal of the American Medical Directors Association.
"State Nursing Home COVID-19 Vaccine Mandates, Staff Vaccination Coverage, and Staff Shortages" (with Brian McGarry, Maggie Syme, Sarah D. Berry, Elizabeth M. White, and David Grabowski). 2022. JAMA: Health Forum.
- Media Mentions: Reuters, McKnight's
"Staffing Patterns in US Nursing Homes During COVID-19 Outbreaks" (with Karen Shen, Brian McGarry, David Grabowski, and Jonathan Gruber). 2022. JAMA: Health Forum.
- Media Mentions: USA Today, McKnight's
"Evaluating the Findings of the IMPACT-C Randomized Clinical Trial to Improve COVID-19 Vaccine Coverage in Skilled Nursing Facilities" (with Sarah D. Berry, Keith S. Goldfeld, Kevin McConeghy, David Gifford, H. Edward Davidson, Lisa Han, Maggie Syme, Susan L. Mitchell, Jill Harrison, Amy Recker, Kimberly S. Johnson, Stefan Gravenstein, and Vincent Mor). 2021. JAMA: Internal Medicine.
- Media Mentions: Vox, McKnight's, The Atlantic
"Nursing Home Staff Vaccination and COVID-19 Outcomes" (with Brian E. McGarry, Michael L. Barnett, and David C. Grabowski). 2021. New England Journal of Medicine.
- Media Mentions: Boston Globe, CNN, PBS, NBC, US News & World Report, McKnight's, Anderson Review
"Association of Nursing Home Characteristics With Staff and Resident COVID-19 Vaccination Coverage" (with Brian E. McGarry, Karen Shen, Michael L. Barnett, and David C. Grabowski). 2021. JAMA: Internal Medicine.
- Media Mentions: New York Times, Bloomberg Law, Modern Healthcare
"Estimates of COVID-19 Cases and Deaths Among Nursing Home Residents Not Reported in Federal Data" (with Karen Shen, Lacey Loomer, Hannah Abrams, and David C. Grabowski). 2021. JAMA: Network Open.
- Media Mentions: USA Today, Forbes, The Hill, Associated Press, U.S. News, AARP, McKnight's, Modern Healthcare
"Association between Nursing Home Staff Turnover and Infection Control Citations" (with Lacey Loomer, David Grabowski and Huizi Yu). 2021. Health Services Research.
"Larger Nursing Home Staff Size Linked To Higher Number Of COVID-19 Cases In 2020" (with Brian McGarry, David Grabowski, and Michael Barnett). 2021. Health Affairs
- Media Mentions: Bloomberg Law, Miami Herald, McKnight's, Modern Healthcare, Skilled Nursing News, Annals of Long-Term Care
"High Nursing Staff Turnover in Nursing Homes Offers Important Quality Information" (with David Grabowski and Huizi Yu). 2021. Health Affairs.
- Media Mentions: New York Times, Bloomberg Law, McKnight's, Modern Healthcare, Vox, Politico, Forbes, UCLA Anderson Review
"Characteristics of U.S. Nursing Homes with COVID ‐19 Cases" (with Hannah Abrams, Lacey Loomer, and David Grabowski). 2020. Journal of the American Geriatric Society.
- Media Mentions: Wall Street Journal, Forbes, McKnight's, Provider Magazine, Anderson Review
"Secret Shopper Data on Private Prices in the Nursing Home Industry From 2008 to 2010" (with Lacey Loomer, Fangli Geng, and David Grabowski). 2021. Medical Care Research and Review.
Work in Progress
"Detection, Deterrence, and Adaptation in the Certification of Medical Necessity" (with Maggie Shi)
"Staff Composition and Patient Outcomes at Nursing Homes" (with David Grabowski, Brian McGarry, and Ljubica Ristovska)
"Healthcare Reimbursements and Staffing" (with Andrew Olenski, Krista Ruffini, and Karen Shen)
"Reexamining Income Tax Overwithholding as a Response to Uncertainty" (with Michael Kuehlwein). 2016. Public Finance Review.
"The Political Economy of Legislation on Terrorism" (with S. Brock Blomberg and Gregory Hess). 2011. Defence and Peace Economics