Regulators are testing many payment reforms to improve US healthcare productivity. The vast majority of these reforms allow market participants to opt in rather than mandating participation. Allowing choice can enhance outcomes if firms select contracts based on unobserved treatment gains....

Voluntary participation is a central feature of reforms being tested across US healthcare. Allowing choice can enhance effects if participants sort on unobserved treatment gains. However, selection may also bias program evaluation, misleading policymakers. We study this trade-off in the case of...

Privatization has been shown to increase growth and profitability of public firms. However, effects on consumers are understudied. We study potential trade-offs in the US hospital sector where public control declined by 42% over 1983-2019. Private operators may improve hospitals' financial...