Our work
We measure how Medicaid rules, hospital ownership, prices and place shape access to cancer care.
Featured research
What our studies show
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First published in JAMA Oncology, 2026
The screenings that won’t happen
New federal Medicaid restrictions could mean about 484,000 missed cancer screenings and 63 excess deaths within two years.
Modeling coverage losses from work requirements and 6-month renewals among Medicaid expansion adults, our base scenario projects that 3.2 million people lose coverage at some point in 2027–2028. The breast, colorectal and lung screenings they miss would leave 952 cancers undetected and 134 more diagnosed at an advanced stage.
484,197 missed screenings
63 excess cancer deaths
- Colorectal20
- Breast31
- Lung11
Updated estimate, October 2026 · updated as new data become available
Read the study: The screenings that won’t happenMore on this study: The screenings that won’t happen
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Health Affairs, 2026
When the hospital is also the insurer
Insurance plans run by health systems negotiated significantly lower prices than traditional insurers for 44 of 46 services with mandatory price reporting.
Using hospital price-transparency data, the study compared prices that provider-sponsored health plans (insurance offered by health systems themselves) negotiated with their health systems against prices negotiated by nonintegrated insurers. In 2023, 179 of 639 US health systems (28.0%) offered an insurance plan, most often Medicare Advantage.
44 of 46 services had significantly lower negotiated prices for provider-sponsored plans than for traditional insurers, 2024
2 not significantly lowerContext, 2023: 179 of 639 US health systems (28.0%) offered an insurance plan.
Read the study: When the hospital is also the insurerMore on this study: When the hospital is also the insurer
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Health Affairs, 2025
After the buyout, more deaths after surgery
After private equity firms bought hospitals, 30-day death rates after four common operations rose 2.7 percentage points compared with similar hospitals.
The rise appeared to be driven by failure to rescue. The death rate among patients who had a complication rose 3.9 percentage points, while complication rates did not change significantly.
Change in 30-day postoperative mortality vs. similar hospitals, in percentage points
+6 +4 +2 0 −2 −4Acquisition Before acquisition From acquisition on−8 −6 −4 −2 0 +2 +4 +6 +8Quarters relative to acquisition
Read the study: After the buyout, more deaths after surgeryMore on this study: After the buyout, more deaths after surgery
Research themes
Studies of coverage, ownership, prices, place and the quality of care.
Our organizing question, the allocation paradox, asks how coverage, ownership and payment quietly decide which patients reach timely, high-quality cancer care.
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Coverage and Medicaid
How eligibility rules, work requirements and insurance status change who is screened, diagnosed and treated.
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Ownership, prices and payment
How quality and spending change when hospitals and practices join systems or are bought by private equity.
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Place and vulnerability
How neighborhood, rurality and historic policy shape access to high-quality cancer care.
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Surgical quality and outcomes
How surgical approach, timing, and the surgeon and hospital shape outcomes after liver, pancreas and emergency operations.