In this paper, we test whether the Affordable Care Act Medicaid expansions are associated with maternal morbidity. The ACA expansions may have affected maternal morbidity by increasing pre-conception access to health care, and by improving the quality of delivery care, through enhancing hospitals' financial positions. We use difference-in-difference models in conjunction with event studies. Data come from individual-level birth certificates and state-level hospital discharge data. The results show little evidence that the expansions are associated with overall maternal morbidity or indicators of specific adverse events including eclampsia, ruptured uterus, and unplanned hysterectomy. The results are consistent with prior research showing that the ACA Medicaid expansions are not statistically associated with pre-pregnancy health or maternal health during pregnancy. Our results add to this story and find little evidence of improvements in maternal health upon delivery.

Managers are often seen as drivers of firm decisions, strategies, and performance. Further, manager characteristics have been linked to employee wages, decisions of mergers and acquisitions, and financial performance. Health care policies in the US often focus on improving quality of care without increasing costs, and yet it is unclear whether hospital managers might contribute to this goal. In this paper, I estimate the differential response to such quality incentives by different types of nonprofit hospital executives, those with and without a clinical training background. I find that hospitals without clinically trained executives respond more to the financial incentives than those with clinically trained executives. I provide evidence that this may be due to differing preferences for profit vs. patient welfare. Thus, incentivizing clinically trained executives in hospitals could be an effective method to improve value in the US health care system.

Technology adoption in health care has the potential to improve patient outcomes, and in some cases, decrease costs. However, new technologies can also be burdensome for physicians. I add to our understanding of how new technology can affect its users by investigating changes in physician behavior as a result of a major technology shift in US hospitals, electronic health records (EHRs). I treat EHR adoption in hospitals as an exogenous shock to hospitalists, and estimate average group time treatment effects on various labor market outcomes. I find that hospitalists are more likely to leave clinical work altogether, and more likely to shift work to an office setting due to EHRs. For hospitalists that continue working in the hospital, EHRs lead to an increase in patients seen. These findings inform the full costs and benefits of technology adoption, relevant to both technology adopters and policymakers who incentivize technology adoption.