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Selling Subscriptions

American Economic Review 2025 115(5), 1650-1671
We study one benefit to firms of selling subscriptions: the prospect that consumers will continue to pay for subscriptions they no longer value. We use comprehensive data from a large payment card network to document that months during which cards are replaced, when active renewal is required, are associated with much higher rates of cancellation. Using two stylized models of consumer inertia—driven by inattention or switching costs—we estimate that these cancellation frictions roughly double seller revenues on average, holding fixed initial subscribers. We use the estimated models to explore the impact of possible regulatory remedies.

Producing Health: Measuring Value Added of Nursing Homes

Econometrica 2025 93(4), 1225-1264 open access
We develop a stylized model that allows us to estimate a value-added measure for nursing homes ("SNFs") which accounts for patient selection both into and out of a SNF. We use the model, together with detailed data on the physical and mental health of about 6 million Medicare SNF patients between 2011 and 2016, to estimate the value added for about 14,000 distinct SNFs. We document substantial heterogeneity in value added. Nationwide, compared to a 10th percentile SNF, a 90th percentile SNF is able to discharge a patient at the same health level almost a week sooner, or one quarter of the median length of stay. Heterogeneity in value added within a market is almost as large as it is nationwide. Our results point to the potential for substantial gains through policies that encourage reallocation of patients to higher-quality SNFs within their market.

Targeting Precision Medicine: Evidence from Prenatal Screening

Journal of Political Economy 2025 133(2), 604-651
We study the introduction of a noninvasive prenatal screening—cell-free DNA (cfDNA) screening—which is used to target a more costly invasive test that elevates miscarriage risk. Using Swedish administrative data, we document that coverage of cfDNA substantially increases cfDNA screening and reduces invasive testing. We develop and estimate a stylized model of prenatal choices and find that narrow targeting of cfDNA coverage can improve outcomes and reduce costs, while broader coverage also improves outcomes but with increased costs. These findings point to the potential gains from well-designed targeting of screening but at the same time highlight the importance of the targeting design.