We study whether mandatory surveys of patient experience affects patient mortality in U.S. hospitals. We exploit two settings where healthcare regulators mandated the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey: the 2003 Maryland pilot study and the 2007 nationwide adoption. Difference-indifferences analyses show increased mortality for hospitals that were subject to the mandate, relative to other comparable hospitals. We observe this effect before hospitals disclose their HCAHPS ratings, which suggests that it is attributable to measurement, rather than to disclosure. An analysis of changes in hospital expenses shows that, after the mandate, affected hospitals experienced a relative increase (decrease) in non-clinical (clinical) expenses. This finding is consistent with theories of multitasking, which predict that more incentives for one task (in this case, patient experience) cause some reallocation of resources from other tasks (clinical care).

ABSTRACT Using data on the registration of clinical trials and the disclosure of trial results, we examine how firms respond to peer disclosures. We find that firms are less likely to disclose their own trial results if the results of a larger number of closely related trials are disclosed by their peers. This relation is stronger if the firms face higher competition (as measured by the number of competing trials). It is weaker if the firms are further along in their research than the peers (as measured by the trials’ phase) and if the peers’ disclosures convey more negative news (as measured by the firms’ stock price reaction). We also find that firms are more likely to abandon ongoing trials if a larger number of peers disclose the results of closely related trials. Additional tests suggest that this real effects channel does not drive the impact on the firms’ disclosure decisions. Data Availability: Data are available from the public sources cited in the text. JEL Classifications: M4.