Christopher M. Whaley

@cm_whaley on Twitter

Economist; Professor, Pardee RAND Graduate School

Santa Monica Office

Education

Ph.D. in health economics, University of California, Berkeley; B.A. in economics, University of Chicago

Overview

Christopher M. Whaley is a health economist at the RAND Corporation and professor at the RAND Pardee Graduate School. His research focuses on health care price transparency and market structure and has been published in clinical, health policy, and economics journals. Whaley's research has also been covered in the New York Times, the Wall Street Journal, Forbes, and CNN. He has presented results to state and federal policy makers, including the California State Assembly, the Congressional Budget Office, and the Federal Trade Commission. Whaley received his Ph.D. in health economics from the University of California, Berkeley.

Research Focus

Recent Projects

Innovative Insurance Benefit Designs

Commentary

Modeling and Simulation

We Studied COVID-19 Cases After Birthdays. Family Gatherings Can Still Be Dangerous
The high toll of COVID-19 in the United States is likely partly due to informal social gatherings that have not been subject to state and local restrictions. They are often small, intimate, and involve people we trust. And that makes them dangerous.
Jun 28, 2021
USA Today
Gender Equity in the Workplace

The Link Between Workplace Diversity and the Gender Pay Gap
Many factors explain the gender earnings gap, including workplace biases, differences in how credit is attributed, and differences in how men and women negotiate. But another factor could influence the pay women receive: the number of men in their workplace.
Aug 15, 2020
USA Today
Health Care Access

Non-Emergency Medical Transportation in the Time of COVID-19
More widespread availability of rideshare for non-emergency medical transport may save lives, reserve emergency resources for those who need them, and provide safe pathways to primary care for the chronically ill. It could also save livelihoods, providing employment in a time of economic hardship.
May 5, 2020
The RAND Blog
Health Care Costs

Addressing Surprise Medical Bills Without Raising the Cost of Health Care
Patients who try to stay within their insurers' networks can be hit with surprise bills when they unknowingly receive care from out-of-network physicians. How much should a physician be paid for providing a service that is critical but rendered without the patient's ready ability to choose an in-network provider?
Apr 1, 2019
The Hill
Health Legislation

Removing Maternity Care and Mental Health Treatment from Coverage Requirements Would Reduce Premiums, but Lead to Significant Spending Increases for Some Consumers
The American Health Care Act passed by the U.S. House of Representatives to repeal and replace the Affordable Care Act allows states to waive benefits that the ACA deemed “essential.” Dropping maternity care coverage, for example, would reduce premiums by 5 percent but increase out-of-pocket spending for new mothers.
May 18, 2017
The Commonwealth Fund Blog
Health Insurance Mandates

Can a Continuous Coverage Requirement Produce a Healthy Insurance Market?
A continuous coverage requirement is intended to discourage individuals from waiting until they become sick to purchase insurance. Such a requirement works well in theory to maintain a healthy marketplace, but there is little evidence on how well it might work in practice.
Jan 4, 2017
The Hill

Publications

Journal Article
Association Between Hospital-Physician Vertical Integration and Medication Adherence Rates
Increases in vertical integration were not associated with changes in medication adherence rates. However, adherence rates after vertical integration declined for non-Whites, patients over 80 years old, and patients with greater comorbidities.
Oct 28, 2022
Journal Article
Higher Medicare Spending On Imaging And Lab Services After Primary Care Physician Group Vertical Integration
This study highlights how the growing trend of vertical integration, combined with differences in Medicare payment between hospitals and nonhospital providers, leads to higher Medicare spending.
Sep 20, 2022
Testimony
Health Care Affordability: State Policy Options to Control Costs
Testimony presented before the Texas House of Representatives Select Committee on Health Care Reform on August 4, 2022.
Aug 4, 2022
Journal Article
Linking State Health Care Data to Inform Policymaking: Opportunities and Challenges
This report provides additional detail on the objectives of and use cases for APCDs, the current APCD landscape, and implementation challenges that constrain the use of APCDs for some valuable applications.
Jun 29, 2022
Journal Article
US Health Care Workforce Changes During the First and Second Years of the COVID-19 Pandemic
Health care employment levels declined from 22.2 million in 2019 to 21.1 million, in 2020 but rebounded to 21.8 million in second quarter of 2021.
Jun 22, 2022
Report
Prices Paid to Hospitals by Private Health Plans: Findings from Round 4 of an Employer-Led Transparency Initiative
The lack of transparency of prices in the health care market limits the ability of employers to knowledgeably develop or implement benefit design decisions. This report is designed to allow an easy comparison of hospital prices using a single metric.
May 17, 2022
Journal Article
Trends In Hospital Prices Paid By Private Health Plans Varied Substantially Across The US
We describe how commercial hospital payment rates changed relative to Medicare rates during 2012–19 and how trends differed by hospital referral region.
Apr 20, 2022
Journal Article
The Impact of the COVID-19 Pandemic and Policy Response on Health Care Utilization: Evidence from County-Level Medical Claims and Cellphone Data
Shelter-in-place policies during the COVID-19 pandemic were associated with reductions in the use of preventive care, elective care, and the number of weekly visits to physician offices, hospitals and other health care-related industries.
Mar 31, 2022
Report
Experiences of Health Centers in Implementing Telehealth Visits for Underserved Patients During the COVID-19 Pandemic: Results from the Connected Care Accelerator Initiative
This mixed-methods study followed 45 health centers serving low-income populations for 18 months of the COVID-19 pandemic. Researchers investigated changes in telehealth utilization and health center staff experiences with implementation.
Mar 14, 2022
Journal Article
Female Physicians Earn An Estimated $2 Million Less Than Male Physicians Over A Simulated 40-Year Career
Over a simulated forty-year career, male physicians earned an average adjusted gross income of $8,307,327 compared with an average of $6,263,446 for female physicians—an absolute adjusted difference of $2,043,881 and relative difference of 24.6 percent.
Dec 10, 2021
Journal Article
Physician Compensation In Physician-Owned And Hospital-Owned Practices
Vertical integration of physician practices with hospitals or health systems was associated with lower income for nonsurgical specialists, no difference in income for primary care physicians, and slightly higher income for surgical specialists.
Dec 10, 2021
Journal Article
Association Between COVID-19 Relief Funds and Hospital Characteristics in the US
CARES Act funds may have disproportionately gone to hospitals that were in a stronger financial situation prior to the pandemic compared to those that were not.
Nov 2, 2021
Journal Article
Use of Buprenorphine for Those with Employer-Sponsored Insurance During the Initial Phase of the COVID-19 Pandemic
This study examined changes in the use of buprenorphine to treat opioid use disorder in 2020 during the onset of the COVID-19 pandemic using pharmaceutical claims.
Oct 22, 2021
Journal Article
Trends in Visits to Substance Use Disorder Treatment Facilities in 2020
This study examined weekly changes in the number of substance use disorder treatment facility visits in 2020 compared to 2019, and explored variation in change in weekly visits by COVID-19 incidence and historical fatal drug overdose rate.
Oct 22, 2021
Report
Going to the Doctor: Rideshare as Nonemergency Medical Transportation
The authors examine rideshare's role in nonemergency medical transportation (NEMT) and identify key populations for whom and the types of rides for which NEMT could be a model, rideshare's role in NEMT, and the policies that support such a role.
Oct 12, 2021
Draft
Raising the Stakes: Physician Facility Investments and Provider Agency
Explores medical regulations concerning physician investment in ambulatory surgery centers.
May 26, 2021
Research Brief
Reducing Hospital Spending: Three Policy Options
This Research Brief summarizes the spending impact of policy options to reduce hospital prices paid by private health plans, outlining design choices and effectiveness levels for each approach.
Apr 21, 2021
Research Brief
U.S. Prescription Drug Prices Are 2.5 Times Those in Other OECD Countries
RAND researchers used 2018 prescription drug volume and price data to compare U.S. drug prices with those in 32 other nations, both overall and for specific categories of drugs, such as brand-name and generic medications.
Apr 14, 2021
Journal Article
Who Is (and Isn't) Receiving Telemedicine Care During the COVID-19 Pandemic
COVID-19 has affected telehealth utilization disproportionately. The increase in telemedicine use was greatest among patients in counties with low poverty levels, among patients in metropolitan areas, and among adults compared with children.
Mar 18, 2021
Research Brief
10Plan, How Would It Affect Health Care Spending by Consumers and the Federal Government
The 10Plan is a self-pay plan for individuals currently uninsured or covered by a private nongroup health insurance plan. The authors built a microsimulation model to estimate health care spending under both the status quo and the 10Plan.
Feb 25, 2021
Research Brief
Private U.S. Health Plans Pay Hospitals 247 Percent of What Medicare Would Pay
RAND researchers used data from 49 states and Washington, D.C., to assess hospital prices paid by private health plans. Data sources included $33.8 billion in spending from 3,112 community hospitals—more than half of community hospitals nationwide.
Feb 24, 2021
Report
Impact of Policy Options for Reducing Hospital Prices Paid by Private Health Plans
The authors analyze the spending impact of policy options to reduce hospital prices paid by private health plans, with various design choices and effectiveness levels for each approach.
Feb 18, 2021
Draft
The Doctor Will See You: Online Physician Transformations During COVID-19
Examines physicians use of telemedicine during COVID-19 to quantify physician-level substitution between in-person interactions with patients and virtual interactions.
Feb 16, 2021
Journal Article
Telehealth Use Among Safety-Net Organizations in California During the COVID-19 Pandemic
During the COVID-19 pandemic, visit volume at a sample of FQHCs declined modestly for primary care visits and remained stable for behavioral health visits because telehealth visits replaced in-person visits.
Feb 4, 2021
Report
International Prescription Drug Price Comparisons: Current Empirical Estimates and Comparisons with Previous Studies
This report provides findings related to international prescription drug price comparisons, noting that 2018 drug prices in the United States were substantially higher than those in other countries.
Jan 28, 2021
Report
Analysis of the 10Plan: A Self-Pay System Designed to Minimize the Burden of Health Care Costs
The 10Plan is a self-pay plan for individuals currently uninsured or covered by a private nongroup health insurance plan. The authors built a microsimulation model to estimate health care spending under both the status quo and the 10Plan.
Jan 25, 2021
Report
Balancing Access and Cost Control in the TRICARE Prescription Drug Benefit
The Military Health System provides health and drug coverage to beneficiaries through TRICARE. This report describes the TRICARE pharmacy benefit and the trade-offs in TRICARE pharmacy policies between increasing access and controlling costs.
Jan 14, 2021
Report
Nationwide Evaluation of Health Care Prices Paid by Private Health Plans: Findings from Round 3 of an Employer-Led Transparency Initiative
The authors use data from 2016 to 2018 to document variation in facility prices for the commercially insured population. They report differences in standardized negotiated prices and prices relative to Medicare reimbursement rates.
Sep 18, 2020
Draft
The Extent of Externalities from Medicare Payment Policy
Uses a contemporary bundled payment reform and a difference-in-differences research design to estimate spillovers from Medicare payment reforms to non-Medicare populations.
Sep 9, 2020
Draft
Who Pays for Health Care Costs? The Effects of Health Care Prices on Wages
Leverages geographic variation in health care price growth caused by changes in hospital market structure, and in particular, mergers, to test the impact of health care prices on wages and benefit design.
Jul 28, 2020
Draft
Treatment consolidation after vertical integration: Evidence from outpatient procedure markets
Using detailed physician ownership information and a universe of Florida discharge records, shows novel evidence of hospital-physician integration foreclosure effects within outpatient procedure markets.
Jul 6, 2020
Report
The Price and Spending Impacts of Limits on Payments to Hospitals for Out-of-Network Care
Researchers estimated the effects that four proposed out-of-network payment limits for hospital care would have on negotiated in-network prices and total payments for hospital care.
Mar 12, 2020
Journal Article
Changes in Health Services Use Among Commercially Insured US Populations During the COVID-19 Pandemic
This study found that during the initial phase of the COVID-19 epidemic in March and April of 2020, patients significantly reduced use of preventive and elective care and increased use of telemedicine but not enough to offset reductions in in-person care.
2020
Journal Article
Medical Practice Consolidation and Physician Shared Patient Network Size, Strength, and Stability
Practice consolidation can increase the stability of physician networks, which may have positive implications for organizational effectiveness.
Sep 1, 2019
Report
Prices Paid to Hospitals by Private Health Plans Are High Relative to Medicare and Vary Widely: Findings from an Employer-Led Transparency Initiative
Based on all hospitals analyzed in this report, RAND Corporation researchers found that the prices paid to hospitals by private employer-sponsored health plans rose from 236 percent of Medicare reimbursement rates in 2015 to 241 percent in 2017.
May 9, 2019
Journal Article
First Annual Evaluation Report of the Medicare Advantage Value-Based Insurance Design Model Test: 2017, Year 1 of the Intervention
RAND researchers are evaluating a five-year model test to assess whether value-based insurance design can increase use of high-value services, reduce use of avoidable services, improve quality of care, and improve health outcomes and reduce spending.
2019
Report
Integrating Department of Defense and Department of Veterans Affairs Purchased Care: Preliminary Feasibility Assessment
An integrated approach to purchasing health care for U.S. Department of Defense and U.S. Department of Veterans Affairs could have important implications for access, quality, and costs but could face legislative, policy, or contractual challenges.
Nov 26, 2018
Research Brief
Preliminary Feasibility Assessment of DoD-VA Purchased Care Integration
An integrated approach to purchasing health care for U.S. Department of Defense and U.S. Department of Veterans Affairs could have important implications for access, quality, and costs but could face legislative, policy, or contractual challenges.
Nov 26, 2018
Journal Article
Firm Responses to Targeted Consumer Incentives: Evidence from Reference Pricing for Surgical Services
In response to reference pricing for high-priced surgical providers, the study found some evidence of price reductions.
Oct 17, 2018
Journal Article
Consumer Responses to Price Transparency Alone Versus Price Transparency Combined With Reference Pricing
Reference pricing simplifies the "choice architecture" of health care decision making for patients by steering them to low-priced providers and giving them a financial incentive to comply with the nudge.
Aug 2, 2018
Journal Article
The Moral Hazard Effects of Consumer Responses to Targeted Cost-sharing
A targeted cost-sharing program implemented by the California Public Employees Retirement System led to an increase in the use of low-price colonoscopy providers.
Dec 7, 2017
Report
Challenges to the Sustainability of the U.S. Public Cord Blood System
We describe the existing public cord blood bank (CBB) system, assess current trends and economic relationships from the perspective of stakeholders in the CBB system, and provide recommendations for ways to improve the sustainability of the system.
Sep 29, 2017
Research Brief
Public Cord Blood Banks: Worthy of National Investment
RAND studied trends affecting public cord blood banks and considered changes to the program to buttress banks' financial stability. Researchers found a system worthy of investment, especially if it helps improve the quality of the national inventory.
Sep 29, 2017
Journal Article
Association of Reference Pricing with Drug Selection and Spending
Over an 18 month period, reference pricing for drugs was associated with a reduction in employer spending of $1.34 million but an out-of-pocket spending increase of $0.12 million for employees.
Sep 28, 2017
Report
Toward Improved Management of Officer Retention: A New Capability for Assessing Policy Options
This report documents efforts to implement a capability for the U.S. Department of Defense to assess alternative policies to enhance officer retention provides source code and foundations of a spreadsheet version of the model.
Jul 28, 2014