Current Projects

I highlight my central workstreams during my doctoral studies below. My agenda uses my prior experience in health equity and applies these lenses to contemporary topics in health policy and services research. My overall agenda is funded by the Robert Wood Johnson Foundation’s Health Policy Research Scholars and the UC Dissertation Year Fellowship and was previously supported by an AHRQ T32 Fellowship.

Surprise Billing and Medical Debt [Dissertation, Job Market Paper]

Surprise medical billing refers to charges incurred when insured patients unknowingly receive care from an out-of-network provider, often resulting in unexpectedly high bills reflecting out-of-network rates. This practice received considerable scrutiny from advocates, news outlets, and policymakers. To address this issue, several states implemented formal processes for settling out-of-network bills in the mid-to-late 2010s. While these laws were intended to reduce catastrophic financial impacts on patients receiving these bills, think tanks and researchers raised the possibility that these laws could inflate costs for OON care, which would then be passed onto patients by payers.

I use a national 2% sample of credit report data from one of the major credit reporting agencies. I use a set of difference-in-differences estimators suited to the staggered implementation of these laws across seven states, using 18 states and DC, which had never implemented any laws restricting surprise billing before the No Surprises Act, as controls. I find that the overall effects of the surprise billing laws implemented before the No Surprises Act increased the percentage of borrowers with any medical debt tradeline >$500. In analyses examining differences by payment benchmark, I found that states with payment benchmarks hypothesized to be inflationary experienced increased percentages of borrowers with any new medical debt. States with deflationary benchmarks experienced no such increase.

Funding: Robert Wood Johnson Foundation - Health Policy Research Scholars Dissertation Award, Horowitz Foundation for Social Policy Research Award

Hospital Ownership and Medical Debt

As part of a collaboration with Ambar La Forgia, Adam Leive, and Elena Prager (University of Rochester). In our first paper, we analyze how differences in hospital and health system characteristics may be associated with medical debt, leveraging markets with single owners to attribute debt to hospitals.

In our second paper, we leverage a linkage of all-payer admissions data and a full “sample” of borrowers in California to examine how ownership change impacts underlying medical debt.

Funding: An extension of this workstream linking all-payer admissions data and a full “sample” of borrowers in California received a 2026 National Institute for Healthcare Management (NIHCM) Research Grant.

Racial and Ethnic Differences in Medical Debt [Dissertation]

Leveraging a novel dataset of credit reports with imputed race and ethnicity from RAND BISG, I study differences in trends in medical debt in collections. These findings are set to be published in Health Affairs Scholar. My coauthors are Jenny Guadamuz, Charleen Hsuan, and Hector Rodriguez.

Funding: Robert Wood Johnson Foundation - Health Policy Research Scholars Dissertation Award, Berkeley Graduate School’s Mentored Research Award

Hospital Ownership and Health Equity [Dissertation]

While studies of ownership change and consolidation largely focus on overall effects on access and quality, fewer studies examine how these impacts may be differentially distributed across different patient populations. To address this gap, I study the impacts of hospital ownership change on access, quality, and safety by a) racial and ethnic group and b) payer coverage. In this study, I leverage a combination of hospital ownership datasets and all-payer admissions from fourteen states.

Funding: Robert Wood Johnson Foundation - Family Policy Hub to Reduce Racial Inequities and Health, NIMHD F31 Award [pending administrative review; score 21]

Past Research

My pre-doctoral research background can be characterized into three major workstreams:

1. Health among Asian Americans, including Filipino/a/x American health specifically
2. HIV in the Philippines, focusing on mental health impacts, policy responses, and health service utilization
3. Substance use among men who have sex with men in the US