NIHCM Awards $500,000 to Support Research on AI Scribes, Perinatal Market Concentration, Specialty Drug Pricing, and More.

Washington, DC – February 10, 2026 – The 2025-2026 cohort of NIHCM Research Grantees will generate novel, policy-relevant evidence on health care affordability, access, and quality. This year’s grantees will investigate a range of pressing health care issues, including the adoption of GLP-1 medications and downstream spending; the impact of ambient AI scribes on spending and productivity; the relationship between hospital characteristics and medical debt; the effects of insurance coverage in adulthood on later-life health care spending; and the impact of private equity ownership of medical technologies.

“We are excited to support the work of this outstanding group of researchers. Their insights will help policymakers, health plans, and health systems make more informed decisions to improve health care affordability and quality, while addressing the rising costs of care,” said Andrew Dreyfus, CEO and President of NIHCM. 

The NIHCM Foundation is a nonprofit, nonpartisan organization dedicated to improving health care through evidence and collaboration.

2025 - 2026 Grantees:

The Impact of Hospital Mergers and Acquisitions on Consumer Finances 

Nearly one in five US households has medical debt in collections, yet little is known about the role of hospital ownership and consolidation. This study will examine the relationship between hospital characteristics (such as whether a hospital is for-profit or nonprofit) and medical debt, and estimate the causal effect of hospital mergers and acquisitions on consumer finances.

• Ambar La Forgia, University of California, Berkeley
• Adam Leive, University of California, Berkeley
• Elena Prager, University of Rochester
• Alexander Adia, University of California, Berkeley

GLP-1 Adoption and Its Downstream Effects on Health Spending and Utilization Among Privately Insured Adults with Diabetes and Obesity 

The rise of GLP-1 medications is contributing to the rapid growth in spending. This study will estimate the impact of GLP-1 initiation on downstream (non-GLP-1) health care spending and clinical utilization among commercially insured adults with type 2 diabetes or obesity. The study will provide evidence on whether GLP-1 use “pays for itself” in real-world settings.

• Coady Wing, Indiana University
• Sih-Ting Cai, Indiana University
• Daniel W. Sacks, University of Wisconsin - Madison
• Kosali I. Simon, Indiana University

Ambient AI Documentation and Billing Intensity: Evidence from Commercial Claims 

Ambient listening AI scribe tools are rapidly growing in use, and early reports indicate reduced charting time and higher clinician satisfaction, but ambient AI may also increase coding intensity, leading to higher reimbursement. Using a novel physician survey and commercial claims data, this study will provide a multi-site assessment of ambient AI’s effects on coding intensity related to billing and quality outcomes of adopting hospitals.

• Tinglong Dai, Johns Hopkins University
• Daniel Polsky, Johns Hopkins University

The Effect of Ambient AI Scribes on Productivity, Coding Intensity, and Spending

Ambient scribes may alleviate clinician documentation burden and improve patient satisfaction by facilitating better clinical interactions. However, they may also increase health care spending due to increased clinician productivity or more intensive service and diagnostic coding. This study will analyze the effect of ambient scribes on visit volume, diagnostic coding, share of high-intensity visits, and total and per-visit spending. By analyzing these outcomes in multiple sources of nationwide data on publicly and privately insured populations, this analysis will provide policymakers with the evidence necessary to encourage innovation without sacrificing affordability.

• Hannah Neprash, University of Minnesota
• Paige Nong, University of Minnesota

The Impact of Insurance Coverage in Adulthood on Later-Life Health Care Spending: Evidence from the Affordable Care Act’s Medicaid Expansion

The US faces a critical challenge: how to control rising health care spending as the population ages. This study will examine whether expanding insurance coverage earlier in adulthood impacts health care spending later in life, using the expansion of Medicaid eligibility under the Affordable Care Act as a natural experiment. The project will assess savings to Medicare attributable to earlier Medicaid coverage, using linked Medicaid and Medicare claims data to provide policymakers with estimates of federal budget impacts.

• Yasin Civelek, Cornell University
• William Schpero, Cornell University

COMPASS – Creating Optimal Markets for Perinatal Analysis of Service Systems Amid Concentration from Hospital Closures

Provision of obstetric care has declined nationally, creating a risk for perinatal market concentration. Maternal and infant mortality rates have also increased, with persistently high costs. This study will examine how changes in market concentration due to hospital and service line closures influence care charges and outcomes for individuals who gave birth and their babies. 

• Elizabeth G Salazar, Children’s Hospital of Philadelphia (CHOP) and University of Pennsylvania
• Scott Lorch, CHOP and University of Pennsylvania
• Nicolas Goldstein Novick, CHOP
• Ciaran Phibbs, Stanford University
• Sarah Kunz, Beth Israel Hospital
• Matthew Coyle, CHOP

Evaluating the Impact of State Cost Growth Benchmarks on Hospital Spending

Nine states have adopted health care cost benchmarks to monitor and control health care spending growth. The effectiveness of these policies—particularly in addressing hospital prices—has not been formally evaluated. This study will compare the impact of benchmarks in states with early adoption to those without on hospital prices, service use, and spending in the commercial market. 

• Roslyn C Murray, Brown University
• Andrew M Ryan, Brown University

The Impact of Private Equity Ownership on Medical Technologies

Most existing research on private equity (PE) in health care focuses on care delivery despite 63% of PE health care investments involving medical devices, pharmaceuticals, and biotechnology. This study will provide novel evidence on how PE ownership of medical device manufacturers affects innovation, prices paid by providers for devices, product safety and recalls, and business performance. 

• Atul Gupta, University of Pennsylvania
• Parker Rogers, Indiana University
• Jay Sastry, University of Pennsylvania

Price Benchmarks and Limits for Biologics and Specialty Drugs

Medicare limits its exposure to drug prices through payment formulas and ceilings; however, private insurers do not have similar authority. This study will use claims data from Blue Cross and Blue Shield plans nationwide to develop four sets of benchmarks for assessing and limiting drug prices charged by hospitals to private insurers for complex specialty and biologic drugs, and estimate potential savings for purchasers and insurers if prices are limited to benchmarks.

• James Robinson, University of California, Berkeley
• Christopher Whaley, Brown University

Quantifying Growth in Provider Billing Margins on Cancer Drugs

Oncology has the largest segment of clinician-administered drugs, and drug markups are a substantial revenue source for oncology practices. This study will quantify recent trends in provider revenue on cancer drug markups and the underlying factors driving these trends using manufacturer-reported drug revenue data and multi-payer claims (Medicare, Medicaid, and commercial).

• Aaron P Mitchell, Memorial Sloan Kettering Cancer Center
• Pragya Kakani, Cornell University
• Aaron N Winn, University of Illinois Chicago