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Christina Marsh Dalton - Wake Forest University. Winston-Salem, NC, US

Christina Marsh Dalton Christina Marsh Dalton

Associate Professor of Economics & Adjunct Appointment, Public Health Sciences, Wake Forest School of Medicine | Wake Forest University

Winston-Salem, NC, UNITED STATES

Dalton’s research focuses on health economics, health care markets, public and private insurance, and the economics of public health policy.


Dalton’s work is at the intersection of health economics and market organization. Her research focuses on improving health care by analyzing how markets for health care goods and services work. What influences whether firms offer insurance to their workers? How do the number and type of providers affect care that patients receive? These are just a few areas where Dalton’s expertise can offer insights.

Dalton can also comment on hospitals and markets such as nonprofit providers, insurance, rural healthcare, nursing homes, and hospice care. She is an expert on the economic impact of the Affordable Care Act and the impact of uncertainty and policy changes both regionally and nationally.

Areas of Expertise (7)

Health Economics

Health Insurance / Affordable Care Act

Employer-based Health Plans

Economic Analysis

Health Plan Financing

Medicare / Medicare Part D

Health Care Markets





Christina Marsh Dalton loading image Christina Marsh Dalton teaching a class loading image



Education (2)

University of Minnesota - Twin Cities: Ph.D., Economics

Cornell University: B.A., Economics

Media Appearances (4)

WFU expert: How Amazon, Berkshire, JP Morgan deal could shake up health care market

Triad Business Journal  


Amazon.com Inc.'s plans to form an independent health care company with Berkshire Hathaway Inc. and JP Morgan Chase has the potential to be "quite disruptive" to the health care market, said Christina Dalton, an assistant professor of economics at Wake Forest University with an adjunct appointment with Public Health Sciences at Wake Forest School of Medicine. "There's probably a large potential if they can innovate and do this job well," she said. "There's a lot of cost savings that would be on the table for them."

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Obamacare isn’t dead. Here’s how much not having health insurance will cost you

The Charlotte Observer  


The Affordable Care Act requires individuals to have health insurance. If they don’t, they have to pay a fee. For the past two years that fee has been either $695 for each uninsured adult and $347.50 for each uninsured child or 2.5 percent of your household income – whichever is higher. The penalty was a stick to force people into the health insurance marketplace, said Christina Dalton, a health care economist with Wake Forest University. One benefit to more people having health insurance is helping people take care of their illnesses earlier instead of waiting for more costly treatment, Dalton said.

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How much is your health insurance costing you? Two Panthers season tickets worth

The Charlotte Observer  


Money [for family healthcare costs] has to come from somewhere – offsetting pay raises or reducing the amount of money workers can save and spend. “They can’t spend it on housing, they can’t spend it on food, they can’t spend it on education,” said Christina Dalton, a health care economist at Wake Forest University. And as employers pay more for health care they, like their employees, will have to prioritize where the money will come from. “Either they’ll hire fewer people or they might decide to stop offering health insurance as a benefit,” Dalton said

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UNC Health, Carolinas HealthCare likely to win in deal. But who would lose?

The News & Observer  


If efficiencies are about allocation of the resources, then it might be less about cutting jobs and more about using the jobs to effectively help patients, said health care economist Christina Dalton of Wake Forest University. When insurance companies are more organized they can force hospitals to accept low prices, Dalton said. “Insurance companies might be worried about having a new consolidated system that their ability to ask for low prices is going to be less,” she said.

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Articles (2)

Why Do Firms Use Insurance to Fund Worker Health Benefits? The Role of Corporate Finance Journal of Risk and Insurance

Christina Marsh Dalton, Sarah Holland


When a firm offers health benefits to workers, it exposes the firm to the risk of making payments when workers get sick. A firm can either pay health expenses out of its general assets, keeping the risk inside the firm, or it can purchase insurance, shifting the risk outside the firm. Using data on insurance decisions, we find that smaller firms, firms with more investment opportunities, and firms that face a convex tax schedule are more likely to hedge the risk of health benefit payments. We show how firms trade of the benefits that come from financing and investment characteristics with the costs of regulation when choosing insurance.

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Cost versus Control: Understanding Ownership Through Outsourcing in Hospitals Journal of Health Economics

Christina Marsh Dalton, Patrick Warren


For-profit hospitals in California contract out to a much greater extent than either public hospitals or private nonprofit hospitals. To explain why, we build a model in which the outsourcing decision is a trade-off between net revenues and "quality", any factor of interest to the hospital manager over-and-above its impact on net-revenues. Since nonprofit firms must consume profits indirectly through perquisites, they trade off differently from for-profit firms. This difference is exaggerated when "quality" is particularly important or the firm is hit with a favorable fixed-cost shock. We test these predictions in a panel of California hospitals, finding evidence for each. These results suggest that a model of public or nonprofit make-or-buy decisions should be more than a simple relabeling of a model derived in the for-profit context.

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