About

Mario Macis is a professor and Area Chair for Economics at Johns Hopkins Carey Business School. He is also a core faculty member and part of the leadership team at the Hopkins Business of Health Initiative, an affiliate faculty at the Johns Hopkins Berman Institute of Bioethics, a research associate at the National Bureau of Economic Research (NBER), a research fellow at the Institute of Labor Economics (IZA), and a research associate at the Center for Economic Research North-South (CRENoS). Macis is an applied economist whose research spans the intersection of markets, policy, and society, with a particular emphasis on health-related issues. His work focuses on understanding the factors that influence people's support for markets and market-based solutions to social problems, attitudes toward regulation and technology, and the impact of these elements on economic and social outcomes. He explores how incentives, social norms, and moral values shape individual choices and societal policies, contributing to fields such as health, labor, development, market design, and managerial economics. Although his research is primarily economic, it is interdisciplinary in nature, and he has published in leading academic journals including the American Economic Review, the American Economic Journal series, the Journal of Labor Economics, the Journal of Health Economics, and others. His research has also been featured in prominent media outlets like The Economist, The Atlantic, The Washington Post, The Wall Street Journal, The New York Times, and The Financial Times. Macis has conducted field- and survey-based experimental studies on topics such as the effects of economic incentives and social norms on blood donation, attitudes toward compensating organ donors, reactions to price surges and price controls during emergencies, the impact of firms' exporting on workers’ wages, the influence of female CEOs on gender wage inequality, the effects of unemployment benefits on job reallocation, and the adoption of efficient management practices in health care. He has also studied incentivized peer referrals to improve infectious disease detection. Currently, his research includes studying Americans' trust in the health care system, attitudes about human enhancement technologies and AI, decision-making at the end of life, and market design solutions for ethical and efficient biobanking. These efforts aim to shape policies and practices that promote welfare-enhancing solutions aligned with public values and ethical standards in a technology-driven world. During the COVID-19 pandemic, Macis co-authored studies on lockdown expectations and compliance, reactions to price surges of essential goods, social networks' effects on preventative behavior adoption, and social distancing compliance. He co-organized interdisciplinary webinars and a joint Johns Hopkins University-London School of Economics online conference on behavioral economics and COVID-19 to foster dialogue and inform policymakers. He teaches courses in microeconomics, behavioral economics, strategic human capital, health economics, and applied behavioral strategy. Macis has consulted for organizations including the World Bank, International Labor Organization, National Marrow Donor Program, United Nations Development Program, and World Health Organization. He served on a National Academies of Sciences, Engineering, and Medicine committee on organ donor procurement and contributed to a United Nations report on the social and economic impact of the Zika virus. He is a member of the editorial board of the Italian Economic Journal and writes op-eds and articles on health economics for various outlets. Before joining Johns Hopkins, he was a faculty member at the University of Michigan's Ross School of Business. He holds a PhD in Economics from the University of Chicago and a Laurea in Economics and Social Disciplines from Bocconi University in Milan, Italy.

Research topics

• Medicine
• Virology
• Social psychology
• Psychology
• Economics
• Economic growth
• Internal medicine
• Pathology
• Environmental health
• Business
• Family medicine

Selected publications

• “Keep track of your own story:” decentralized biobanking for community engagement in biospecimen research

  Journal of Information Technology Case and Application Research · 2026-01-02

  article
  PublisherDOI

• Management of Health Care Facilities and Patient Attendance during Major Disruptions: Evidence from Kenya

  Washington, DC: World Bank eBooks · 2026-05-01

  bookOpen access

  This paper measures and analyzes management practices in the Kenyan health care sector, drawing on a nationally representative survey and linked administrative data. The paper adapts the World Management Survey to measure management quality in primary health care facilities and hospitals, surveying 429 primary health care facilities and 73 hospitals. Primary health care facilities are the primary point of contact for most patients, providing treatment for common infectious diseases and chronic conditions, as well as services related to maternal and child health. Management quality is low on average, and the distribution is highly compressed. The analysis uses administrative data to test the association between the management quality and performance of primary health care facilities, measured by outpatient attendance, during a period of disruption that included the COVID-19 pandemic and a public health workers' strike. Overall attendance fell during this period. Private facilities experienced a smaller decline than public facilities, consistent with substitution during the strike. Within the private sector, better-managed facilities showed greater resilience, driven primarily by operations management. These results underscore the role of management quality in strengthening facility-level resilience and the complementarity of public and private sectors in absorbing healthcare shocks.

  PublisherOA PDFDOI

• The Morality Of Market Exchanges: Between Societal Values And Trade-Offs

  SSRN Electronic Journal · 2026-01-01

  preprintOpen accessSenior author
  PublisherDOI

• Decentralized Biobanking Pathway to Precision Medicine: Futures Study

  Journal of Medical Internet Research · 2025-06-26 · 3 citations

  articleOpen access

  Background: Biobank privacy policies remove identifiers from donated specimens, siloing patients, discounting multimodal data, and hindering precision medicine. Decentralized biobanking is a new paradigm that unlocks value by uniting patients, specimens, scientists, and physicians in a blockchain-backed platform with robust incentives, governance, and ethical oversight. Informed by a real-world pilot, this mixed methods futures study explores how we advance decentralized biobanking from theory to practice. Objective: This study aimed to define the implementation strategy, synthesize pilot experiences into future vision, and highlight the implications and potential roadblocks. Methods: We applied backcasting from 2021 to 2024 through ethnography, alignment exercises, surveys, interviews, site visits, and futures workshops to map biospecimen supply chains and define principles for decentralized biobanking, using a breast cancer biobank for prototyping and software development. A decentralized biobanking app was piloted to engage breast cancer biobank members in participatory visioning. Thematic analysis of pilot experiences revealed a technology-enabled future vision. We systematically analyzed the pilot event via a Futures Wheel, organizing participant quotes as first-order effects, indirect effects, and anticipated implications. Results: Backcasting unveiled a pathway for designing an initial app for patients to track their biospecimens within institutional databases. We defined the "rails, rules, and tools" for a long-term, effective, and structurally just Biomediverse. Pilot enrollment was robust, and concurrent biobank enrollment was increased. Qualitative themes revealed impact on dignity, recognition, understanding, belonging, ownership, and empowerment. A vision for the future emerged from user journeys: "From 'Lab Rat' to Research Partner," vividly depicted as a path transitioning from sterile graveyard to flourishing community garden. Primary themes were matched to first-order effects, indirect effects, and future implications, culminating in gratitude and unity, network effects reinforced by reciprocity, as well as potential for compensation and precision medicine. Conclusions: Reconnecting patients with their donated biospecimens via decentralized biobanking apps unlocks value for patients and aligns incentives across the Biomediverse. We illuminate the future person-centered biomedical data economy and put forward the goal of enabling all US biospecimen donors with decentralized biobanking by 2030.

  PublisherDOI

• Free-Text Responses in a Nationally Representative Experimental Survey about End-of-Life Care Choices: ChatGPT-4o-Assisted Qualitative Analytical Study

  JMIR Aging · 2025-09-22 · 1 citations

  articleOpen access

  Background: Little is known about how surrogates make end-of-life care choices for patients who lack the ability to make decisions for themselves. Objective: The study aims (1) to identify key themes that emerged from participants' free-text responses to a large nationally representative vignette survey about surrogate decision-making in end-of-life care and (2) to determine if an advanced artificial intelligence (AI) chatbot could assist us in accurately and efficiently performing qualitative analyses. Methods: Our dataset included 3931 free-text responses from a nationally representative survey of 6109 individuals. In this qualitative study, we first familiarized ourselves with the free-text responses and hand-coded the first 200 responses until we reached saturation. We then created a codebook, initial themes, subthemes, and illustrative quotes. Subsequently, we prompted ChatGPT-4o to analyze the entire dataset of 3931 responses and identify frequent keywords and generate themes and quotable quotes. We validated responses by comparing the AI's keyword counts to qualitative software (NVivo, Lumivero) counts and cross-validating AI-generated quotes with the original transcripts. Results: We identified several key themes: surrogates more often chose comfort care for care recipients with dementia, particularly at advanced stages. They also strongly weighed the patients' perceived quality of life and functional status. Many reported making surrogate decisions based on their own lived experiences or values, rather than making decisions aligned with the patients' previously stated wishes. There was no significant difference between the AI and qualitative software's keyword counts. The most frequent keywords included "life" (2051/81,713, 2.51%), "quality" (903/81,713, 1.11%), and dementia (507/81,713, 0.62%). Overall, AI-generated themes closely aligned with aforementioned human-generated themes. Manual coding of the first 200 free-text responses required 4 hours, including codebook development. In contrast, ChatGPT-4o generated themes in <10 seconds using the predefined codebook. However, dataset preparation, output verification, iterative prompting, debugging, and validation required several weeks. Conclusions: Surrogates often base end-of-life decisions on dementia stage, perceived quality of life, and their own lived experiences, rather than patient preferences. Using an AI chatbot to perform qualitative analysis on free-text responses may help extend the work of qualitatively trained investigators, especially for large datasets such as free-text responses to large surveys.

  PublisherDOI

• Trust in AI-assisted health systems and AI’s trust in humans

  npj Health Systems · 2025-03-28 · 47 citations

  articleOpen access

  Abstract Artificial intelligence (AI) is reshaping healthcare, promising improved diagnostics, personalized treatments, and streamlined operations. Yet a lack of trust remains a persistent barrier to widespread adoption. This Perspective examines the web of trust in AI-assisted healthcare systems, exploring the relationships it shapes, the systemic inequalities it can reinforce, and the technical challenges it poses. We highlight the bidirectional nature of trust, in which both patients and providers must trust AI systems, while these systems rely on the quality of human input to function effectively. Using models of care-seeking behavior, we explore the potential of AI to affect patients’ decisions to seek care, influence trust in healthcare providers and institutions, and affect diverse demographic and clinical settings. We argue that addressing trust-related challenges requires rigorous empirical research, equitable algorithm design, and shared accountability frameworks. Ultimately, AI’s impact hinges not just on technical progress but on sustaining trust, which may erode if biases persist, transparency falters, or incentives misalign.

  PublisherOA PDFDOI

• Decentralized Biobanking for the Future of Precision Medicine (Preprint)

  2025-03-15 · 1 citations

  preprintOpen access

  <sec> <title>BACKGROUND</title> Biobank privacy policies remove identifiers from donated specimens, siloing patients, discounting multi-modal data, and hindering precision medicine. Decentralized biobanking is a new paradigm that unlocks value by uniting patients, specimens, scientists and physicians in a blockchain-backed platform with robust incentives, governance and ethical oversight. Informed by a real-world pilot, this mixed-methods futures study explores how we advance decentralized biobanking from theory to practice. </sec> <sec> <title>OBJECTIVE</title> 1) Define implementation strategy; 2) Synthesize pilot experiences into future vision; 3) Highlight implications and potential roadblocks. </sec> <sec> <title>METHODS</title> We applied backcasting from 2021-2024 through ethnography, alignment exercises, surveys, interviews, site visits and futures workshops to map biospecimen supply chains and define principles for decentralized biobanking, utilizing a breast cancer biobank for prototyping and software development. A decentralized biobanking app was piloted to engage breast cancer biobank members in participatory visioning. Thematic analysis of app user experiences and pilot reflections revealed a technology-enabled future vision. We systematically analyzed the pilot event via a Futures Wheel, organizing participant quotes as first order effects, indirect effects, and anticipated implications. </sec> <sec> <title>RESULTS</title> Backcasting unveiled a pathway for designing an initial application for patients to track their biospecimens within institutional databases. We defined the “rails, rules and tools” for a sustainable, effective, and structurally just Biomediverse. Pilot enrollment was robust, and concurrent biobank enrollment was increased. Qualitative themes revealed impact on dignity, recognition, understanding, belonging, ownership, and empowerment. A vision for the future emerged from user journeys: “From ‘Lab Rat’ to Research Partner,” vividly depicted as a path transitioning from sterile graveyard to flourishing community garden. Primary themes were matched to first order effects, indirect effects and future implications, culminating in gratitude and unity, network effects reinforced by reciprocity, as well as compensation and precision medicine, suggesting next steps. </sec> <sec> <title>CONCLUSIONS</title> Reconnecting patients with their donated biospecimens via decentralized biobanking applications unlocks value for patients and aligns incentives across the Biomediverse. We illuminate the future person-centered biomedical data economy and put forward the goal of enabling all U.S. biospecimen donors with decentralized biobanking by 2030. </sec>

  PublisherOA PDFDOI

• Understanding Attitudes Toward Human Enhancement Technologies

  AEA Randomized Controlled Trials · 2025-10-08

  dataset1st authorCorresponding
  PublisherDOI

• Privacy, Policy, and Profits: Survey of Patient Preferences for Research on De-Identified Biosamples

  Journal of Empirical Research on Human Research Ethics · 2025-06-12

  articleCorresponding

  This study aims to identify patient preferences to inform ethical frameworks, policies, and technologies for advancing biobanking and precision medicine while balancing competing objectives and priorities. We surveyed 109 American breast cancer patients in 2022 about conditions for receiving research results, how their biospecimens are used, partnerships between nonprofit health systems and for-profit companies, and the distribution of financial returns from research. Survey questions explored the balance between objectives like maintaining de-identification versus receiving research results and other benefits. Patients in our sample generally prefer to be re-identified to receive information about the use of their donated tissue-especially research results. They support public-private partnerships if they speed up new therapies and favor the idea of sharing in financial returns generated from research on their tissue. These insights can inform the development of frameworks and technologies that position patients as key stakeholders in biobanking research.

  PublisherDOI

• Understanding Attitudes Toward Human Enhancement Technologies

  AEA Randomized Controlled Trials · 2025-10-08

  dataset1st authorCorresponding
  PublisherDOI

Frequent coauthors

• Nicola Lacetera

  University of Bologna

  521 shared

• Julio Elías

  Universidad del Centro de Estudios Macroeconómicos de Argentina

  138 shared

• Fabiano Schivardi

  64 shared

• Robert Slonim

  58 shared

• Pradeep K. Chintagunta

  University of Chicago

  48 shared

• Jessica Goldberg

  45 shared

• Tito Boeri

  Bocconi University

  38 shared

• Angelo Mele

  35 shared

Awards & honors

• Johns Hopkins University Discovery Award (2016)
• Johns Hopkins University early-career Catalyst Award (2015)
• Johns Hopkins University Alumni Association Excellence in Te…
• National Institutes of Health (NIH) Creative and Novel Ideas…
• National Science Foundation (NSF) Grant for Field Experiment…