My research focuses on healthcare participation among Medicare beneficiaries, particularly people with complex health and social needs. I am interested in understanding why access to healthcare, information, and resources does not always translate into patients' ability to meaningfully participate in their care.
Across my work, I examine how individual capacity, social and structural conditions, healthcare delivery systems, and coverage arrangements shape patients' ability to navigate healthcare, make decisions, manage chronic conditions, and engage with available services and technologies. Together, this work examines healthcare participation as the product of interactions among individual capacity, social context, available resources, and healthcare system design.
My research is organized around four interconnected areas:
🏥 Healthcare Delivery & Medicare Populations
I study how healthcare delivery systems and coverage arrangements affect Medicare beneficiaries, particularly dual-eligible beneficiaries and people with complex health, functional, and social needs.
This work examines how the organization of care, insurance design, care coordination, and continuity influence patients' experiences and ability to participate in their care.
🤝 Healthcare Participation & Self-Management
I examine why some patients are better able than others to participate in and manage their healthcare, even when healthcare services and resources are available.
This work includes research on patient activation, self-management, care coordination, and the individual and social conditions that can enable or constrain participation.
📱 Digital Healthcare Participation
I study the distinction between having access to technology and being able to use it meaningfully for healthcare.
My current research examines digital healthcare participation among Medicare beneficiaries, including use of technology to communicate with providers, schedule care, obtain health information, and manage prescriptions, as well as disparities that persist among beneficiaries who are already digitally connected.
🧭 Medicare Navigation & Insurance Literacy
I examine how information, insurance literacy, and administrative complexity influence Medicare beneficiaries' ability to understand their coverage, compare options, and navigate healthcare decisions.
This work is particularly focused on dual-eligible beneficiaries and other populations for whom navigating increasingly complex healthcare and insurance systems may create additional barriers to participation.
Research Approach & Methods
My research primarily uses nationally representative Medicare data, including the Medicare Current Beneficiary Survey (MCBS), to examine healthcare participation, access, and outcomes among Medicare populations. I use quantitative, qualitative, and mixed-methods approaches, including survey-weighted analyses, multivariable regression, decomposition methods, propensity score methods, inverse probability of treatment weighting, and qualitative interviews and thematic analysis.
My research is further informed by nearly two decades of experience analyzing administrative claims and health plan data across Medicare, Medicare Advantage, Medicaid, and commercial populations. This experience provides a practical understanding of healthcare utilization, population health, risk stratification, quality and cost measurement, and the strengths and limitations of the data healthcare organizations use to understand their populations.
Emerging Research
Across these studies is a broader question:
What makes meaningful participation in healthcare possible?
My emerging work seeks to develop a more integrated understanding of healthcare participation that accounts for the interaction among individual capacity, social conditions, available resources, and healthcare system design. Rather than treating engagement or self-management primarily as individual behaviors, this work examines the conditions that enable or constrain patients' ability to participate in healthcare.
Ultimately, I aim to identify how healthcare policy and delivery systems can be designed to make meaningful participation more achievable, particularly for populations facing complex health and social circumstances.