My research examines how healthcare policy and system design shape participation and outcomes among aging populations, particularly individuals dually eligible for Medicare and Medicaid. I study how financing structures, administrative systems, care delivery models, and information environments influence people's ability to navigate care, engage in treatment, and benefit from healthcare services.
A central premise of my work is that many outcomes often attributed to individual behavior, including patient engagement and self-management, are shaped by healthcare system design. Administrative complexity, fragmented financing, and uneven information environments can influence individuals' ability to access and participate in care, producing inequities that may be mischaracterized as personal or behavioral differences. In this way, healthcare systems do not simply influence outcomes; they help determine the conditions under which meaningful participation is possible.
Drawing on nearly two decades of experience in payer and provider organizations, I integrate empirical research with a focus on how policy and healthcare delivery operate in practice. This perspective allows me to examine not only intended policy effects, but also the consequences that emerge through implementation, organizational constraints, and system complexity.
My dissertation, Exploring Patient Activation Among Dual-Eligible Medicare Beneficiaries, examined how individual characteristics, insurance arrangements, and care coordination experiences shape engagement and self-management among individuals navigating complex healthcare environments. Using mixed methods, including qualitative interviews and quantitative analyses of the Medicare Current Beneficiary Survey, I examined how individual circumstances and healthcare system design interact to shape patient activation. This work provides the foundation for my broader research on healthcare participation among high-need Medicare populations.
My current research program is organized around three interconnected areas:
- Healthcare Participation & Care Delivery: I examine how healthcare systems enable or constrain participation among high-need populations, with particular attention to patient activation, care coordination, continuity of care, insurance design, and the capacity to manage health and healthcare.
- Information, Decision-Making & Navigation: I investigate how digital access and use, health and insurance literacy, information availability, and administrative complexity influence people's ability to navigate healthcare and make informed decisions, with particular attention to inequities among older adults and dual-eligible beneficiaries.
- Healthcare Policy & System Design: I examine how Medicare and Medicaid policy, financing and coverage arrangements, and healthcare delivery structures shape access, participation, and outcomes among aging and high-need populations. This work focuses particularly on how policy design is experienced in practice and why its effects may differ across populations.
My research is closely integrated with my teaching, where I engage graduate students in examining healthcare policy, delivery, analytics, and the complexities of translating evidence into real-world decisions. Together, these efforts reflect my commitment to scholarship that is methodologically rigorous, grounded in healthcare practice, and focused on understanding how healthcare systems can better enable meaningful participation.