My research examines how healthcare policy and system design shape participation, access, and outcomes among aging populations, particularly individuals dually eligible for Medicare and Medicaid. I study how financing structures, administrative systems, 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 structured by healthcare system design. Administrative complexity, fragmented financing, and uneven information environments shape individuals’ ability to access and participate in care, often producing inequities that are mischaracterized as personal or behavioral differences. In this way, healthcare systems do not simply influence outcomes, they actively structure who is able to engage with and benefit from care.
Drawing on nearly two decades of experience in payer and provider organizations, I integrate rigorous empirical methods with a focus on how policy operates in practice. This perspective allows me to analyze not only intended policy effects, but also the unintended consequences that emerge through implementation, organizational constraints, and system complexity.
My dissertation, Exploring Patient Activation Among Dual-Eligible Medicare Beneficiaries, examined how integrated care models and care coordination structures influence engagement and self-management among individuals navigating complex policy environments. Using mixed methods, including qualitative interviews and quasi-experimental analyses of the Medicare Current Beneficiary Survey, I investigated how policy and organizational design shape behavior and outcomes. This work demonstrates that engagement is not simply an individual attribute, but a system-level outcome.
My current research program is organized around three interconnected areas:
- Patient Engagement as a System and Implementation Outcome: I examine how healthcare systems operationalize, or fail to operationalize, patient engagement for high-need populations, focusing on how care coordination, digital health tools, and insurance navigation environments shape individuals’ capacity to engage in care.
- Information, Decision-Making, and Navigation
This research investigates how digital access, health literacy, and administrative burden influence individuals’ ability to navigate fragmented systems and make informed decisions, with attention to inequities among older adults with complex needs. - Politics and Governance of Aging and Health Systems
I analyze how competing policy priorities—efficiency, equity, autonomy, and fiscal sustainability—shape the design and implementation of programs such as Medicare and Medicaid, and how these tradeoffs influence resource allocation and disparities in outcomes.
My research is closely integrated with my teaching, where I engage students in analyzing policy tradeoffs and the complexities of public health decision-making. Together, these efforts reflect my commitment to scholarship that is rigorous, practically grounded, and responsive to the challenges of governing healthcare systems for aging populations.