Duke’s engagement with the broader policy community is driven not only by faculty but also by students like Madhu Vulimiri, a second-year public policy candidate at Duke’s Sanford School of Public Policy. Madhu recently joined two senior healthcare leaders in a conversation with Frank Stasio from North Carolina public radio to provide her expert opinion on best practices to improve the state’s healthcare system.

It’s a problem faced by healthcare systems around the nation: a small group of “super users” account for a disproportionate amount of Medicaid costs. Sometimes referred to as “frequent flyers,” these patients create huge expenses because they frequently visit hospitals instead of using preventative care, receiving sub-optimal treatment that doesn’t get to the root of their health problems. Such patients often suffer from other social determinants of health such as substance abuse or homelessness, and thus require a more holistic care environment – one that entails building relationships with social workers, community health workers, and building bridges to coordinate services across the healthcare system.

In North Carolina, such a holistic understanding of health is more salient than ever as the state is poised to move from a fee-for-service system to a managed care system. Instead of the state paying providers directly for volume of care, North Carolina will contract with private insurance companies to pay a fixed amount per month for a group of patients under a provider’s purview. Madhu worked last semester with a cross-disciplinary Bass Connections team to analyze models in other states, take a closer look at Medicaid reform proposals from the former and current governor’s office as well as the General Assembly, and provide actionable recommendations to the North Carolina policymakers and citizens on the question: “What is the best path forward for Medicaid in North Carolina?”.

On April 25th, 2017, Madhu and her Bass Connections team hosted a presentation and discussion in Raleigh for policymakers and citizens where they submitted a report detailing their findings. On that same day, the North Carolina Department of Health and Human Services requested public comments on Medicaid reform and the team submitted  a public comment highlighting recommendations from their full-length report.

Bass Connections is a university-wide initiative that brings together interdisciplinary groups of faculty, undergraduate and graduate students to apply “knowledge, research and skills in problem-solving, with engagement from community partners.” Projects span an array of policy topics from global health to energy and environment, drawing on the wealth of information and thought leadership at Duke to find solutions to some of the most vexing policy questions.

Want to learn more? Contact bassconnections@duke.edu to find out what projects are in the pipeline!