Barak Richman, Edgar P. and Elizabeth C. Bartlett Professor of Law

Bass Connections Project Team: NC Medicaid Reform Advisory Team

What is the best path forward for Medicaid in North Carolina? One of the most important policy issues of the 21st century is to provide quality healthcare at sustainable costs to low-income individuals and families.

Richman’s Bass Connections project team drew on Duke’s expertise in public policy, law, medicine, nursing and business to craft a Medicaid reform proposal that fits the constraints and demands of North Carolina politics. The team submitted its report to North Carolina policymakers and citizens in April 2017 and hosted a presentation and discussion in Raleigh.

Under Richman’s guidance, four undergraduate team members received a Bass Connections Follow-on Student Research Award to take their team’s work further through a project called Reforming North Carolina Medicaid. In 2017-18, this group worked to identify health policy patterns and develop county case studies detailing the challenges in North Carolina healthcare. The team will submit its findings to the Department of Health and Human Services as the state pursues Medicaid reform.

Below are excerpts from Richman’s remarks at a Bass Connections information session for faculty.

Building an Interdisciplinary Team

The healthcare policy world has been criticized for being insular, and its resistance to voices outside medicine has been blamed for many of its shortcomings. As an economist and a lawyer, I’m an outsider myself, but I knew that a deeply interdisciplinary team could develop a creative list of Medicaid reforms that a traditional medicine-oriented team could not. I recruited a number of grad students, found an outstanding doctoral student in nursing and got a very nice cross-section of undergrads in public policy, life sciences and political science, and assigned them the goal of providing policy recommendations to local and state governments.

The students wanted to produce a comprehensive, ambitious report, so we had to organize ourselves effectively. Our undergraduates were divided into several teams, each of which was mentored by a graduate student who brought a unique disciplinary perspective. These sub-teams had their own tasks and formulated their own recommendations for their policy area. This instilled a sense of ownership among team members, and I was thoroughly impressed with the initiative and creativity they brought to the project. It was a uniquely collaborative educational experience for students and faculty alike, and it allowed undergrads to work closely with both their peers and graduate student supervisors that they otherwise were unlikely to meet.

Reevaluating Goals as a Group

One of the unique aspects of our experience was that we had to reevaluate and rearticulate our goals after the 2016 election. As a team, we had to recast our project’s selling points and to adjust our goals and expectations to the new political setting. Ultimately, I think the students produced an incredible piece of work and learned a lot about civic discourse, healthcare policy and collaborative research.