Madhalika Vulimiri

Vulimiri
When I saw this Bass Connections project, I was excited for the opportunity to work on Medicaid reform in North Carolina—especially at a time when states have really been at the forefront of innovating in health care—to think about what we could do to further improve the public health of citizens in North Carolina.

Degree

Master of Public Policy

Project Team

As a native North Carolinian and a student of health policy, I’ve been following health reform for a long time. When I saw this Bass Connections project, I was excited for the opportunity to work on Medicaid reform in North Carolina—especially at a time when states have really been at the forefront of innovating in health care—to think about what we could do to further improve the public health of citizens in North Carolina.

This project has allowed me to speak with executives from Duke University Health System, state legislatures and the folks at the Department of Health and Human Services who run Medicaid, hearing their unique viewpoints about how changes to the Medicaid program would affect their organizations. It’s really exciting to take those perspectives and incorporate them into final recommendations.

The most surprising thing I’ve learned is that if you know one state Medicaid program, you know one state Medicaid program. There are certainly lessons to be learned from what other states are doing. However, every state has such a unique history and political environment that we really need to dig into the North Carolina context to understand what hospitals, providers, patients, and government officials want out of a state Medicaid program. We really have our work cut out for us to understand North Carolina’s unique political environment in forming recommendations for the state legislature.

As a student of public policy, it’s my goal to use evidence and research to inform changes to such a massive program like Medicaid that will inevitably affect a number of stakeholders. It’s very important that we are grounding our recommendations in facts about the program, especially at a time when there are a lot of different opinions about how the program has or has not succeeded.

There are a lot of myths swirling around about Medicaid. In particular, you hear people say “Medicaid is broken.” While there are certainly aspects of Medicaid that should be improved, the North Carolina Medicaid Program has a critical way for North Carolinians to get access to life-saving health care and ultimately improve their health outcomes.

If I’ve learned anything, it’s that Medicaid is not one monolithic program. It’s a program that serves a number of diverse beneficiaries, most of them being children. It’s important to remember that with Medicaid, we’re talking about the most vulnerable people in our state, from children to the disabled and the elderly. It’s our responsibility to be the best stewards to those patients and make sure they have access to high quality, affordable health care.