Megan Cole


Megan Cole, PhD candidate in Health Services Research (HSR), successfully defended her dissertation, titled "The impact of Medicaid expansion on community health centers."

Tell us about your time at Brown. What did you enjoy most about being a doctoral student here?

Four years ago, as I was deciding on PhD programs, I was initially drawn to Brown because of the great mentorship, accessible and welcoming faculty, and the many research opportunities and resources. All of these initial perceptions were fully upheld and led to a truly enjoyable experience as a doctoral student. Faculty and staff are incredibly generous with their time, thoughtful in their feedback, and provide a level of mentorship that is difficult to find elsewhere. The resources available in the department—including data, financial support, system infrastructure, and data support staff—truly expand research opportunities and possibilities for students. I’ve had the chance to work on two large research projects, in addition to my dissertation, and this has afforded me the opportunity to expand my skill sets while gaining more research experience in my areas of interest (and it’s been fun!). I have also appreciated the flexible structure of the program, where students are able to focus on research and coursework that best aligns with their interests and goals. Finally, I am grateful to have been surrounded by extremely supportive peers, with whom I’ve developed great friendships.

What public health issues do you hope to address through your dissertation?

My dissertation focuses primarily on the impact of Medicaid expansion on community health centers, which provide primary care services to low-income, underserved patients and vulnerable populations. I specifically examine how Medicaid expansion has affected health insurance coverage, quality of care, and patient volume at health centers. My findings suggest that expansion was associated with large gains in coverage as well as increases in quality of care and patient volume, particularly in non-urban areas. I am hopeful that policymakers both at the state and federal levels will be attentive to these findings as they consider potentially reversing their expansion decisions and/or changing or repealing key provisions within the Affordable Care Act (ACA), including Medicaid expansion.  Such changes could translate into millions of low-income patients losing health insurance coverage, which could reverse the positive effects that we’ve observed on quality and primary care service use. This would be particularly detrimental to low-income patients in non-urban areas, where there is less primary care capacity. In my future work, I hope to build on this research by continuing to examine the impact of policy or programmatic changes on low-income and vulnerable patient populations, particularly as related to quality of care and equity in care.

What are your future plans now that you have finished your PhD?

I am excited to join the Department of Health Law, Policy, & Management at Boston University School of Public Health, where I will be an assistant professor starting in July.


(Distributed June 20, 2017)