Supplying the Evidence to Drive Policy: Rebecca Thorsness ‘13
In this spotlight, we talk with Rebecca Thorsness ‘13 about how she explored domestic health policy through Princeton’s Global Health Program (GHP) and has dedicated her career to improving healthcare access in the US through Medicaid policy and access.
Erin: What interested you in the GHP and how did the program influence your career path.
Becca: I was actually more interested and involved with domestic health policy part of the GHP. The ACA [Affordable Care Act] passed my freshman year and I had spent time talking to my home state senators. Learning more about health policy seemed like an obvious way to explore my interest further and deepen the impact I could have on health care access. While there were fewer classes in domestic health policy, I was also able to be involved with a junior task force at Woodrow Wilson School that was domestic-focused—so you could certainly go the domestic route within the GHP.
I did an internship after my sophomore year through PICS with the Association of American Medical Colleges and this was the first time I saw what health policy looked like in the real world. Before this internship, I hadn’t fully appreciated the role of national organizations in providing content and policy expertise in the federal legislative and regulatory process. I was able to do the internship with a Princeton GHP classmate, so I had someone to share and discuss the experience with. I also worked with the Center for Health Care Strategies after my junior year and learned about state decision making and implementation in the Medicaid program.
Coming back to Princeton my junior year, I took the GHP core courses and I really loved the “real world” focus of GHP program and that I was able to learn from the professors who had so much experience in the field. They could talk to you about the implementation challenges they faced as well as about non-academic career paths; there was such a large wealth of experience and knowledge from faculty both in the academic or non-academic side. These courses encouraged me to think about the role of evidence and how to bring an academic perspective to policymaking generally, and health policy in particular.
Erin: Tell me what have you been up to since graduation?
Becca: After graduation, I worked at an organization in DC called the Association for Community Affiliated Plans (ACAP), a trade organization for non-profit Medicaid health plans. There I helped small health plans across the country share best practices around delivering high-quality health care for the vulnerable and low-income populations they served. In this role, I learned a lot about the innovative work occurring at the state and county level, but also about the challenges that health insurers and providers face in implementing federal and state policies. I was with ACAP for three years, and last fall I started a PhD program at Brown, in health services, policy, and practice. I was eager to strengthen my analytic skills in order to contribute to the evidence base for future policymakers. I’m really interested in state decisions on health care policy, particularly how Medicaid coverage affects people in the state who are low income and or have multiple chronic conditions. A lot of my research is focused on the ACA and decisions states have made in how they offer or expand coverage. But I am also continuously watching the policy environment—particularly because many things are in flux with the change in presidential administrations. My hope is to provide good evidence through my research and that policymakers use this evidence to inform their decisions.
Erin: What skills that you gained at Princeton—hard or soft—have been useful to you in your career?
Becca: The core epidemiology class has been so useful—particularly how to critically read a journal article. For example in my job at ACAP, I would look to academic articles to help develop our advocacy priorities. Being able to assess the strength of the articles and easily identify issues such as inadequate sample size or selection bias was so important, especially in a field where the evidence is often misinterpreted for political or ideological reasons. Reading studies and critiquing study approaches or differentiating the strength of evidence in order to critique it was an important skill and one that has been so useful in my job and studies.
Erin: What are the aspects that you like most about what you do? What aspects frustrate you?
Becca: I like that I’m working for a cause I believe in—improving healthcare access and quality for low-income people—and that my work is based on good evidence. I’m led by evidence and focusing on building policies that have strong evidence to suggest they work. I do get frustrated with how political the work gets; sometimes the evidence shows one thing and politicians disregard it—but then sometimes they don’t!
Erin: What advice do you have for current GHP students?
Becca: Have really interesting summer internships! I loved the PICS summer internship. At ACAP we also hosted a Princeton intern in the summer. And internships showed me what type of organizations exist and job roles exist. Even though I didn’t go to one of the organizations I interned with, I wouldn’t have known about the type of job I wanted without these experiences.