Q&A with Alumni Leadership Award Recipient Sharon Arnold

At the Commencement Weekend Celebratory Dinner, Sharon Arnold talks about her experiences

Photo by Maria Martin/RAND Corporation

June 20, 2018

Sharon Arnold (cohort '85) received Pardee RAND's fourth Alumni Leadership Award during Commencement Weekend 2018. She sat down for a Q&A about her experience at the School and how her time at RAND has influenced her career, and also spoke at the Celebratory Dinner on Friday, June 15.

How did you end up at RAND Graduate School?

Initially, I was studying health planning at UCLA, but the program was dismantled by the Reagan administration. The field was relatively nascent and was a way in which to study health services and improve their quantity, quality and effectiveness, along with planning for future population growth. So, I came to RAND to work as a research assistant for Robert Kane, who then encouraged me to attend RAND Graduate School. Only two RAND employees were accepted as part of the program, and I was one of them. I was a Pew Fellow focused on health policy.

How did your education at Pardee RAND help you in your career?

I was more interested in applied research than academic research. I loved doing OJT – it made real what I was learning in the classroom. It also allowed me to interact in a different way with the faculty – as a student on the one hand, and then almost as a peer on the other. Another great aspect of my education at RAND was that I learned how to work as part of a team. I truly felt when I left that I had skills I could take with me into the workforce.

What is one of your favorite memories from your time at Pardee RAND?

During lunch a few times a week, a bunch of us would change into swimsuits and swim the bay. The old building wasn’t air conditioned, so it was refreshing. When I was working on my dissertation it was in the days of mainframes so students would come in late during the afternoon and overnight to submit programs. It established a real “esprit de corps”. We were a small group of students and we all pulled together to help each other.

How do you feel you have made an impact?

After the Affordable Care Act passed I was at CMS working to implement it. Bringing insurance to so many more people was very exciting. We put in place all the financial provisions: how much to pay insurance companies; risk adjusting to managed care plans; appropriately reimbursing people and redistributing money to insurance companies; and methodologies to pay reinsurance for insurance, among so many other things. Some of the research we did was figuring out what kind of solicitations to put out for research programs as well as looking at healthcare costs over time along with healthcare systems, mergers and acquisitions over time. Our work informed the execution of many different policies.

Who is someone you admire for being the answer to a policy problem?

One of the people I admire the most is Joe Newhouse for the RAND Health Experiment. People are still using the findings from it. He was so young and used it as an opportunity to develop a measurement agenda. I also worked with Bob Brook on how you measure health status over time to study impact. That work has been pretty unrivaled since.

Who were your favorite professors at RAND and why?

Before coming to RAND, I had read the work of giants like Emmett Keeler, Bob Brook, Joe Newhouse and Al Williams. Coming to RAND, I got to meet these giants and learned quickly that each one of them is human and willing to talk to students and people like me. It was so exciting to work alongside them.

What do you think is the most critical issue facing the world — and policymakers — today?

The question that most interests me today is how you harness research findings and have them be used in practice and policy. People are not getting evidence-based care 50 percent of the time, despite dozens of years of health research. The question is: how do you take those findings and operationalize them in a way to where they can be put into practice? I would like for the lines not to be so distinct – to increase cross-fertilization. Researchers are asking good questions but stop short of asking the applied questions. This is critical before we can see solutions.

Alumni Leadership Award Speech

It is a great pleasure to be back at RAND, to see old friends and colleagues and to admire the beautiful facilities here. It is a bit different from when I was here, when we were in the old building!

I would also like to express my appreciation and gratitude to Jeffrey Wasserman for nominating me, and to Susan Marquis and others at Pardee RGS for selecting me for this award. I am very honored and humbled, and I accept not only for myself but also on behalf of all of the Pardee RGS graduates who are working on interesting public policy questions of all types.

I would also like to congratulate the Pardee RGS graduates who are celebrating their commencement this weekend, as well as the honorary degree recipients. I am so impressed by the rich set of experiences and wide range of expertise you possess. And I know that each of you will "be the answer" as you work towards changing the world for the better.

I have had the great fortune to have been a part of some significant changes in health policy in the almost 30 years since I graduated. While some of that I attribute to being in the right place at the right time, in large part it is due to the preparation and skills I received in my training at RGS. As you well know, the RGS education focused not only on skills: economics, statistics, survey methodology, but also on applying those skills to real world problems. And as you also know, the real world applications taught through seminars, and through on-the-job training, is the "secret sauce" that made RGS such a special place.

My job experiences since RAND include researcher, funder, policymaker, and program implementer. While that seems like a lot of different roles, the common theme is that each allowed me to experience first-hand the intersection of research, policy, and practice. This has led me to spend more than a little bit of time thinking about this intersection and how to fill in some of the gaps that exist. For example, how to help researchers ask the "right" questions. How to make sure research results get to the right audience. How to assess different, and possibly conflicting, findings. How to make sure policy is evidence-based. How to make sure we are using the latest research in practice.

Here are just a couple of suggestions on how this can be done:

1. Think about your audience.

Many researchers, especially those at RAND, cultivate relationships with policymakers so that their research is relevant and the findings can be used. But policymakers are not a monolithic body. Which policymakers do you envision using your research and how? Is it the legislator? The regulator? The program implementer that needs to think about all the operational details associated with implementing a policy or program? Having an idea of which type of policymaker would use your research will help you better communicate your findings. And how you communicate your findings is also important. Identifying which policymakers and cultivating relationships with them takes time and effort, and I would guess that most of these policymakers do not generally read academic journals or long reports! They want the findings relevant to their specific problem in a timely and succinct format. It’s probably unrealistic to expect each researcher to identify what issues are ripe for policy change, identify the relevant policymakers, and provide the right information at the right time, so I urge you all to utilize the intermediaries out there that exist to translate research findings – these include public and private sector entities, foundations, associations, and many others. In the longer term, we need more systemic change – such as re-thinking our academic promotion criteria away from counting publications to criteria more focused on meeting the needs of the audience and better use of the research. But even within the current structure of research and promotion, there’s a lot more to be done.

2. The kinds of research questions researchers ask are really only the start of the numerous questions that policymakers need addressed.

RGS does a great job preparing its students to do policy research. But it was only when I was on the other side, as a policymaker, that I realized that there were a number of additional questions that I needed addressed before I could use the research findings. While the researchers appropriately place the research in the context of the body of research that came before it, and ask important questions about impact in a particular setting or on a particular population, the policy official comes at the issue from the perspective of the specific problem at hand. The questions for the policymaker are rooted in the constraints of the current environment and the possible options moving forward. So, for the research to be most helpful to policy officials, the findings need to be framed in the current environment, with a particular focus on the impact of changes on various stakeholders and analyses of winners and losers. What do we know about the fidelity of the findings to the situation at hand? How confident are we that we can extrapolate the findings to other settings/populations? What are the costs of incorporating particular research findings – to the organization and to other stakeholders? Conversely, what are the costs of not acting? How do we incorporate the research findings? Are there particular tools or resources that are needed? New measurement systems? Training?

I could go on forever, and would be happy to discuss this further with any of you who are interested, but I know time is short. Before I go, I would like to thank my family for their support. For my husband, Jeff, who has been my rock and my support for the past 25 years, and for my sons, Randy and Mitch, who always remind me what is important. Thank you. And thank you Susan and the Pardee RAND Graduate School for this great honor.