If it wasn’t for a typo, Dr. William Schpero, a health economist and an assistant professor in population health sciences at Weill Cornell Medicine, may have taken a very different career path.
It was 2010 and he was nearing graduation from Dartmouth College, where he studied biology and government while also writing and editing for the school newspaper. Unsure of whether to pursue a career in medicine or possibly law, he applied for a reporter-researcher job with New Republic magazine, the nearly century-old publication.
“There was a glaring mistake at the top of my cover letter that I only found out about after the fact,” Dr. Schpero said. “Needless to say, I did not get the job.” Instead, he accepted a position as research assistant and speechwriter for Dr. Jim Yong Kim, a physician and then-president of Dartmouth, who previously founded the non-profit Partners in Health and went on to lead the World Bank.
Working with Dr. Kim — who has devoted his life to fighting poverty and disease — Dr. Schpero saw firsthand how public policy drives patient outcomes at the population level, he said. The experience cemented a core idea that continues to guide his work: that policy can be a powerful force for improving health equity — or, if poorly designed, a barrier to it. It’s a tenet that he takes to heart daily in his work as an associate director of the Cornell Health Policy Center, a universitywide initiative focused on bringing evidence into practice to inform health policymaking. And it’s driving his creation of the new Medicaid Policy Impact Initiative at Cornell, which recently launched with an Arnold Ventures grant worth more than $950,000 to launch an online dashboard of Medicaid spending nationwide.
Improving Patient Outcomes at Scale
What may have felt like a missed opportunity at the magazine led Dr. Schpero to a new and rewarding path: health economics.
During his year working for Dr. Kim, Dr. Schpero ended up collaborating with researchers at The Dartmouth Institute for Health Policy & Clinical Practice. One of the first academic departments in the United States focused on health policy research, The Dartmouth Institute is famous for the Dartmouth Atlas of Health Care, a decades-long effort using big data to examine the drivers of variation in spending and outcomes in the Medicare program.
“At The Dartmouth Institute, I saw how empirical research on our health care system could inform the evolution of law,” Dr. Schpero said. “Work at Dartmouth motivated key provisions of the Affordable Care Act, shaping how doctors and hospitals are reimbursed for care today.”
Dr. Schpero stayed on at The Dartmouth Institute to earn a master’s of public health in health policy, followed by a two-year research fellowship.
“It was really a confirmatory experience for me,” Dr. Schpero said. “I didn’t really have any conception of what a Ph.D. was before my time at The Dartmouth Institute. While there, I became inspired by health economists who were doing cutting-edge research to make our health care system work better for everyone.”
Dr. Schpero went on to Yale University in 2014, where he earned a doctorate in Health Policy and Management, concentrating in economics, and joined the Weill Cornell faculty in 2019.
Turning Evidence into Policy: The Medicaid Policy Impact Initiative
Today, much of Dr. Schpero’s work focuses on Medicaid. Although Medicaid is the single largest payer of health care services in the United States, Dr. Schpero notes it is understudied relative to the Medicare program and commercial insurance markets.
“Every state has its own Medicaid program, which leads to a very fragmented data environment,” he said. “Moreover, it can be difficult to know if what works in one state’s program will be just as effective in another state.”
To help solve this problem, Dr. Schpero co-founded the Medicaid Data Learning Network, a national consortium of more than 70 institutions and 400 people dedicated to sharing best practices for working with Medicaid claims data.
The 2025 One Big Beautiful Bill Act, which imposes significant cuts on the Medicaid program, has only served to increase the urgency surrounding this work.
“This is the largest shock to Medicaid since the Affordable Care Act and involves lots of policy changes where we have very little evidence to guide implementation,” Dr. Schpero said. “There is incredible need to think creatively about how we can use data to implement the law as thoughtfully as possible.”
That is precisely the goal of the Medicaid Policy Impact Initiative, launched this month through the Cornell Health Policy Center. Uniting faculty across Cornell’s Ithaca and New York City campuses, the initiative seeks to catalyze research into actionable policy recommendations.
Faculty affiliates will investigate ways to more effectively finance and organize care in the safety net while also ensuring equity. The new Medicaid Atlas Project, which will use national Medicaid claims data to evaluate variation in Medicaid spending across states, plans, and populations — is a big part of that.
“Ultimately, our goal here is to leverage a new age of big data in health policy research to ensure that local, state and federal policy makers have the strongest possible evidence to make the best decisions,” Dr. Schpero said.
Dr. Schpero’s research has already shaped how policymakers think about the health care safety net. His work on Medicaid financing has shown that a substantial share of federal payments intended for safety-net hospitals are not reaching the providers they are meant to support, highlighting opportunities for more equitable allocation of resources. Other studies have revealed structural barriers to care within Medicaid, including the prevalence of so-called “ghost networks,” in which physicians listed as accepting Medicaid see few or no Medicaid patients — findings that have informed recent federal regulations aimed at strengthening access to care.
A central focus of Dr. Schpero’s work is understanding and addressing disparities in access to care. His research has examined how Medicaid policy affects racial, ethnic and socioeconomic inequities — from barriers to physician access to disparities in clinical trial participation — and identified policy levers to make the health care system more equitable. At Cornell, he also serves as an associate director of the Cornell Center for Health Equity, where he works with colleagues across disciplines to advance research and policy solutions aimed at reducing health disparities.
Closing the Gap Between Research and Practice
Despite the scale and complexity of the challenges facing the health care safety net, Dr. Schpero remains focused on a simple question: How can research make Medicaid more effective?
“Too often, research is conducted in isolation from the people it is ultimately meant to serve,” Dr. Schpero said. “If we want evidence to shape policy, we need to engage policymakers and communities from the start — what we study, how we study it and how we share what we learn.”
In many ways, that approach reflects a return to his early interest in journalism. Both fields, he notes, are driven by a common goal: to investigate complex systems, surface overlooked problems and bring clarity to issues that affect people’s lives.
“The questions are similar,” he said. “The difference is that in policy research, we have tools to not only describe problems, but to rigorously evaluate solutions.”
