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With the new academic year underway, I want to extend a warm greeting to our colleagues, students, and partners across the Sheps Center and beyond. The start of the fall season always brings a sense of renewal and possibility, and this year is no exception—even as we continue to navigate complex and uncertain times in health care and public policy. Your commitment to meaningful work and collaboration is what keeps us true to our mission.
This issue of the newsletter highlights the incredible breadth of activity across the Center. From the Medicaid Symposium in Raleigh, which showcased highlights of the waiver evaluation and new research on Medicaid expansion, to the launch of ShepsGME (a new initiative supporting graduate medical education in rural and underserved communities) we are seeing real momentum in our efforts to understand factors that shape our healthcare system. We share updates on NC-BELL, a multi-year evaluation of crisis and child behavioral health systems, and spotlight new research from the UNC Behavioral Health Workforce Research Center that is shaping national conversations on workforce development and service delivery.
We’re also proud to highlight a partnership with Subsalt to streamline access to Sheps-managed data by leveraging synthetic data, accelerating project timelines and maximizing efficiency. As AI continues to transform the research landscape, Sheps plays a critical role by being actively engaged in shaping and leveraging its potential. And as always, we celebrate the people behind the work—welcoming new team members and sharing recent recognitions and publications.
Thank you for your continued dedication. Whether you're returning to campus, starting a new role, or continuing your work in the field, we hope this newsletter inspires you and reminds you that your efforts are part of something bigger. Let’s keep moving forward.
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Medicaid Symposium Highlights Expansion Success and Rural Health Gains in North Carolina
The Sheps Center and NC Medicaid teamed up to host a Medicaid Symposium on May 30th in Raleigh, NC, which brought together researchers, policymakers, and stakeholders to assess the impact of recent Medicaid changes in North Carolina. With opening remarks by NCDHHS Secretary Dev Sangvai and Gillings Dean Nancy Messonnier, the event highlighted the early results of Medicaid managed care and the December 2023 expansion. Experts shared data showing reduced preventable hospital admissions and improved financial stability for healthcare providers.
Presenters included Christopher Shea, PhD; Alejandra Madrid; Susie Gurzenda, MSc; Sandra Greene, DrPH; Mark Holmes, PhD; Valerie Lewis, PhD; and Seth Berkowitz, MD, MPH. Representative Sarah Crawford and Senator Jim Burgin from the NC General Assembly shared their reflections of the data presented, and Deputy Secretary for NC Medicaid Jay Ludlam wrapped up the symposium.
| | Clockwise from top left: Secretary Sangvai; presenters; Ms. Gurzenda; Dr. Holmes with Mr. Ludlam, Rep Crawford, and Sen Burgin. | |
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NC Hospital Discharge Data: Insights from 2023
Sandra Greene, DrPH formally presented the 2023 North Carolina hospital discharge data at two meetings this spring. She presented at the Division of Health Service Regulation annual meeting, which was held virtually on March 24th, and also with the NC Medical Care Commission in Raleigh, NC on May 9th. The presentations were well-received at both events and led to fruitful discussion and questions. Dr. Greene shared information derived from the three sources of NC hospital discharge data: 1) inpatient hospital episodes, 2) emergency department visits, and 3) hospital outpatient and free-standing ambulatory surgery visits.
The data behind this presentation are available to UNC researchers, find out more at https://www.shepscenter.unc.edu/data/nc-hospital-discharge-data/.
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AcademyHealth ARM 2025
AcademyHealth's Annual Research Meeting was held in June in Minneapolis, MN and focused on the impact of health services research (HSR) on policy and practice in a changing landscape. UNC and the Sheps Center had a large presence with several presentations reflecting a rich and diverse set of themes centered around HSR including Health Workforce, Behavioral Health, Rural Health, Medicaid, Data Analytics, and Maternal & Child Health.
| | Behavioral Health Workforce team members Lisa Zerden, PhD, MSW, Maria Gaiser, MPH, and Brianna Lombardi, PhD, MSW | | T32 Postdoc Chris Bosley, PhD | | Sheps Faculty Featured in UNC Research Stories | | Introducing ShepsGME: Advancing Graduate Medical Education in Rural and Underserved Communities | | |
The UNC Sheps Center is proud to announce the launch of ShepsGME, a new program dedicated to supporting the creation and sustainability of graduate medical education (GME) in rural and underserved settings through technical assistance, research, and policy analysis.
ShepsGME brings together three major initiatives, two federal and one state, under one umbrella:
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RuralGME (ruralgme.org) – supporting rural GME development and sustainability
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THCGME (thcgme.org) – advancing teaching health center GME programs
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NCGME (ncgme.org) – leading GME expansion efforts across North Carolina
Through ShepsGME, the Sheps Center continues its commitment to ensuring that communities—especially medically underserved areas and populations—have access to a strong, locally trained health workforce.
| | Sheps Center Holds First NCGME In-Person Event | |
 | | On June 2, ShepsGME officially launched the NCGME Technical Assistance Center, the newest TA Center in the ShepsGME family. The kick-off event included representatives from UNC, ECU, NC AHEC, MAHEC, and SEAHEC. Many Sheps team members participated in the event. Emily Hawes, PharmD, BCPS, CPP shared insights about building rural and health center GME training from ShepsGME’s national work. Erin Fraher, PhD, MPP presented current data on GME training outcomes in NC. Mary Alice Scott, PhD described new maps developed in collaboration with Mukesh Adhikari and Evan Galloway, MPS demonstrating where GME training is happening in comparison to current physician supply. Lori Rodefeld, MS presented examples of GME training strategies from other states to generate ideas for future GME development in North Carolina. The team also unveiled their new website [www.ncgme.org], which will be a resource for those who are interested in starting or sustaining GME training in rural and underserved areas of the state as well as for medical students looking for residencies in these areas.
| | Launching NC-BELL: A Collaborative Evaluation of Crisis and Child Behavioral Health Systems in North Carolina | | |
A research team from the Program on Behavioral Health Services Research is partnering with the NC Department of Health and Human Services on a 3-year evaluation of the state’s crisis and child behavioral health systems. The state recently invested in improving crisis services for individuals experiencing mental health or substance use crises. Further, state investments have targeted a range of initiatives to improve the children’s behavioral health service system.
The crisis system evaluation is led by Helen Newton, PhD, MPH (School of Medicine); the child behavioral health system evaluation is led by Paul Lanier, PhD, MSW (School of Social Work). This new initiative, the NC Behavioral Health Evaluation and Learning Lab (NC-BELL), is supported by the Sheps DATA+ team and campus partners including the Carolina Survey Research Laboratory and the UNC Gillings Center for Artificial Intelligence and Public Health.
Joining the Sheps NC-BELL team are four Research Associates: Sasha Zabelski, PhD and Amanda Dale, PhD (crisis evaluation) and Monica Landers, PhD and Emily Forrest Hutchens, PhD (child behavioral health evaluation). Sasha recently received her PhD from UNC Charlotte and completed a fellowship with AcademyHealth. Amanda graduated from Gillings with a PhD in Maternal and Child Health and has worked the past year with the NC Institute of Medicine. Monica received her PhD from the University of South Florida where she also worked for 10 years as a Social and Behavioral Health Researcher. Emily is also a recent Gillings graduate, with a PhD in Health Behavior.
Join us in welcoming our new team members as we launch this new partnership!
| | Tracking Physician Retention: Outcomes of NC Residency Graduates | | |
The June 2025 NC GME Report from the Sheps Program on Health Workforce analyzes the workforce outcomes of physicians who completed residency in North Carolina between 2017 and 2019, focusing on retention in the state and rural areas five years post-graduation. Despite significant public investment in graduate medical education, only 37% of 2017-2019 graduates remained in North Carolina and less than 3% practiced in NC rural areas five years after graduation. Family medicine programs showed the highest in-state retention (50%), especially among those who also attended North Carolina medical schools (88%).
The report highlights growing subspecialization trends, declining retention in key specialties like psychiatry and surgery, and limited practice in underserved communities. It calls for improved accountability in GME funding and strategic investments to strengthen the generalist and rural physician workforce.
| | Sheps Center is a Leader in Rural Health Innovation | | |
The Sheps Center is advancing rural health care through innovative, data-driven research. Our North Carolina Rural Health Research Program, led by Mark Holmes, PhD, tackles disparities such as higher mortality rates in rural areas by partnering with hospitals and agencies to inform policy and improve care delivery.
The Sheps Center also focuses on workforce development. Dr. Erin Fraher’s research supports rural residency programs, while Emily Hawes, PharmD, BCPS, CPP leads an $11 million initiative to expand physician and dental training in underserved areas—boosting retention of providers in those communities. Additional efforts include Dr. Jacquie Halladay’s work to enhance primary care practices and Dr. Kristin Reiter’s financial tools for Critical Access Hospitals, helping them benchmark and improve performance.
Together, these projects reflect the Sheps Center’s commitment to improving rural health through research, collaboration, and targeted interventions.
| | Re-thinking Diabetes Testing | | Katrina Donahue, MD, MPH and Jen Rees, RN, CPF are leading a statewide initiative through the North Carolina Network Consortium (NCNC) to improve diabetes care by reducing unnecessary daily glucose testing for patients with Type 2 diabetes who are not on insulin. Their project, “Rethink the Strip,” builds on their previous research showing that routine testing in these cases doesn’t improve outcomes. By partnering with clinics across North Carolina, they’re promoting evidence-based practices that support both patients and providers. Early results are promising, though sustaining change—especially during the pandemic—has posed challenges. | | EXTERNAL PARTNER SHOUTOUT | | |
Faster Research, Smarter Data:
AI at Sheps
The Sheps Center is excited to announce a new strategic partnership with Subsalt to modernize how researchers access and utilize high-value health data. By combining Sheps data expertise with Subsalt’s advanced machine learning technology, we’re creating synthetic data sets—realistic, non-identifiable replicas of actual health data.
This collaboration aims to make research more efficient by streamlining access to Sheps-managed datasets. Researchers can now begin their work in hours, not months, thanks to synthetic data that mirrors the structure and statistical properties of real data without compromising privacy. This process aligns with rigorous privacy, governance, and compliance standards, with data owners and stewards maintaining control throughout.
By enabling faster hypothesis testing, feasibility studies, and iteration, this partnership promises to accelerate research timelines while keeping privacy and ethical considerations at the forefront.
We’re very excited about the transformative potential of this collaboration and look forward to seeing the groundbreaking research it will empower.
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Ian Coleman, MCS
Sheps Integrated Research Solutions (SIRS)
Ian is a senior developer on the SIRS team. He leads development on GoNAPSACC in partnership with the Community Health and Wellness Resource Team at the Center for Health Promotion and Disease Prevention (HPDP). He has also contributed to Dementia Comfort and the NC Health and Safety Assessment and Encounter Tool.
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Jennifer Headley, MSW
Program on Health Workforce Research and Policy
In her role as a project manager with the Workforce Program, Jennifer assists with study design and planning, manages project implementation, and facilitates research dissemination. Her work focuses on two projects: 1) A 5-year evaluation of UNC System Office nursing expansion grants and their impact on increasing nursing graduates and strengthening the NC nursing workforce, and 2) a behavioral health workforce landscape project building the data infrastructure to analyze the adequacy of NC’s behavioral health workforce.
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Patrick Tang, MPH
North Carolina Institute of Medicine (NCIOM)
Patrick is a project director at the NCIOM. His current projects focus on maternal healthcare, healthcare workforce development, and opioid treatment and prevention. Patrick earned his Master of Public Health in Health Behavior from the University of North Carolina at Chapel Hill and his Bachelor of Arts in Molecular Biology from Princeton University.
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Joacy Gerard Mathias, PhD
Data Analytics and Research Team (DART)
Dr. Mathias is a Biostatistician at Sheps. With a background in epidemiology, her work focuses on healthcare access, Medicaid waiver evaluations, behavioral health, and maternal and child health, all to advance health through meaningful data analysis. She completed postdoctoral training at UNC Gillings and Duke. When she's not deep in data, she’s likely cuddling with her 55lb labradoodle, recreating her grandma’s South Indian recipes, curled up with a book club pick, or getting bossed around by her toddler.
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📆November 13
2025 NCIOM Annual Meeting
8:00 am - 4:00 pm
McKimmon Center, Raleigh, NC
"Healthy North Carolina 2030: A Path Towards Health"
Keynote Speaker: Umair A. Shah, MD, MPH
This year’s meeting will focus on a mid-decade update on the status of the work to achieve the goals of Healthy North Carolina 2030. Attendees will learn from and connect with health leaders, policymakers, and community partners from across the state as they:
- Reflect on progress,
- Share innovative strategies,
- Identify persistent challenges, and
- Chart a course toward improved health outcomes for all North Carolinians.
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Tania Jenkins' research on professional culture and physician burnout was cited in a Medscape article about how medicine can be unhealthy for doctors.
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The UNC Behavioral Health Workforce Research Center (UNC-BHWRC) recently released five new studies that shed light on critical issues shaping the behavioral health workforce. These publications explore a range of pressing topics—from workforce entry pathways, anticipated retention in the field, to service delivery gaps and behavioral health regulatory inconsistencies.
- Using a Latent Class Analysis, one study identified Educational Pathways to Graduate-Level Behavioral Health Professions and found distinct routes into the field and links them to workforce characteristics, offering insights for training and recruitment strategies.
- Another study examined the Characteristics of Treatment Facilities with Perinatal Programs for SUD and Mental Health Disorders across U.S. treatment facilities. Findings revealed significant gaps in access and geographic disparities.
- The UNC-BHWRC also explored Factors Associated With Variation in Telemental Health Delivery at Federally Qualified Health Centers and how different clinician types are delivering virtual care.
- The team published a study on the non-graduate level addiction counselor workforce that included a systematic review of state Practice Acts, credentialing rules, and licensure and credentialing bodies to examine how addiction counselors are defined, regulated, and paid.
- Another project examined job satisfaction and anticipated retention among over 2,500 behavioral health clinicians working in federally designated Mental Health Professional Shortage Areas (mHPSAs).
Together, these publications provide actionable evidence to inform policy, improve access, and strengthen the behavioral health workforce nationwide.
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Bianca Allison, MD, MPH (Pediatrics), from the Sheps Child Health Program, is working with a team to build a program designed to help parents and kids have more comfortable, confident conversations about puberty, relationships, and growing up. 💬✨
They launched a new website, www.lets-talk-families.com, to showcase the program. Whether you're a parent, educator, or just someone who believes in supporting healthy, open communication in families—check out the website and consider joining their mailing list. Their goal: 1,000 email sign-ups to show there’s real demand for this program. Reaching this milestone will help them secure the funding they need to bring it to families everywhere.
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Want to read a previous issues of this newsletter? Click here.
Have feedback on this newsletter or suggested content for future newsletters? Contact Lindsay McCall.
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