Home – Nils Franco

I study health care systems, with the end goal of empowering innovators and good actors. I focus on long-term care, behavioral health, complex chronic conditions, and providers’ efforts to improve and innovate.

In my free time, you can find me on a bike ride, at a coffee shop, or on a phone call noodling over how we interpret and use science as a society, or how we use more data, more reporting, and more information to allow a better debate, rather than a more bitter one. In general, I believe that the questions that get asked are entirely subjective in their framing, and that too often we ignore

The following topics are a through line in my work:

  1. Efficiency of taxpayer dollars: How we optimize public spending on healthcare, social services, education, and criminal justice, taking advantage of cost savings from preventing or compressing high-cost outcomes, and investing in cost-effective programs that improve well-being and dignity relative to the status quo
    • Key example #1: How can the federal Administration for Community Living, Area Agencies on Aging, the federal Medicare and Medicaid programs, and state Medicaid agencies align their funding across programs and across time when investing so that this system of public agencies will invest a dollar in one public coffer in 2021 in programs that would improve well-being while avoiding more spending (inflation-adjusted) in another public coffer in 2023.
    • Key example #2: How a state’s Medicaid agency, behavioral health agency, housing authority, and municipal and state criminal justice agencies can align spending to address the harms of substance use disorders while promoting the well-being of people afflicted with the disorders and the entire community at risk of harms cause by those disorders.
  2. Transparent policy: Public and open data about and providers of government-paid services, their payments, and (when appropriate) their cost structures, margins, and finances
  3. Industrial organization: How the government’s role in markets that are already majorly influenced (or financed) by the government can be better structured for public benefit (some set of transparently stated, and ideally measurable, public goals)