Sarah Drain

Sarah Drain is a Ph.D. candidate in economics at West Virginia University. She holds an M.A. in Economics from West Virginia University and a B.A. from Duquesne University. Her research focuses on health economics, labor economics, and occupational regulation, with particular attention to how healthcare workforce policy shapes provider supply, access to care, healthcare spending, and the organization of care delivery.

Her job market paper, The Cost of Care Substitution: Healthcare Spending Implications of Midlevel Provider Expansion , studies how expansions in nurse practitioner and physician assistant scope of practice affect healthcare spending and utilization. Using state-level variation in scope-of-practice reforms and claims-based measures of healthcare spending, the project examines whether shifting primary care delivery toward midlevel providers changes costs through reimbursement differences, service intensity, or downstream utilization.

This project is part of a broader research agenda on how healthcare workforce regulation shapes provider supply, care delivery, access, and costs. Her published work includes research on Certificate-of-Need laws and substance use disorder treatment access ( Southern Economic Journal, 2025) and chiropractic scope-of-practice regulation and provider distribution in Pennsylvania ( Knee Center, 2026). Her ongoing work examines how differences in provider authority across states affect healthcare labor markets, substitution across provider types, and geographic disparities in access to care, with broader implications for access, spending, and health outcomes.

In addition to her academic research, Sarah brings applied policy and measurement experience from the U.S. Bureau of Economic Analysis and the RAND Corporation. At BEA, she has worked on regional economic measurement, subnational economic accounts, and experimental approaches to measuring local economic activity. At RAND, she contributed to research on physician workforce policy and military medical recruitment. These experiences complement her academic work by connecting healthcare regulation and labor-market structure to broader questions in economic measurement, public policy, and applied empirical research.

Edgar Orozco

Edgar Orozco is a fourth year PhD student of economics at West Virginia University. He has been with the Knee Center since the fall of 2023. His work at the Center focuses on health topics, specifically scope of practice, labor supply, and Certificate of Need laws. 

Edgar has lead data collection and manuscript development for work in pharmacist collaborative practice agreements, supported the data collection on a comprehensive, multi-state Certificate of Need law dataset, and has written numerous policy briefs on various state's Certificate of Need laws. 

Edgar Orozco has a number of upcoming and published works from his time with the Knee Center, including: 

"Healthcare Policy Spillovers: Impact on Nurse Practitioners and Health Outcomes in North Carolina." Forthcoming

"Optometry Associations and the Free Rider Problem Revisited." Forthcoming:  Theoretical Economics Letters. (Hall, Orozco, Mullis, 2026). 

Blog on physician assistants' regulation; in collaboration with the Cardinal Institute for WV Policy.

Dataset on occupational licensing requirements; in collaboration with the Pelican Institute.

"I value the opportunity to network and collaborate with professionals across disciplines. Engaging not only with economists, but also legal scholars, healthcare experts, and policy practitioners has broadened my perspective and deepened my understanding of how research can inform real-world decision-making." 

Haoyu (Leonard) Wang

Haoyu (Leonard) Wang is a fourth year PhD student of economics at West Virginia University. His position as Graduate Student Research Assistant serves directly under Dr. Alicia Plemmons. His work with the Knee Center includes updating and analyzing state-level data across various occupational licenses.

In addition, Leonard is currently collaborating with Dr. Plemmons to design a health outcomes survey that will be distributed across higher education institutions in West Virginia. 

His favorite part of his work "is the opportunity to build connections — talking and meeting, as well as collaborating on papers, with researchers from other institutions. This has allowed me to develop a strong professional network that I truly value." 

Isaac Saunders

Isaac Saunders is a second year PhD student of economics. His focus, within the Knee Center, is research support on projects in Criminal Justice regulation under Regulatory Frontiers Director Dr. Darwyyn Deyo. His role has involved working with a number of offices within West Virginia University and external to the University and the Knee Center in order to collect information on public records 

Xavier Fankhouser is a senior student of economics at West Viginia University. His work at the Knee Center had involved multiple projects and responsibilities, such as data collection for the Annual Licensing Database Snapshot (ALDS) and literature review in Scope of Practice laws for chiropractors. In addition, he is actively writing about the data collection from the ALDS, in regard to specific occupational requirements and changes from year to year.

When asked about memorable takeaways from working with the Knee Center, Xavier said "My favorite part of working here is working alongside the team we have." 

McPherson Stone is a senior economics student at West Virginia University with plans to graduate early, come fall 2026. Starting work in the Knee Center in fall 2025, he has been a major contributor to the data collections for the Annual Licensing Database Snapshot (ALDS), including natural hair braiders, pharmacists, licensed practical nurses, and dental hygienists. 

With the completion of the 2025 Annual Licensing Database Snapshot, McPherson has now begun writing short blog pieces on the database, as well as professional licensing, as a whole.

Wyatt Armbrester is a senior student majoring in economics here at West Virginia University. Previously, he has held positions as both a Research Apprentice and as a Knee Student Fellow. This year, he has been awarded one of the highest scholarships and fellowships offered by the Knee Regulatory Research Center, the Stockman Fellowship. 

Wyatt's work at the Knee Center has included support of the Annual Licensing Database Snapshot, as well as data collection alongside Dr. Alicia Plemmons for a project analyzing differences in state regulation for the scope of practice of chiropractors. This project was published and further educates the literature on the current state of chiropractic practices and regulation, and how this varies by state. 

Sara Ratley is a senior at West Virginia University majoring in Political Science and Criminology. Sara supports the creation of the Annual Licensing Database Snapshot (ALDS) at the Knee Center through the data collection of occupational requirements for: veterinarian, veterinarian technician, dentist, dialysis technician, physical therapist, and physical therapist assistant.  

In addition to the ALDS data work, Sara also writes short articles on the collection and findings of the Annual Licensing Database. 

"My favorite part of work here is how kind and helpful everyone is, no matter what. From a question about the data, to a question about a class, everyone here makes me feel so welcomed."