Duke-Margolis and the Sanford School of Public Policy are rolling out a powerful and structured way for Duke undergraduate to study health policy. Launching this fall, the Health Policy Certificate offers accepted first-years, sophomore, and juniors the opportunity to learn evidence-based health policy analysis, development, and implementation so they are prepared to address complex challenges in health and health care at local, state, national, and global levels.

“Duke is uniquely positioned to educate students in health policy, with our medical school, nursing school, other health and professional programs, a huge health system together with the University’s multiple majors and training programs. It's is a wonderful place for cross disciplinary research and education. The health policy certificate is a great opportunity to bring all those resources together for students, along with mentorship, classroom learning, and guided field work to be able to learn about health policy and use those skills across a variety of sectors after their education here at Duke.”

- Nathan Boucher, Faculty Director for the Health Policy Certificate, Associate Professor at Sanford, and Core Faculty member at Duke-Margolis.

Visit the Health Policy Certificate website for more information and to apply to the program.

The growing and energized Duke-Margolis Postdoctoral Associates & Affiliated Fellows Program, led by Marianne Hamilton Lopez, aims to advance the careers of tomorrow’s health policy leaders by offering a range of opportunities for those early in their research and/or clinical careers, with an interest in, and commitment to, health policy.

The Center’s program offers three different opportunities for in-depth, hands-on training; mentorship from leading health policy experts; and study of complex, real-world health policy problems with a dedicated team of Duke researchers and colleagues. The program includes:

The Postdocs and Fellows selected for these prestigious opportunities will engage as a cohort during their time at Duke on research, health policy-focused programming, journal clubs, and seminars. Duke-Margolis welcome them and the new Margolis Scholars at a special August 27 orientation organized by the Center’s Education team.

Sandra Yankah, Ph.D. is a postdoctoral researcher at the Duke-Margolis Center for Health Policy. Dr. Yankah graduated from Western Carolina University’s Honors College with Bachelor’s degrees in Psychology and Sociology and subsequently completed a Master’s degree in Clinical Psychology at Valdosta State University. Afterward, she completed a doctoral degree in Clinical Psychology at Virginia Commonwealth University. While completing her doctoral degree, Dr. Yankah completed numerous research and service initiatives centered on health policy, including serving on the university’s Health Insurance Advocacy Committee, participating in the Research to Policy Collaboration, and completing the Virginia Academy of Science Engineering and Medicine’s COVES fellowship. Dr. Yankah brings her background and extensive experience in social drivers of health outcomes, dissemination and implementation science, and health services research.

Cara Smith, MD developed her interest in health equity policy as an undergraduate at the University of Kansas. Through her experience with the University’s Work Group for Community Health and Development, she walked blocks in Kansas City neighborhoods to evaluate social determinants of health. She earned her medical degree at the Howard University College of Medicine, where she was mentored by amazing family doctors who deeply understood their patients’ health-related social needs, and she was inspired to follow their lead into family and community medicine. She recently completed her family medicine residency with a concentration in health systems leadership at the Lawrence Family Medicine Residency in Massachusetts.

Sarah Allin, MPP, is the Center’s new Policy Fellow for Child and Family Health Policy, leading the Duke-Margolis work with North Carolina Integrated Care for Kids (NC InCK), where she also serves as the program’s Managing Director. Sarah’s passion for promoting child and family well-being grounds her research interests in strengthening public sector services for children, especially those insured by Medicaid and CHIP and those engaged with the child welfare system. Sarah holds a Master’s in Public Policy degree from Harvard University’s John F. Kennedy School of Government, where she was a Gleitsman Fellow for Social Change and the Editor-in-Chief of the Kennedy School Review.

We extend a warm welcome to Jeylan Close, MD, Tyra Girdwood, RN, PhD, Ceshae Harding, MD, Gabriela Plasencia, MD, Carri Polick, RN, PhD and Judith Vick, MD, who are the 2022-2024 NCSP cohort at Duke.

Click here for more information about the NCSP at Duke.

HEALTH POLICY IN ACTION

The COVID Global Accountability Platform (COVID GAP’s) released two updates in their ongoing series of Accountability Reports, which highlight and analyze recent developments, track progress toward national, regional, and global targets, and identify high-priority recommendations for a more effective, efficient, and equitable pandemic response and preparedness.

In addition to the Accountability Report updates, COVID GAP published three brand-new blog posts highlighting important news and trends in the fight against COVID-19.

1.     With its rapidly growing urban population, high burden of infectious disease, and widespread gaps in health care capacities, Africa is particularly vulnerable to potentially devastating epidemics. The Africa Centres for Disease Control and Prevention (Africa CDC) has been on the forefront of addressing the issue. One important example is the Biosafety and Biosecurity Initiative, which aims to improve the handling of dangerous substances across the continent. Click here to read the blog, co-written by Africa CDC’s Senior Biosafety and Biosecurity Officer, exploring how the Biosafety and Biosecurity Initiative 2021-2025 Strategic Plan could be a successful model for other regional approaches to improving health emergency preparedness and response.

2.     COVID-19 has disrupted clinical care and supply chains throughout the world, testing the resilience and flexibility of health systems everywhere. Services for those living with HIV/AIDS are no exception. New data shows shrinking resources and growing inequalities that could result in millions of new infections and AIDS-related deaths if the current course is not reversed. “AIDS 2022 Highlights COVID's Disruptions, Innovations” explores how COVID-19 offers critical guidance for effective disease prevention and control. Click here to read more.

3.     While the world developed and distributed COVID-19 vaccines with unprecedented speed, the required emergency focus, coupled with response inequities and disruptions caused by the pandemic itself, took an enormous toll on health services. Health workers burned out, access to care fell, and childhood vaccinations suffered the largest sustained decline in 30 years. The latest blog by COVID GAP explores how WHO and UNICEF are developing a document outlining considerations for incorporating COVID-19 vaccination into national immunization programs and primary care.

RESEARCH

Lead author and Margolis Scholar Ethan Borre collaborated with Duke-Margolis co-authors Gillian Sanders Schmidler and Osondu Ogbuoji to publish “Model-Projected Cost-Effectiveness of Adult Hearing Screening in the USA.” Click here to read the article, which estimates long-term clinical and economic effects of alternative adult hearing screening schedules in the US.

In a new Health Affairs Forefront article, Duke-Margolis researchers Caleigh Propes, Trevan Locke and Rachele Hendricks-Sturrup discuss how a point-of-care trial is an operational approach to conducting clinical trials that integrates clinical research and routine care delivery. Read the full article, “Improving Evidence Generation Through Point-Of-Care Trials,” here.

Duke-Margolis researcher David Anderson co-authored a recent investigation that evaluates whether cuts to the funding to the Affordable Care Act (ACA) navigator program were associated with changes in the volume of private sector advertising. Click here to read “Association of Funding Cuts to the Patient Protection and Affordable Care Act Navigator Program with Privately Sponsored Television Advertising.”

NEW GRANTS & UPCOMING RESEARCH

Duke-Margolis launched of a new effort to assist communities and states in investing opioid settlement funds to support local, sustainable community-based substance use disorder treatment and recovery infrastructure. With support from the Elevance Health Foundation, Duke researchers will work with Third Horizon Strategies to create resources for policymakers to maximize use of these funds in their communities. Read more here.

Duke-Margolis researchers have launched a new grant funded by the Kate B. Reynolds Charitable Trust, “Timely Lessons for Advancing and Aligning North Carolina’s Health Care Transformation Leadership to Address Social Needs.” This work will generate practical implementation lessons and policy recommendations for NC’s innovative Medicaid managed care program to address social needs, the Healthy Opportunities Pilots. The work also will study other efforts in the state to address social needs beyond the Pilots—bringing stakeholders together regionally and statewide to align infrastructure to address social needs and improve health equity in North Carolina. The Duke-Margolis research team, led by Will Bleser, includes Katie Huber, Yolande Pokam Tchuisseu, Rob Saunders, Andrea Thoumi, Brianna Van Stekelenburg, and Rebecca Whitaker.

12:00 noon – 5:00 PM ET

A lack of standardization of safety data analysis and visualization has resulted in inconsistencies in how adverse events are defined, categorized, analyzed, and presented in marketing applications. The U.S. Food and Drug Administration’s (FDA) Center for Drug Evaluation and Research’s Office of New Drugs led the development of two documents to facilitate internal review of safety data.

On September 14, 2022, Duke-Margolis and the FDA will hold a public workshop presenting the Agency’s work and perspective on premarket review of safety data. The FDA documents will serve as a launch point for broader conversations on best practices and innovative approaches for advancing premarket safety signal analytics.

Click here for more information and register.

2:00 – 4:00 PM ET

A lack of standardization of safety data analysis and visualization has resulted in inconsistencies in how adverse events are defined, categorized, analyzed, and presented in marketing applications. The U.S. Food and Drug Administration’s (FDA) Center for Drug Evaluation and Research’s Office of New Drugs led the development of two documents to facilitate internal review of safety data.

On September 14, 2022, Duke-Margolis and the FDA will hold a public workshop presenting the Agency’s work and perspective on premarket review of safety data. The FDA documents will serve as a launch point for broader conversations on best practices and innovative approaches for advancing premarket safety signal analytics.

Click here for more information and register.

1:00 – 5:15 PM ET

The FDA requires Risk Evaluation and Mitigation Strategies (REMS) for certain medications to ensure that the benefits outweigh the risks. REMS requirements can be burdensome for prescribers, pharmacists, and patients, as they are completed often outside of standard clinical workflows, which can be costly and time-consuming and can create delays or barriers to medication access for patients. FDA has supported the development of a proof-of-concept prototype that will allow certain REMS activities to be integrated into standard health information technologies.

On October 11, 2022, Duke-Margolis and FDA will host a virtual public workshop to solicit feedback from key stakeholders on the REMS integration prototype. Speakers from FDA and MITRE will provide an overview of the prototype’s aims, core functions, and role in FDA’s ongoing efforts to modernize REMS. Patients, prescribers, pharmacists, health system representatives, informaticists, and other key stakeholders will participate in a series of moderated panel discussions that focus on how the prototype can address challenges associated with integrating REMS requirements into clinical workflows to facilitate safe medication use.

Click here to register and learn more about the workshop.

Duke-Margolis and FDA convened a webinar, as a follow-up to a January 2022 workshop, to provide an overview of the key themes and future directions on Niemann-Pick Type C treatments. Niemann-Pick Type C is a rare genetic condition that currently has no approved US treatments. Experts discussed clinical endpoints relevant to clinical trials and innovative measurement strategies with the overall goal of supporting the development of safe and effective treatments for those living with NPC.

Both the House and Senate Appropriations Committees recently featured NPC, and FDA’s work with Duke-Margolis, as part of a FY2023 appropriations bill:

“The Committee commends the FDA for convening a meeting early in 2022 on Niemann-pIck Type C, a rare progressive and universally fatal disease that impacts children and young adults. The Committee encourages FDA to continue to better understand this always fatal condition by improving collaboration with NPC patients and caregivers. The Committee also encourages the FDA to work in partnership with NPC experts, industry and the patient community to ensure the viability of trials and clinical development and to apply patient and caregiver perspective when evaluating risk benefit of experimental therapies that are already in use in the NPC community. Further, the Committee is particularly interested in follow up to the FDA’s recommendation to the NPC community to work with the Critical Path Institute. The Committee requests an update from the FDA on progress as well as the findings from the 2022 meeting.”

With funding provided by Arnold Ventures, Duke-Margolis convened a diverse group of Duke specialty physicians to identify key clinical and policy challenges to specialist participation in Accountable Care Organizations (ACOs).

Key takeaways from the meeting include: bundled payment models may help improve the quality of care but may not lead to more effective utilization of procedures, siloes between specialties and primary care hinder communication and care coordination, and non-financial incentives can be a powerful tool to engage specialists in ACOs. Click here to learn more about this ongoing project.

With support from Arnold Ventures, Duke-Margolis hosted the third in a series of independent, yet interconnected, multipayer alignment workshops designed to accelerate progress on payment and delivery reforms. The first workshop in April focused on setting a vision for multipayer alignment, the second workshop in May continued that discussion with a specific focus on data and infrastructure needs. At the August workshop, attendees reviewed an operational framework of elements to support multipayer alignment, assessed interest in specific action areas and recommendations, and discussed how new initiatives can build toward more comprehensive alignment initiatives and support long-term improvements in areas such as health equity and care transformation.

Strategic and technical leaders from North Carolina’s health systems, provider groups, payers, Department of Health and Human Services, and other stakeholders met to identify potential, near-term priorities for improving equity-oriented data and quality measurement to advance equity and health care transformation in the state.

We are pleased to introduce the 2022-2023 Margolis Scholars, representing six graduate/professional schools and 14 undergraduate majors, including five different self-designed “Program II” courses of study. These students are in either their first or second year of the program, which will provide them with the necessary knowledge, skills, and abilities to be the next generation of health care leaders. Welcome, Scholars!

This summer, 37 summer interns successfully complete the Margolis Summer Experience Program and 14 of these interns were asked to continue working with their mentors after the program ended. Margolis Summer Interns spent 10 weeks working on health policy research and gained knowledge and skills in the health policy field. As part of the experience program, the interns were required to complete a program deliverable and present it at our Summer Research Symposium. Jonathan Barber, an intern with the Education Team produced, “What is the Summer Experience?” a great video where mentors and interns share their experiences and the importance of the Center’s efforts to provide this opportunity for up and coming health policy leaders.

Bass Connections and Duke-Margolis have announce a new theme, Health Policy & Innovation, to support interdisciplinary teams of faculty and students in their exploration of solutions to improve health and wellbeing in the United States. Duke-Margolis will administer the theme, which will be led by Beth Gifford, associate research professor in the Sanford School of Public Policy and a Duke-Margolis core faculty member. Click here to learn more about this exciting new opportunity.

Welcome Back Margolis-Bass Connections team! Check out the exciting new projects slated for 2022-2023!

Director Mark McClellan discussed with the Associated Press potential policy options to sustain Medicare's Hospital Insurance trust fund, which is at risk of running out of money in 2028. Read the full article.

Duke-Margolis Research Director Christina Silcox spoke with PEW for a recent article, “How to Understand and Fix Bias in Artificial Intelligence-Enabled Health Tools,” covering a recent Duke-Margolis white paper During the interview, Dr. Silcox discussed the four sources of AI bias in health care and ways to mitigate them.

Continuing with her work on AI in health care, Christina also presented an “AI Flash Talk” at the Society for Standards Professionals 71^st Annual Conference, explaining how AI works, the different types of AI, and where AI presents different challenges in development, regulation, and implementation.

Duke-Margolis Core Faculty Member Barak Richman co-authored three published journal articles:

Core Faculty Member Brystana Kaufman was selected to the Health and Aging Policy Fellows Program. The Fellows are comprised of outstanding scholars and practitioners from across a range of disciplines who promise to continue the tradition of leadership in shaping policies for older Americans. Click here to learn more about the Fellows Program. Way to go, Brystana!

Duke-Margolis Health Equity Policy Fellow Andrea Thoumi was selected to serve a two-year appointment on AcademyHealth’s Disparities Interest Group (IG) Advisory Committee. The group’s mission is to improve the health and health care of diverse populations by promoting research and engaging researchers, practitioners, policymakers and communities committed to equity in health and health care. Congratulations on this appointment, Andrea.

Center Research Director Rachele Hendricks-Sturrup was featured in an article from the August 2022 edition of Medical Ethics Advisor discussing the importance of diversity inclusion in clinical trials. In her interview, she notes, “but there’s another layer to that — it’s an equity component, to ensure that subpopulations that are affected the most by the disease, and thus stand to benefit the most from trial engagement, that they are specifically targeted for engagement.” Read the full article, “Updated Guidance Provides Sense of Urgency to Improve Clinical Trial Diversity,” by clicking here.

Center Director Mark McCellan discussed trends in value-based care participation among providers and patient with Medical Economics. Read the full article here.

Do you want to be part of health policy in action? Do you want to work on the leading health policy issues confronting cities, states, the nation, and the globe? The Duke-Margolis team is a dynamic, high impact national leader in leveraging policy to ensure high quality, affordable care for all. Multiple positions are currently available with new ones added frequently. Click here to view all of our career opportunities.