Dr. Gabriela Plasencia, a Duke family medicine physician scientist, aims to deploy health policy to improve care for marginalized populations. With her commitment to advancing health policy, health equity, and family medicine, Duke-Margolis and Duke Family Medicine and Community Health (FMCH) enthusiastically selected Gaby as the 2023-2024 Health Equity Policy and Primary Care Fellow.

A one-year fellowship sponsored collaboratively by Duke-Margolis and FMCH, this opportunity aims to help clinicians improve their practice by equipping them with knowledge and experience surrounding health equity and policy. Also a Duke National Clinician Scholar, Gaby is only the second Duke Health Equity Policy and Primary Care Fellow. The inaugural fellow, Dr. Cara Smith, worked throughout her fellowship to advance health equity policies for North Carolina’s underserved communities and is now pursuing a family medicine residency program in California.

During her residency at Duke, Gaby worked with Duke-Margolis Health Policy Fellow Andrea Thoumi on projects around the systemic exclusion of Latinx communities from COVID-19 testing, vaccination, and treatment. Gaby also has worked on other projects with LATIN-19 to improve health outcomes for Latinx populations in North Carolina. She plans to continue using population health strategies to reduce health disparities in the community through this fellowship.

Recent PhD graduate Dr. Kun Li takes the next step in her career as the 2023-2025 Duke-Margolis Postdoctoral Associate. The Duke-Margolis Postdoctoral Program in Health Policy is a two-year experience that provides opportunities to apply academic and professional experiences to real-world health policy problems through original research. Kun’s interdisciplinary perspective and her dedication to improving patient outcomes through policy research made her this year’s top candidate for the program.

Kun uses her background in economics to inform her analysis of the organization and operation of health care providers. Her research interests center on the impact of market incentives on health centers and the downstream effect on patient outcomes. Community health centers and safety net providers are of particular interest to Kun, as much of the existing research on these providers hasn’t been conducted from an economic perspective. Kun is interested in analyzing their financial positions, their operations, and how they compete with other providers.

Working closely with Senior Research Director, Marianne Hamilton Lopez, who serves as the Faculty Program Director for the Postdoctoral and Affiliated Fellows Program, Kun looks forward to working with members of the Health Care Transformation workstream, who are currently pursuing ways to improve patient care through payment model reforms. She also hopes that her time with Duke-Margolis will help determine the course of her future, whether she continues in academia or explores opportunities in industry.

Lee Fleisher, MD, former Chief Medical Officer and Director of the Center for Clinical Standards and Quality at the Centers for Medicare & Medicaid Services (CMS), has joined Duke-Margolis as a Visiting Fellow. In this volunteer role, Fleisher will participate in and provide expert perspectives to Duke-Margolis efforts and research on coverage and reimbursement policies, real-world data and evidence, quality measurement and risk adjustment, and more.

Currently, Emeritus Professor of Anesthesiology and Critical Care and a Senior Fellow at the Leonard Davis Institute of Health Economics at the University of Pennsylvania Perelman School of Medicine, Fleisher teaches the development of novel ideas and technologies to drive quality and value in health care in the Penn Masters in Healthcare Innovation.

Rushina Cholera, Will Bleser, Rob Saunders, and Charlene Wong co-authored research in JAMA: “Analysis of North Carolina Medicaid Claims Data to Simulate a Pediatric Accountable Care Organization.” The paper explored what an accountable care organization (ACO) for child populations would look like, as the vast majority of ACOs nationwide focus on adults. Though some pediatric ACOs exist, more information is needed to help improve the design and to better understand health care costs and utilization in younger populations. The authors aimed to provide that information by simulating a pediatric ACO using Medicaid claims data. Read their analysis here.

Gary Maslow, Rushina Cholera, Yolande Pokam Tchuisseu, Sam Repka, and Rebecca Whitaker co-authored an article in the Journal of Racial and Ethnic Health Disparities: “Telehealth Utilization Among Adult Medicaid Beneficiaries in North Carolina with Behavioral Health Conditions During the COVID-19 Pandemic.” The authors studied adult Medicaid beneficiaries with behavioral health conditions and their usage of telehealth services during the COVID-19 pandemic, and found that telehealth allowed for more continuity of care. However, they also noted that barriers to equitable access to care persist. Read the article here, and the Duke-Margolis project page here.

Duke-Margolis and Dell Medical School at the University of Texas at Austin submitted a response to the CMS Request for Information regarding the design of a future episode-based payment model. Building on Duke-Margolis’ existing specialty condition model work, the response presented evidence-based recommendations aiming to leverage steps that CMS can undertake now to implement a short-term episode program. The letter also provided advice to strengthen the data and infrastructure necessary to support future reforms that account for the different incentive and payment structures of physician-group-led and hospital-led ACOs. Read the comment letter here.

Comment Letter to U.S. House Committee on Energy and Commerce: Stop Drug Shortages Act

Duke-Margolis submitted a comment letter outlining recommendations regarding the discussion draft of the Stop Drug Shortages Act. In addition to recommending actions that federal and private-sector entities could take to improve drug supply chain and manufacturing reliability, the letter advises that drug shortages could be minimized through exemptions from inflationary rebates under Medicaid and Medicare programs, and from 340B pricing requirements. Read more here.

Sam Repka, Kristen Ukeomah, Frank McStay, and Rob Saunders co-authored a post in Johns Hopkins Bloomberg School of Public Health’s Opioid Principles Blog: “Data-driven decision making for opioid settlements.” The blog highlighted the recently released, Duke-Margolis designed Opioid Abatement Needs and Investment Tool (OANI), which is the first resource in an Elevance Health Foundation-funded project to provide resources to guide states, counties, and municipalities on investing opioid settlement resources for their communities. The authors describe how the interactive mapping tool can help inform policymakers and advocates participating in coordination and priority-setting conversations for opioid settlement funds. Read more here.

Core Faculty member Barak Richman co-authored a report, “Hospitals Suing Patients: How Hospitals Use N.C. Courts to Collect Medical Debt,” that highlighted the thousands of lawsuits brought forth by North Carolina hospitals to collect debt from their patients. Many patients have been sued years after treatment, and hundreds of them owed over $10,000 in interest alone.

Barak hopes that hospitals will approach billing “with more humanity,” and will present bills and prices more clearly so patients aren’t entrapped in debt. He also notes that the NC court system, as it stands now, is challenging for individuals to navigate. The report illuminates opportunities for reform both in NC hospitals and the state court system. Read more here.

KFF Health News featured this report in their article, “North Carolina Hospitals Have Sued Thousands of Their Patients, a New Report Finds,” and pointed to legislation that NC lawmakers have been trying to pass in order to restrict some of these hospitals’ collection activities. Read the article here.

Research Associate Beth Boyer and Visiting Fellow Tanisha Carino co-authored an op-ed in BioCentury: “A key rapid-response tool for the next pandemic? Drug repurposing.” The article highlighted the potential of existing drugs to treat patients in future health emergencies, and called for a coordinated effort to establish an efficient and effective drug repurposing system. Both authors of this op-ed also co-authored a recent Duke-Margolis white paper, “Drug Repurposing for Pandemic Innovation: Establishing an Effective and Efficient Ecosystem,” that covers this topic as well.

BioCentury also published a commentary, co-authored by Tanisha and Beth, that discussed the white paper. The authors explored how drug repurposing could be a promising tool for future health emergencies, and summarized findings from the original work. Read the commentary here.

Former Scholar Jackie Nikpour (’21) co-authored an article in Health Affairs Forefront: “To Improve Outcomes Under CMS’ ‘Making Care Primary’, Focus On Registered Nurses.” The authors analyze the potential of registered nurses (RNs) to improve coordinated care, and outline the challenges and opportunities to using RNs in primary care. Read more here.

The digital marketing landscape is a dynamic and rapidly evolving ecosystem, and marketers have a growing array of communication channels to promote products to consumers. It is important to understand how current and emerging trends in digital marketing may impact information conveyed to various audiences in prescription drug promotional materials. This workshop will explore the state of digital prescription drug promotion, including the technologies and strategies currently available to and commonly used by marketers.

Learn more here.

Postapproval pregnancy safety studies (or studies that focus on medication use after approval) can provide useful information to guide safe use of medication during pregnancy. During this workshop, participants will hear more about designs of postapproval pregnancy safety studies for drug and biological products regulated by the FDA’s Center for Drug Evaluation and Research and the Center for Biologics Evaluation and Research, and experiences with implementing these studies.

Learn more here.

Convened by the Duke-Margolis Real-World Evidence Collaborative, this public convening will provide a venue for reviewing recent Collaborative activities, real-world data (RWD) and real-world evidence (RWE) policy developments, and promising future applications of RWD/RWE. Discussion will focus on the role of master protocols for RWE, evaluating real-world efficacy in patient subgroups, and the generation of more practically relevant evidence by leveraging RWD.

Learn more here.

Duke-Margolis invited policymakers, legislative advisors, and others interested in addressing emerging infectious diseases to learn about emergency preparedness in the context of bacterial threats, like antimicrobial resistance (AMR). Speakers compared viral and bacterial threats, discussed antiviral and antibacterial product supply chains, and highlighted the impact these issues have on global public health, national security, and economic prosperity. Stakeholders learned more about policy approaches to advance emergency preparedness, particularly approaches that align actions to address both viral and bacterial threats, and approaches that support access to current and future life-saving antibiotics.

Learn more here.

Duke’s Bass Connections model brings together students, faculty, postdocs, and others to examine current societal challenges in interdisciplinary research teams. Duke-Margolis leads the Health Policy and Innovation theme as part of our commitment to educate the next generation of health policy leaders. For the 2023-2024 academic year, we have 13 Bass Connections teams working on the following projects:

This fall, Duke-Margolis welcomes 33 new and returning Scholars to build their professional experience and knowledge of health policy. During the course of the academic year, our 2023-2024 Scholars Cohort will participate in research, complete health policy coursework, and engage with the community. We look forward to guiding them and witnessing their accomplishments.

Beena Bhuiyan Khan has accepted a new role at Duke-Margolis and will be the Research Director for Medical Products Payment and Coverage Policy, within the Biomedical Innovation portfolio.

In her new role, Beena will lead the strategic design, management, and direction of the Center’s work in medical products payment and coverage policy, will oversee the Value for Medical Products Consortium, and will implement research and policy objectives to contribute to the execution of Duke-Margolis’ strategic goals. We look forward to Beena’s new leadership role and her ongoing dedication to increasing access to medical technologies.

Scholar Elaijah Lapay ('23) presented a poster at Healthy Eating Research (HER) and Nutrition and Obesity Policy Research and Evaluation Network (NOPREN)’s Summer Student Speaker Series. His poster, “Arraigados Juntos: Lessons Learned from a Cross-Sectoral Food as Medicine Pilot,” highlights how community-based food resources can be best used to support the health of food-insecure populations, especially those experiencing diet-related chronic illness. Learn more here.

Politico quoted Core Faculty member Frank Wharam in an article, “GOP push to get more Americans into high-deductible health is dividing Democrats,” as they discussed the opposing points of view on high-deductible health plans. Frank has published a number of papers in the past few years that focus on the effect of high deductibles on people with diabetes. Read his thoughts on this topic here.

Core Faculty member Barak Richman was quoted in Bloomberg Tax’s article, “Pharma’s Challenge to Drug Price Excise Tax Sits on Shaky Ground.” The article discusses the legal complications surrounding the excise tax that pharmaceutical companies may face if they do not comply with price negotiations set up under the Inflation Reduction Act, particularly the claim that this excise tax violates the Eighth Amendment’s clause on excessive fines. Read more here.

Barak was also quoted in the KFF Health News article, “Your Exorbitant Medical Bill, Brought to You by the Latest Hospital Merger.” Years of hospital mergers have resulted in a few medical systems monopolizing large portions of a state, or a whole region of the country. These monopolies result in higher prices, and the article highlights the challenge to regulate the spread of hospital mergers. Read more here.

 After working with Duke-Margolis as a Duke Fuqua business graduate student, Stephen Colvill has joined the Center as an Assistant Research Director in Biomedical Innovation, where he will focus on supporting the new Duke-Margolis Drug Supply Chain Resilience and Advanced Manufacturing Consortium and other related topics. Stephen is also the Executive Director of RISCS, a non-profit rating and certification organization with a mission to prevent drug shortages.

Before Duke-Margolis and RISCS, Stephen was Director, Business Analytics Team Lead, at Pfizer Injectables. He also held various other roles at Pfizer and Hospira in supply chain, manufacturing, finance, marketing, and commercial portfolio management. He serves as a board member for the End Drug Shortages Alliance and as an advisor for Angels for Change and Medicines360. He frequently speaks at national forums on pharmaceutical supply chains, drug shortages, pharmaceutical regulation, and biomedical innovation.

Grace Hoover is a Policy Research Assistant in Biomedical Innovation, and will be supporting the work around drug pricing and value-based payment models. Previously, Grace worked at the Carolina Population Center, where she created the first database for nurse midwife reimbursement through Medicaid and explored global implications of chlorhexidine policy for umbilical cord disinfection. She was also the co-president of UNC Partners in Health-Engage, a CNA at Duke Regional Hospital, and a volunteer violin teacher for child refugees in the Chapel Hill area. Grace graduated from UNC Gillings School of Global Public Health in May 2023 with a Bachelor of Science in Health Policy and Management and a minor in Chemistry. 

Kate Tsiandoulas has joined Duke-Margolis as a Policy Analyst with the Biomedical Innovation team, supporting the work on medical products development and regulations. Kate recently graduated from Johns Hopkins with a Masters in Bioethics. During graduate school, she wrote her thesis on birth control misinformation on TikTok and was also a research assistant at the Berman Institute of Bioethics. She completed her undergraduate studies at the University of Toronto where she graduated with a Bachelor of Arts in Bioethics & Health Studies.

Mia Williams is a Policy Analyst working with the Biomedical Innovation team to support the work occurring under the FDA Cooperative Agreements. Prior to joining Duke-Margolis, Mia worked at the Institute for Policy and Governance on the Connection to Care project, an initiative to address the opioid epidemic in the Roanoke Valley area. Mia graduated from Virginia Tech where she received a Bachelor of Science in Human Nutrition, Foods, and Exercise and a Master of Public Health in Health Education. She is also a Certified Health Education Specialist.

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.