COVID-19 RESPONSE:

HEALTH POLICY IN ACTION

NATIONAL

Duke-Margolis, together with Families USA and United States of Care, released a COVID-19 Health Care Response and Resilience Program on July 30. This program aims to protect providers’ ability to deliver high-value care to families both during and after the pandemic by building on reforms in care and helping providers move away from fee-for-service payment. Read more about the program, a summary of it, and related organizational and leaders sign-on letters here.

Duke alum David Rubenstein interviewed Mark McClellan , Dr. Ashish Jha of Harvard Global Health Institute, and Gabrielle Webster of Boys & Girls Clubs of Greater Washington regarding the response to the current COVID-19 surge, the progression of vaccines and therapeutics, and the overall effects of the pandemic. Watch here .

Center Director Mark McClellan and former FDA Commissioner Scott Gottlieb published a Wall Street Journal commentary , “Covid Shows the Need for a Diagnostic Stockpile,” in which they urge Congress to address and incentivize an increase in the nation’s testing and screening capabilities to meet the current COVID-19 surge and prepare for future pandemics . 

Center Deputy Director, Policy, Marta Wosińska commented on Bloomberg News on both the potential for success and the risks when reopening schools in the fall. Watch the interview . Marta also addressed recent COVID surges affecting multiple states in Politico . Read the article . In addition, Marta addressed ICU and bed capacity as two key metrics of health system strain in STAT . Read the article .

Core Faculty Member Charlene Wong penned an op/ed in The Hill  on how much of the nation is asking the wrong questions about school reopening – and as a result, failing children. Rather than asking “should” schools reopen, we need to be asking “how” we can open schools safely for teachers and students. Read more here .

Core Faculty Member Charlene Wong joined other Duke pediatricians in a Duke media briefing on the impact of COVID-19 on children and families. Watch the briefing .

Core Faculty Members Charlene Wong and Beth Gifford co-authored “Mitigating the Impact of COVID-19 Pandemic Response on At-Risk Children” in the journal Pediatrics . View the authors discussing their research and read the paper. 

Center Director of Undergraduate Education and Research Initiatives and Core Faculty Member and Janet Prvu Bettger co-authored, “Nursing Homes and Long Term Care after COVID-19: A New ERA?” in the Nature Public Health Emergency Collection. Read the paper . 

Core Faculty Member Brystana Kaufman and Center Managing Associate Rebecca Whitaker co-authored a study “Half of Rural Residents at High Risk of Serious Illness Due to COVID-19, Creating Stress on Rural Hospitals” in the Journal of Rural Health . Read the paper .

Research Associate David Anderson co-authored “Preparing the Health Insurance Marketplaces for the COVID Recession” in JAMA Forums, where the authors recommended lowering the administrative burden and integrating data systems as much as possible to two key reforms. Read the Insight .

Research Director Robert Saunders moderated a panel for the Alliance for Health Policy Signature Series Summit on “Using Data to Disrupt the Spread of COVID-19 and Prevent Future Pandemics.” Watch here . 

Senior Policy Fellow Susan Dentzer published an editorial about rural hospitals care for cancer patients during the pandemic in the journal Oncology Practice . Rea d the editorial . Susan also discussed hospitals’ needed preparedness to address the health care inequities is magnified by the pandemic in a US News & World Report article, “How the Pandemic Is Changing the Way Hospitals Care for Patients.” Read the article .

Duke-Margolis co-hosted a briefing for congressional staff with the Infectious Diseases Society of America, BIO, Cystic Fibrosis Foundation, Partnership to Fight Infectious Disease and The Pew Charitable Trusts. The briefing, “Antimicrobial Resistance and COVID-19: How Congress can Address Converging Crises” featured Center Director Mark McClellan. Watch the briefing .

STATE

Duke-Margolis hosted a public webinar featuring North Carolina Secretary of Health Mandy Cohen and other state leaders who discussed health care resilience, including public and private policies enacted during the COVID-19 pandemic that resulted in widespread and massive changes to health care delivery, what payers and health care providers perceive to be working well, and what additional changes are needed for the future. Watch here .

Center Director Mark McClellan discussed the rise of COVID-19 in younger generations on the North Carolina NBC affiliate, WRAL. Watch the interview here .

GLOBAL

Core Faculty member Gavin Yamey published a number of Time columns in July as well as conducted a host of media interviews addressing the global response to the COVID-19 pandemic, including:

In addition, the Duke’s Center for Policy Impact in Global Health, which Gavin leads, launched a Pandemic Preparedness-COVID 19 webpage. View the site.

EVENTS

Duke-Margolis, in partnership with the U.S. Food and Drug Administration (FDA), organized a two-day webinar public meeting to explore potential approaches to developing a high-quality, Real World Data (RWE) ecosystem. Discussion considered technical challenges and cultural barriers to the scalability of data capture processes, as well as emerging practices being implemented among the stakeholder community. View Day 1. View Day 2

Duke-Margolis, under its cooperative agreement with FDA, held a private workshop to explore opportunities to develop systems and approaches to gain better insight into the safety of cannabidiol (CBD) use and products with the goal of informing policymakers and public health professionals. Learn more about the workshop here .

EDUCATION

Congratulations to the Duke-Margolis 2020 Interns!

This summer, the Center’s 28 Margolis Interns came from undergraduate and graduate levels at Duke and other universities. Students worked closely with their mentors remotely on research projects focusing on aspects of Health Care Transformation, Biomedical Innovation, Global Health, and Education as well as COVID communications, public outreach, and other topics. Watch here for the Interns’ reflections on their experience in August. 

RESEARCH

The Value in Healthcare Initiative - Transforming Cardiovascular Care, a two year collaboration of Duke-Margolis and the American Heart Association aimed to model and test solutions in cardiovascular care and treatment, document impact and results and develop a framework for system-wide reform that supports an equitable and affordable system of care.

The initiative culminated in July with the publication of recommendations and three final papers, all published in Circulation: Cardiovascular Quality and Outcomes . The papers where co-authored by Duke-Margolis Managing Associate William Bleser , along with Center faculty and researchers Bradi Granger , Adrian Hernandez , Emily O’Brien ,  Elizabeth Singletary , Marianne Hamilton Lopez , Robert Saunders, Rachel Roiland , Hannah Crook , Karley Whelan , and Mark McClellan.

Duke-Margolis researches David Anderson, Mark Japinga and Rob Saunders took a close look at the serious ill population in California, research that could inform future state efforts to target, benchmark, and evaluate their serious illness initiatives. The Center conducted this study with the Integrated Healthcare Association with the support of the Gordon and Betty Moore Foundation. The American Journal of Accountable Care published this work. Read the study .

Research Associate David Anderson co-authored a research study published in Russell Sage Foundation Journal of Social Sciences that measured the relationship between different types of public and private television advertising and Marketplace enrollment. The research found that while private advertising dominates airwaves, the effect of state-sponsored ads have a small but significant effect.

Core Faculty Members Adrian Hernandez and Lesley Curtis commented on the National Hospital Quality Rankings in a JAMA Viewpoint , where they state that current publicly available hospital rating systems are conflicting and can confuse the public and suggest risk-adjusting for population served.

Core Faculty Members Nathan Boucher and Courtney Van Houtven co-authored “Inclusion of Caregivers in Veterans’ Care: A Critical Literature Review” in Medical Care Research and Review . Read the paper .

Core Faculty Member Matthew Maciejewski co-authored, “Regression Discontinuity Design” in JAMA . The paper examined how to use regression discontinuity design to determine if a 2011 change in Medicare policy, expanding the number of secondary diagnostic codes allowed in Medicare billing from 9 to 24, was associated with a change in the observed disease severity of Medicare patients, independent of any real change in these patients’ medical condition. Read the paper.

Research Director Robert Saunders discussed a recently published Duke-Margolis paper that examined the strengths that Medicare Advantage plans have in tackling serious illness as well as the challenges that they face in tailoring benefits for these populations, in Health Payer Intelligence. Read the article.

PEOPLE

Nancy M. Allen LaPointe has joined the Center as a Duke-Margolis Faculty Fellow and Core Faculty member. Formerly a faculty member in the Department of Medicine, Nancy’s focus at the Center will be healthcare transformation, cross-specialty, cross-department Duke Health clinical engagement related to payment and delivery reforms, and the Duke-Margolis North Carolina policy portfolio. 

Michelle Franklin , a 2018-2020 Duke-Margolis Scholar and 2020 Duke School of Nursing PhD graduate has joined Duke-Margolis as a Postdoctoral Research Associate. Michelle will contribute her expertise to research projects specific to pediatric integrated care within North Carolina, and the Center’s ongoing COVID response as well engage in the Center’s educational initiatives, and mentor students and scholars. 

Duke-Margolis and the National Pharmaceutical Council announced that Salama Freed has been named the 2020-2022 post-doctoral health policy fellow. The two-year fellowship position, based in Washington, D.C., is designed to bridge a persistent gap between health research and policy analysis. During her fellowship, Salama will focus on the intersection of payment reform such as provider rate changes, insurance rate setting and bundled payment initiatives and how this can encourage, rather than discourage, equitable health care access.

Margolis Scholar Jacqueline Nikpoou r is a 2020 recipien t of Academy Health’s Alice S. Hersh Student Scholarship, which aims designed to encourage professional and educational development in health services research and policy. 

Core Faculty Member Charlene Wong is the 2020 recipient of the Nemours Child Health Services Research Award, which recognizes the scientific work of emerging scholars in the field of child health services research, particularly research on quality improvement of pediatric health services.

Welcome Kelly Wahl! Kelly has joined Duke-Margolis as a Research Associate, working closely with the Center’s biomedical innovation team on both our Real-World Evidence Collaborative and the Center's FDA portfolio. Prior to joining Duke-Margolis, Kelly worked at Booz Allen Hamilton where she supported a variety of projects across FDA, including a PDUFA-mandated evaluation, scientific tool development for post-market surveillance, stand-up of the Office of Laboratory Safety, and most recently, operationalizing FDA’s opioid system dynamics model for policy decision-making. Kelly has a Master of Public Health in Epidemiology and Bachelor’s in Biology.