HEALTH POLICY IN ACTION

Duke-Margolis, Duke’s Center for Global Development, and the Center for Strategic & International Studies, together the COVID Collaborative, published an open letter urging G7 leaders to share one billion to two billion vaccine doses to low- and middle-income countries by the end of 2021. The leaders emphasized the urgent need to help countries distribute and deliver vaccines quickly and equitably across their populations, striving to achieve at least 60 percent, and ideally 70 percent, vaccination coverage in every country in 2022. With the endorsement of renowned global health experts, the coalition calls for and details a five-step G7 Action Plan “to assure the fastest possible path to access billions of doses of high-quality vaccines and ensure local capacity to deliver them.” Read the letter here.

Duke-Margolis Advisory Board Member Esther Krofah co-authored, “A Global Early Warning System for Pandemics: Mobilizing Surveillance for Emerging Pathogens,” which seeks to lay the framework for mobilizing a more rapid and nimble early warning system. Read more here.

Director Mark McClellan co-authored a Washington Post op/ed that calls for a COVID-19 Commission, contending that a systemic and comprehensive process is needed to learn from the failures and successes in responding to the pandemic. Read the opinion piece here.

Assistant Research Director Christina Silcox co-authored a blog post in partnership with the Rockefeller Foundation (RF) and Mathematica, “Calculating the Impact of Next Phase of Covid-19 Testing Scenarios for Schools.” The blog provides updates to a May 2021 white paper Duke-Margolis published with RF and announces a new interactive online dashboard that explores the costs and drawbacks of providing routine COVID-19 testing in schools. The dashboard enables schools to ask questions about the impact of testing on school attendance, the risks of less frequent testing, and the various risks of different testing strategies. View the dashboard here. Read the blog here.

In a series of interviews this month, Director Mark McClellan commented on the current state of vaccination efforts, vaccine hesitancy, the reopening of schools and workplaces, as well as methods to reduce COVID-19 rates within communities. He also shared his concerns regarding newly emerging variants as well as strategies that have been keeping infection rates low despite the reopening of the country. Listen to his full interview with NC Policy Watch here, read the full article with Duke Today here, and view his remarks at the webinar, “A Brighter Future: Tackling a Global Pandemic” here

Senior Policy Analyst Kirk Williamson and Assistant Research Director Katie Green, with National Governors Association, published “State Strategies for Engaging and Leveraging Primary Care Providers as COVID-19 Vaccinators.” The paper details state efforts to engage communities with low vaccine uptake and provides Governors and state officials with promising practices and strategies for reaching those not yet vaccinated. Read the report here.

RESEARCH

A new case study, co-authored by Duke-Margolis’s Jonathan Gonzalez-Smith, Katie Huber, Rob Saunders, Christine Goertz, and Trevor Lentz as well as the Duke Department of Orthopaedic Surgery, details the West Virginia University Center for Integrative Pain Management, where an interdisciplinary team provides a variety of pain management services to maximize patients’ function, minimize the burden of acute and chronic pain, and avoid opioid prescribing. The first in a series, this study is part of broader project to highlight successful approaches that deliver integrated pain management while overcoming challenges to implementation and payment. Read more here.

A new project, led by Core Faculty Member Janet Bettger and Assistant Research Director Rebecca Whitaker, called “Equitable Access to Care and Outcomes using Telehealth in the Transition to Medicaid Managed Care” is funded by the Kate B. Reynolds Charitable Trust. Additional Duke-Margolis staff affiliated with the project include Rushina Cholera, Susan Dentzer, Salama Freed, Yolande Tchuisseu, and Jessica Genova. The team hopes to understand possible disruptions to care networks and barriers created by the increasing use of telehealth services as well as establish a data-driven policy that advances equitable care and outcomes for beneficiaries.

Research Associate Mark Japinga and Research Assistant Elizabeth Singletary published an article in NEJM Catalyst about telehealth and recent shifts in its regulations due to the COVID-19 pandemic by the Centers for Medicare & Medicaid Services (CMS). The authors also discuss the challenges that payers, providers, and policy makers will face moving forward. Read the article here.

Duke-Margolis researchers Jonathan Gonzalez-Smith, William Bleser, and Robert Saunders, with Duke undergraduate student Aaron Zhau, published a new issue brief that considers why the waiver flexibilities that the CMS offers to encourage broader adoption of value-based payment models are underutilized. The team’s analysis found that waivers can be improved by expanding technical guidance and increasing clarity about what is allowed in implementing waivers; reducing the administrative complexity involved, such as in the waiver application; and aligning waivers, such as through a core set of waivers across CMMI-sponsored models. Read the issue brief here.

Core Faculty Member David Ridley conducted research regarding the increase in launch prices for new drugs since 2005. His analysis suggests that Medicare Part B reimbursement has been encouraging the increase in drug prices. Read more about his research here.

Duke-Margolis Research Associate David Anderson co-authored a two-part Health Affairs blog about ways to improve consumer plan selection in Accountable Care Act marketplaces. Part 1 discusses automatic re-enrollment as a key policy to maintain stability in insurance markets while Part 2 discusses the challenging choice environment that individuals must face as well as the burden that states take on to improve choice quality and outcomes. Read Part 1 and Part 2 for more information.

Duke-Margolis researchers Brystana Kaufman, Robert Saunders, David Anderson, William Bleser, and Mark McClellan issued a study characterizing spending on seriously ill beneficiaries in accountable care organizations (ACOs). The published paper discussed the spending habits of ACOs in regard to various patient and geographic factors. Read the full paper.

Health Services Research published an article co-authored by Core Faculty Member Barak Richman, “Reducing administrative costs in US health care: Assessing single payer and its alternatives,” that discusses excessive administrative costs within the US health care system and the reasons why they may occur. Read the full paper. Additionally, Barak o-authored two articles addressing employee health care costs and replacement models for employee health care systems. Read the Harvard Business Review article here and the Health Affairs blog here.

Research Assistant Hannah Crook, undergraduate student Aaron Zhao, and senior research director Robert Saunders authored a research letter, "Analysis of Medicare Advantage Plans’ Supplemental Benefits and Variation by County" in JAMA Network Open. Funded by the Robert Wood Johnson Foundation, the researches found that the uptake of newly allowable supplemental benefits by Medicare Advantage plans is growing, but remains relatively low. Read the article here.

Duke-Margolis Visiting Fellow David Muhlestein, along with the Center’s William Bleser, Rob Saunders, and Mark McClellan, co-authored a Health Affairs blog, “All-Payer Spread of ACOs and Value-Based Payment Models in 2021: The Crossroads and Future of Value-Based Care,” that describes the continued growth and spread of ACOs in all lines of business and for all payers. Read the blog here.

Kaiser Health News (KHN) cited a February 2021 Duke-Margolis issue brief that evaluated if payment reforms are addressing social determinants of health, in an. article about efforts to address patients’ social needs and whether those efforts have any impact on improving health and lowering medical costs. Read the KHN article here.

Duke-Margolis convened a webinar to hear from experts in health care payment and delivery reform, value-based care implementation, and health equity. The webinar featured a fireside chat between CMMI Director Liz Fowler and Mark McClellan. Other speakers and panelists in discussed actions CMMI can take to facilitate and sustain care transformation and address health equity and disparity issues. Watch the recording here.

Monday, July 12: 1:00pm - 4:30pm EDT

Tuesday, July 13: 1:00pm - 4:00pm EDT

Benzodiazepine nonmedical use is widespread, and individuals frequently co-use benzodiazepines with alcohol, prescription opioids, and illicit drugs. Associated harms of benzodiazepine nonmedical use are substantial but occur primarily when people use benzodiazepines in combination with other drugs.

This two-day public workshop will convene regulators, academic researchers, clinicians, patient advocates, and other stakeholders to share information underlying this action and gather input related to the safe use of benzodiazepines. Participants will discuss epidemiological and abuse liability data, patient and clinician perspectives and experiences, and gaps in data and understanding about the safe use of benzodiazepines. Learn more here.

Duke-Margolis Faculty members participated in and moderated discussions during The Virtual National Health Equity Summit produced by Global Health Care, LLC. Health Equity Policy Fellow Andrea Thoumi presented a case study on creating equitable health systems for Latinx communities and Director Mark McClellan led a panel discussion on health equity in Medicaid payment and care delivery reform. Senior Health Policy Fellow Susan Dentzer, a member of the event’s planning committee, led the “Roundtable on the Role of Health System Leadership in Advancing Health Equity” as well as interviewed the Human Rights Campaign President Alphonso B. David regarding health equity challenges and opportunities for the LGBTQI+ community during the summit. Learn more about the summit here.

Core Faculty Members Kate Bundorf and Adrian Hernandez were among 22 Duke University faculty members who were recently awarded distinguished professorships. Kate Bundorf received the J. Alexander McMahon Distinguished Professor of Health Policy and Management while Adrian Hernandez received the Duke Health Cardiology Distinguished Professor. The honorees are the “successors of faculty leaders who helped define the university’s commitment to ethical scholarship, leadership and public service,” said Provost Sally Kornbluth. Congratulations Kate and Adrian!

Director Mark McClellan and co-chair of the LAN’s Executive Forum, discussed updates and next steps with CCMI Director Liz Fowler during the LAN’s quarterly meeting. Mark also announced the launch of LAN’s Health Equity Advisory Team (HEAT), which incorporates a broad range of perspectives, including community-based organizations, patient/consumer representatives, and providers serving populations that have been traditionally marginalized. Learn more about HEAT here.

Director Mark McClellan was invited to be a guest on The #PopHealth Show podcast, where he discussed leadership in policy innovation. Listen to the podcast here.

The American Medical Association (AMA) announced that Duke-Margolis Senior Policy Fellow, Susan Dentzer, will join the search committee tasked with finding the new editor in chief of JAMA and JAMA Network. Read the full press release here.

Congratulations to Keren Hendel for being named a 2021 David A. Winston Health Policy Scholar. Sixteen scholarships were awarded to those who demonstrated their potential to succeed in health policy at the state or federal level. Learn more here.

Christina and Core Faculty Member Arti Rai were panelists at a virtual public town hall, “Future of Tech Commission Town Hall: A Public Discussion on Leveraging Technology to Accelerate Innovation in Health Systems,” hosted by Duke Health, UNC School of Medicine, and the Future of Tech Commission. This event aimed to generate input and feedback on the most urgent tech policy issues facing our economy and democracy. Read more about the event here. 

Duke-Margolis Digital Health Policy Fellow Christina Silcox was interviewed as part of an article about artificial intelligence’s role in healthcare and the FDA’s role in creating regulations. An FDA action plan provides details on how the agency might regulate AI-based devices, however, more issues and details must still be considered. Read the full article.

Policy Analyst Becky Ray and Christina Silcox presented on the recently released “Three Steps to Smart Covid-19 Testing: A Guide for Employers” during NRHI’s COVID-19 Response/Planning Ahead: Returning to the Workplace Webinar. Learn more here.

Abhigya Gigi has joined Duke-Margolis in a newly created position as a Data Analyst Programmer, playing a key role in helping the Center expand its quantitative research capabilities. In this role, Abhigya will be a Center-wide resource for data analytics and management, working with a variety of faculty and staff as well as being a critical part of the Health Care Transformation team.

Hannah Graunke, MPP is a new Policy Analyst with the Biomedical Innovation team where she will focus on medical technology diffusion and medical product payment. A 2021 graduate of Duke’s Sanford School of Public Policy, Hannah’s Master’s project was with Aceso Global and entitled “Overview of OECD Provider Payment Models for Peru.”

Rachele Hendricks-Sturrup, DHSc, joins Duke-Margolis as the Research Director leading the Center’s Real-World Evidence (RWE) portfolio, including managing its RWE Collaborative. A scientist/researcher, health policy and industry professional, journalist, and academician, Rachele brings to the Center her experience serving as the health policy counsel for the Future of Privacy Forum. She is a well-published author and is an Adjunct Instructor at Ohio University, College of Health Sciences and Professions, an Adjunct Fellow at Baystate Health’s Institute for Healthcare Delivery and Population Science, and an Instructor for Medical Ethics and Health Policy at the University of Pennsylvania, Perelman School of Medicine.

Neil Rowen is a new Research Assistant who will support the Center’s payment and delivery system reform work as part of the Health Care Transformation team. Neil comes to Duke-Margolis from UNC where he recently received his bachelor's degree in Health Policy and Management at the Gillings School of Global Public Health.

Humphrey Shen is a new Research Assistant who will be working on the Center’s payment and delivery reform efforts as part of the Health Care Transformation team. Humphrey is a 2021 graduate of the University of Pennsylvania where he received a BA in Health and Societies with a concentration in health care markets and finance.

Michael Zhu is a new Research Assistant who will be working on the Center’s payment and delivery reform efforts as part of the Health Care Transformation team. Previously, Michael worked at the Center for Medicare Advocacy, the Health and Medicine Counsel of Washington, and most recently, with the Connecticut Campaign for Affordable Health Care.