Health Policy Talks is the Duke-Margolis national speaker series, bringing distinguished health policy leaders and their thought leadership to a broad, informed, and consequential health policy audience in order to transform health care, energize biomedical innovation, move us forward toward health equity, and engage and educate tomorrow’s health care leaders. Speakers will serve as the Center’s Scholar-in-Residence during their engagement, meeting with Duke-Margolis faculty, researchers, and Scholars to discuss, challenge, and advance health policy scholarship and action.

Please join us for the inaugural session of Health Policy Talks as we welcome Mark Smith MD, MBA, who will address: The Pursuit of Health Equity and Transformation: Key Lessons for Health Policy and Research to Make a Lasting Difference.

HEALTH POLICY IN ACTION

The COVID Global Accountability Platform (COVID GAP), launched last month by Duke University and the COVID Collaborative, issued its initial analysis on global accessibility to vaccines, critical therapeutic interventions, and future pandemic preparedness. The analysis was covered nationally and internationally. Read more here.

COVID GAP is an independent initiative that aims to provide evidence-based tracking, insights, and recommendations that collectively help hold the world accountable for meeting pressing needs, delivering on commitments, and accelerating the end of the pandemic. COVID GAP is collaborative effort of Duke-Margolis, Duke’s Global Health Institute, and Duke’s Global Health Innovations Center, together with COVID Collaborative, The Rockefeller Foundation, and the Bill & Melinda Gates Foundation. Learn more at covid19gap.org.

Duke-Margolis and the Association of Immunization Managers, with support from The Rockefeller Foundation, released a series of resources for school leaders on how and why schools can serve as critical access points for students and families to receive COVID-19 vaccines. View and download the resources:

Duke-Margolis Director Mark McClellan discussed with CNN the role of COVID-19 booster shots for different age groups as the FDA considered expanding access to booster shots for all adults over the age of 18.

Duke-Margolis released two policy briefs on health equity in partnership with the National Governors Association (NGA) and the National Academy for State Health Policy (NASHP). Since November 2020, Duke-Margolis, NGA, and NASHP have convened governor-appointed health equity task forces to share best practices to improve health equity in the context of the COVID-19 pandemic. Read more about the COVID-19 Health Equity Learning Network and additional resources, including the following case studies that are part of a series featuring innovative state practice to address health equity in COVID-19 response efforts.

The first case study, “Championing Health Equity: Experiences from State COVID-19 Health Equity Task Forces,“ co-authored by Andrea Thoumi, Duke-Margolis Health Equity Policy Fellow, and Research Assistant Kamaria Kaalund, synthesized key accomplishments and lessons learned based on interviews with 10 state COVID-19 health equity task forces. Read the entire case study here.

The second case study, “Achieving Progress Toward Health Equity Using Race and Ethnicity Data,” featured Duke-Margolis co-authors Andrea Thoumi, Policy Analyst Yolande Pokam Tchuisseu, and Margolis Intern Jeremy Jacobs, who summarized state strategies and experiences shared at a June equity summit. The summit convened state leaders from 20 states to discuss challenges and strategies for collecting, reporting and using race and ethnicity data to improve health equity during and beyond the COVID-19 pandemic. Click here to read this case study. 

Duke-Margolis co-authors Andrea Thoumi, Keren Hendel, and Nikhil Chaudhry show how Durham-based coalition, LATIN19 NC, has increased vaccine uptake for Latinx communities in a Health Affairs blog, “Bridging The Health Equity Gap: Strategies To Create An Equitable Health System For Latinx Communities.” Read more about this success.

RESEARCH

Duke-Margolis Research Associate David Anderson co-authored a new research article in Health Affairs examining what the ACA Marketplace has offered over the past six years and found that increased competition may lead to lower gross premiums in the ACA Marketplaces. The co-authors also found that two-thirds of Americans have more insurer options in 2021 than they did in 2018, partially reversing a trend of insurer exits from 2016-2018. Read the research here.

Center Core Faculty Member Frank Wharam co-authored a study published in Diabetes Care entitled “Diabetes Microvascular Disease Diagnosis and Treatment after High-Deductible Health Plan Enrollment-” which examines how out-of-pocket costs and high deductibles delay treatment and can significantly worsen microvascular disease outcomes. Read the full study here.

Core Faculty Members Brystana Kaufman and Courtney Van Houtven co- authored the study “Cost and Quality of Life Outcomes of the STepped Exercise Program for Patients With Knee OsteoArthritis Trial,” which finds that STEP-KOA (STepped Exercise Program for patients with Knee OsteoArthritis), compared with arthritis education in a randomized clinical trial, improves quality of life and has a high probability of cost-effectiveness. Read the full study here.

Brystana Kaufman also co-authored “Alternative Payment Models and Associations with Stroke Outcomes, Spending, and Service Utilization: A Systematic Review.” This systematic review evaluates historical and current evidence regarding the impacts of alternative payment models on stroke outcomes, spending, and utilization. Read more about their conclusions here.

Margolis Core Faculty Members Virginia Wang and Matthew Maciejewski co-authored, “Trends in dialysis industry consolidation after Medicare payment reform,” which examines the connection between Medicare’s 2011 End-Stage Renal Disease Prospective Payment System and closures and/or acquisitions of dialysis facilities. Read the full article in the JAMA Health Forum.

Core Faculty members Trevor Lentz and Christine Goertz, along with Center researchers Katie Huber, Jonathan Gonzalez-Smith, Robert Saunders, and William Bleser, published two case studies highlighting integrative pain management programs in Texas and New Mexico that provide person-centered care to medically underserved populations. Click here to read the Texas case study, here for New Mexico and here to learn more about the project. The project is funded by the Duke School of Medicine Opioid Program portfolio, a grant supported by the Duke Endowment and administered through the Duke Department of Population Health Sciences. The Opioid Program portfolio projects are designed to save lives and reduce the harmful impact of opioids in North Carolina through the development, implementation, and/or evaluation of sustainable, system-level interventions.

Health Equity Policy Fellow Andrea Thoumi and former Margolis Intern Sarah Bond co-authored “Policy Considerations to Promote Equitable Cervical Cancer Screening and Treatment in Peru,” published in authored the Annals of Global Health. The co-authors analyze the disparities in health outcomes and systemic barriers to accessing services for Peruvian women seeking treatment for cervical cancer. Read more about their findings.

Duke-Margolis is hosting a virtual public meeting, Understanding Bias and Fairness in AI-enabled Healthcare Software. This meeting will convene stakeholders across disciplines for conversations on ways in which bias can affect artificial intelligence (AI) in healthcare software and how to promote fairness in artificial intelligence software, including methods to test for and prevent bias throughout the development process. Participants also will discuss whether AI itself can play a role in reducing existing biases in the health care setting. Among the expert speakers will be a diverse array of computer scientists, bioethicists, statisticians, anthropologists, and federal regulators.

Click here for additional information and to register.

The FDA is responsible for ensuring that prescription drug promotion, including direct-to-consumer (DTC) and health care provider-directed promotional materials, is truthful, balanced, and accurately communicated. However, the broader landscape for prescription drug promotion continues to evolve as patients and health care providers increasingly use digital tools to inform and manage aspects of care and drug manufacturers look to these tools to reach target audiences. While some of these tools and communication channels may be outside of FDA’s statutory jurisdiction, understanding the broader digital marketing landscape is an important prerequisite to refining the FDA’s own prescription drug promotion research agenda and identifying potential touchpoints where collective research could improve and safeguard the information that makes its way to patients and providers. This meeting featured an array of experts whose research in prescription drug promotion and digital marketing help inform the FDA of important emerging trends, effective study designs, and other complementary learnings that may have bearing on the agency’s research agenda on prescription drug promotion. The recording of this meeting as well as other meeting materials are now available here.

On November 17, 2021 Duke-Margolis Center and the National Academy for State Health Policy presented Children and COVID-19: Strategies and Partnerships for Vaccination. This webinar featured discussions with White House officials, as well as a panel of state leaders, pediatric providers, school officials, and leaders from community health centers to discuss how they have approached planning and partnerships, and how they are addressing logistical challenges to vaccinating children. The recording of the meeting as well as other meeting materials are now available here.

On November 17, 2021 Duke-Margolis hosted a webinar to discuss U.S. and global approaches to combating rising antimicrobial resistance (AMR) through pull incentives for novel antibiotic development, including the proposed PASTEUR Act. Center Director Dr. Mark McClellan moderated discussions on tailoring pull incentives for priority antibiotic development and the need for pull incentives beyond the U.S. and U.K. Discussions highlight recent modeling describing the appropriate magnitude of pull incentives to secure novel antibiotics, as well as complementary actions to support pull incentives for priority antibiotics and steps toward improved public health preparedness. Discussion will also focus on global leadership and actions among G7/G20 nations to incentivize novel antibiotic development and access. The recording of the meeting as well as other meeting materials are now available here.

The Thirteenth Annual Sentinel Initiative Public Workshop convened members of the Sentinel community along with other leading experts to publicly share key developments in the Initiative from this past year. The workshop began with a keynote presentation from Patrizia Cavazzoni, Director of the Center for Drug Evaluation and Research (CDER), followed by a fireside chat with leaders from each of the three Centers involved in the Sentinel Initiative: CDER, the Center for Biologics Evaluation and Research (CBER), and the Center for Devices and Radiological Health (CDRH). Closing out the first day, Mark McClellan spoke with Rob Califf, FDA commissioner nominee and current Senior Advisor for Verily and Google Health, about robust evidence generation systems, building on themes discussed throughout the day. The second day of the workshop focused on work done by Sentinel, the Biologics Effectiveness and Safety System (BEST), and their collaborating partners to combat the COVID-19 pandemic. The recording of the meeting as well as other meeting materials are now available here.

Mark McClellan participated in panel entitled “Post-Pandemic Recovery: Global Health and the Economy” during the October 2021 Milken Institute Global Conference. The panel discussion explored what innovations, technologies, and partnerships are being leveraged to accelerate recovery at the local, national, and global levels, while also addressing what more can be done to ensure an equitable recovery. Click here to watch a recording of the discussion.

Center Deputy Director Gillian Sanders Schmidler participated as a guest on the JAMA Learning Podcast in an episode entitled “Cost-effectiveness Analysis for Clinicians” where she explains the incremental cost-effectiveness ratio (ICER) in terms clinicians can understand. Download and listen to the podcast here.

Core Faculty Member Charlene Wong was featured as Duke Today’s Blue Devil of the Week for her work to improve and protect the health of the community. Read more about her and her work serving children and families in North Carolina.

Former Margolis Scholar Madhu Vulimiri, who currently works for North Carolina Department of Health and Human Services, has been promoted within the Department to serve as the Deputy Director for Child and Family Well-Being.

Core Faculty Member Brystana Kaufman and Senior Policy Fellow Aparna Higgins presented at the North Carolina Department of Health and Human Services “Deep Dive” external speaker series on the Duke-Margolis research project “Advancing Medicaid-Medicare Integration for Dual Eligibles in North Carolina,” funded by Arnold Ventures.

Core Faculty Members Virginia Wang and Matthew Maciejewski presented “Impact of Medicare Bundled Dialysis Payment on Regional Racial Disparities in Home Dialysis Utilization” at this month’s American Society of Nephrology Annual Meeting. More information regarding the session can be found on the ASN Kidney Week website here as well as from media coverage in Healio.

Melynn Glusman, JD, a Duke alumna, is a new Duke-Margolis Education Program Coordinator, focused on the Center’s Margolis Scholars Program. Melynn comes to Duke-Margolis from Duke Law, where she served as the Program Coordinator for the Environmental Law and Policy Clinic and the First Amendment Clinic, helping students build an experiential bridge between the classroom and legal practice. While there, she also supported the clinics’ litigation efforts on behalf of clients throughout North Carolina and beyond. Melynn received her JD from UNC-Chapel Hill, her Master's degree in U.S. History from UNC-Chapel Hill, and her Bachelors in History from Duke.

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 and new positions have been posted this week! Click here to view all of our career opportunities.