Policy Matters: A monthly newsletter for Duke Faculty, Students, and Staff from the
Duke-Margolis Center for Health Policy
Policy Matters: October 2021
October Highlights:

Duke-Margolis congratulates Sahil Sandhu & Rasheca Logendran for being named to the inaugural class of Samvid Scholars. Sahil, a 2020 Margolis Intern, and Rasheca, a former Bass Connections student, will receive a scholarship that will pay up to $50,000 tuition and fees to the recipient’s graduate program of choice for two years. Read more here.
Margolis Scholar Ethan Borre was awarded the “Milton Weinstein Award for Outstanding Presentation in Applied Health Economics” for his recent presentation on “Development and validation of DeciBHAL-US: a novel microsimulation model of hearing loss across the lifespan” at this month’s annual meeting of the Society for Medical Decision Making. Congratulations Ethan!


Nikhil Chaudry’s essay, “Mobile Health Clinics to Mitigate COVID-19 Systemic Barriers” won first place in the policy opinion and analysis category of the Student Collaborative on Health Policy (SCOHP) summer writing competition. Congratulations Nikhil, a 2020 Margolis intern, on the wonderful achievement!

Takhona Hlatshwako, a former Margolis intern and a current senior at University of North Carolina study public health, has been named a Rhodes Scholar and will study at Oxford next year. Takhona interned with Center Deputy Director Gillian Sanders, who is currently her UNC honor thesis advisor. Congratulations Takhona! Read more.

COVID-19 RESPONSE:
HEALTH POLICY IN ACTION
GLOBAL

Nearly two years into the COVID-19 pandemic, the global collective action continues to be slow, fragmented, and inequitable. In response, Duke University and the COVID Collaborative launched the COVID Global Accountability Platform (COVID GAP), an independent initiative that aims to provide evidence-based tracking, insights, and recommendations that collectively help hold the world to account to meet pressing needs, deliver on commitments, and accelerate the end of the pandemic.
 
This collaborative effort is the results of months of work by Duke-Margolis, Duke’s Global Health Institute (DGHI), and Duke’s Global Health Innovations Center (GHIC). Together with collaborators and the supporters, including the COVID Collaborative, The Rockefeller Foundation, the Bill & Melinda Gates Foundation, and multiple stakeholders and data sources, COVID GAP’s agenda is to:

  • Serve as an independent source of insights and actionable recommendations on vaccine supply, distribution, delivery and demand; global access to diagnostics, therapeutics, oxygen, and PPE; and actions to strengthen pandemic preparedness and health systems
  • Analyze commitments and actions relative to targets, to highlight progress and prioritize needed actions for stronger pandemic response
  • Partner with leaders in low- and middle-income countries to prioritize specific topics and questions of the most importance to inform decisions at the national, regional, and global levels; and create platform for learning and support
  • Collaborate with advocacy organizations and media, and engage directly with policy-makers and decision makers, to translate evidence to action
  • Facilitate virtual and in-person events and other convenings to share insights, drive actions and collaborations

Read more details here.
NATIONAL

Core Faculty Member Kate Bundorf co-authored an original investigation entitled “Trends in US Health Insurance Coverage During the COVID-19 Pandemic,” published in JAMA’s Health Forum. The authors explore how health insurance coverage changed during the COVID-19 pandemic. Read more to find out what they learned.

Digital Health Policy Fellow Christina Silcox and Mark McClellan participated in a White House briefing making recommendations on how to speed and scale more rapid tests into the market through a series of manufacturing supports and regulatory policies, as well as recommending a national education campaign and other policies to increase appropriate use of these tests. In a related article from STAT regarding the use of rapid tests, Dr. Silcox was quoted that more outreach and education is needed to assist the population about the proper use and expectations of rapid testing.
Duke-Margolis researchers Michael Zhu, Robert Saunders, William Bleser, and Mark McClellan, along with Margolis Visiting Fellow David Muhlestein, co-authored the Health Affairs Blog post “The Medicare Shared Savings Program in 2020: Positive Movement (And Uncertainty) During A Pandemic.” Their analysis showed that the Medicare Shared Savings Program continued to show positive trends in 2020, with indications that Accountable Care Organizations were able to provide critically needed primary care during the pandemic while continuing to manage overall expenditures. Read the entire post here.
STATE

Research Associate Michelle DelFavero co-authored a case study with the National Governors Association and National Academy for State Health Policy entitled “California’s ACE’s Aware Initiative.” The case study examines the statewide initiative that trains and reimburses health care providers to screen children and adults for childhood trauma and respond to the effects of toxic stress including the intersections with COVID-19, as the pandemic may have exacerbated these adverse childhood experiences or ACE’s. Read the full case study here.

Center researchers John Bollinger, Katie Greene, Katie Huber, and Mark McClellan together with National Academy for State Health Policy published the issue brief “Ensuring Sustainability and Reach of COVID-19 Vaccine Distribution” with funding assistance from the Commonwealth Fund. This issue brief examines strategies to reach remaining unvaccinated populations and to disseminate key lessons learned and tools from other states. Click here to read the brief.

North Carolina
In conjunction with the Informing North Carolina’s COVID-19 Pandemic Response: Projected Service Needs of Medicaid Beneficiaries project, funded by Kate B. Reynolds Charitable Trust, Dave Anderson, Rebecca Whitaker, Janet Prvu Bettger, and Charlene Wong published research entitled “Comparing health care use and costs among new Medicaid enrollees before and during the COVID-19 pandemic.” The research, intended to characterize health care use and costs among new Medicaid enrollees before and during the COVID pandemic can be found here.
RESEARCH
Employers Focus on Advance Primary Care for Better Care, Value
A new Duke-Margolis report, together with Morgan Health, details an evidence-based approach for employer-based health coverage that can deliver high quality, coordinated and affordable care for employees and their families. By focusing on advance primary care and shifting from fee-for-service to a per member per-month payment model, employers can work to overcome persistent coverage challenges of rising costs, health and health care inequities, and barriers to many employees to get the care they need to stay well. The paper, “A Pathway for Coordinated, Affordable Employer Sponsored Health Care,” is Center co-authors by Mark Japinga, Michael Zhu, Robert Saunders, and Mark McClellan.
Core Faculty Member Brystana Kaufman co-authored the analysis “Access to outpatient services in rural communities changes after hospital closure,” published in Health Services Research. The co-authors evaluated the trends among rural Federally Qualified Health Centers and Rural Health Clinics prior to and following hospital closure. Read their findings.
Former Margolis Intern Sahil Sandhu and Anu Sharma, Core Faculty Member Rushina Cholera, and Director of Undergraduate Education and Research Janet Prvu Bettger published, “Integrated Health and Social Care in the United States: A Decade of Policy Progress,” in the International Journal of Integrated Care (IJIC). The paper outlines three national and state policy initiatives to improve health and social services. Read more about their work and watch Rushina Cholera discuss the work in an interview with IJIC.
The Real-World Evidence Transparency Initiative, a partnership of Duke-Margolis, ISPOR—The Professional Society for Health Economics and Outcomes Research, ISPE & the National Pharmaceutical Council have launched the Real-World Evidence (RWE) Registry as part of establishing credibility for & trust in RWE studies. Read more here.
EDUCATION
Duke-Margolis hosted an Open House event, in conjunction with Family Weekend at Duke, welcoming students and their visiting families, scholars, and faculty to celebrate the accomplishments of our Margolis students. Students, including a number in their first year at Duke, who are interested health policy, joined their families in visiting the Center and heard student intern presentations ranging in topics from Cost-Effectiveness Analysis of Cardiovascular Disease interventions in Myanmar to Telehealth: Disparities in Behavioral Health Treatment.
The Duke Student Collaborative on Health Policy (SCOHP) held their 2nd annual virtual undergraduate health policy case competition in partnership with the Margolis Center for Health Policy, RTI International, and the Duke Consulting Club. Margolis Scholar and intern Josee Li and her undergraduate teammates Zavera Basrai, Sai Harshith Rachakonda, and Katie Heath will present their winning case during an upcoming Margolis Seminar. Winning presentations as well as other information about the case competition will be posted at the student voices section of the SCOHP website.
The Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS) and AcademyHealth announced a competition for graduate students to create interactive data visualizations that address public health issues using NCHS trend data for use by one or more audiences. Learn more about earning greater visibility as a new researcher in the fields of public health and data science. Applications are due by November 15, 2021.

UPCOMING EVENTS

Thirteenth Annual Sentinel Initiative Public Workshop

November 8 & 9, 2021
10:00 AM – 2:00 PM ET

The annual public workshop is a gathering of the Sentinel community and leading experts to share recent developments within the Sentinel Initiative, provide training on the Sentinel System’s tools and data infrastructure, and promote engagement and collaboration with patients, industry, academia, and consumers. The 13th Annual Sentinel Initiative Public Workshop will convene virtually on November 8-9, 2021.

This year’s meeting will feature a keynote by Dr. Patrizia Cavazzoni, director of the FDA’s Center for Drug Evaluation and Research (CDER), as well as presentations from numerous expert panelists who will provide updates on key Sentinel Initiative developments, milestones, and strategic aims. The discussion will also consider recent activities and applications of the Sentinel Initiative as part of the U.S. FDA’s efforts to protect and promote public health during the COVID-19 pandemic.

Click here for additional information and to register.

Ensuring Pull Incentives for Priority Antibiotics Succeed

November 17, 2021
12:00 PM – 2:00 PM ET

Join Duke-Margolis to discuss national and global approaches to combat rising antimicrobial resistance (AMR) through pull incentives for novel antibiotic development, including the PASTEUR Act sponsored by U.S. Senators Michael Bennet and Todd Young.

Center Director Mark McClellan will moderate discussions on tailoring pull incentives for priority antibiotic development and the need for pull incentives beyond those in the US and UK. Discussions will highlight recent modeling that describes the appropriate magnitude of pull incentives to secure novel antibiotics, as well as administrative actions to support pull incentives for priority antibiotics and steps toward improved public health preparedness. Discussion also will focus on global leadership and actions among G7/G20 nations to incentivize novel antibiotic development and access.

Click here for additional information and to register.

Understanding Bias and Fairness in AI-enabled Healthcare Software

December 17, 2021
11:00 AM – 4:00 PM ET
 
Duke-Margolis is hosting a virtual public meeting entitled 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 health care software and how to promote fairness in AI software, including methods to test for and prevent bias throughout the development process. The meeting will also 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.
PAST EVENTS
Reconsidering Mandatory Opioid Prescriber Education Through a Risk Evaluation and Mitigation Strategy (REMS) in an Evolving Crisis
On October 13 & 14, 2021, Duke-Margolis Center held a public workshop convening regulators, clinical researchers, providers, patient advocates, and other stakeholders to exchange information and generate input by discussing prescriber education’s potential role in alleviating the evolving opioid and substance use crisis. The workshop included presentations from the Food and Drug Administration and the National Institute on Drug Abuse, giving historical context of the evolution of the crisis; panel discussions reviewing opioid prescriber education efforts at the federal, state, and healthy system levels; and considerations for the future role of federally mandated prescriber education, including potential challenges associated with mandatory education via the Opioid Analgesic Risk Evaluation and Mitigation Strategy (OA REMS) and potential benefits of such a requirement.
PEOPLE
Friends of Cancer Research named Center Director Mark McClellan to its list of 25 scientific & advocacy leaders who, through their work & partnership, have been instrumental over the course of their 25 years in making significant advancements for patients.

President Biden is reportedly considering nominating former FDA Commissioner and Duke School of Medicine’s Donald F. Fortin, M.D. Distinguished Professor of Cardiology, Robert Califf to take up the FDA post for a second time. Mark McClellan was interviewed by a number of news agencies regarding this possible appointment, telling Politico that Dr. “Califf would be a strong, experienced and effective commissioner.” Read more from The Hill regarding his potential nomination.

Duke-Margolis Deputy Director Gillian Sanders Schmidler presented at the Innovations in Pharmaceutical Manufacturing on the Horizon: A Virtual Dissemination Workshop presented by The National Academies of Sciences, Engineering, and Medicine. Click here for more information regarding the conference and its speakers.

The Duke Center for Research to Advance Healthcare Equity, or REACH, will award Duke-Margolis Core Faculty member Osondu Ogbuoji the REACH Equity Award. The funds from this award will allow him to explore value-based payments and disparities in maternal health outcomes for his project, “Value-based care and racial disparities in maternal health outcomes.” Click here to learn more.
Assistant Research Director William Bleser was a guest on 3M’s Inside Angle Podcast series to discuss how value-based health care transformation models are addressing social determinants of health and unmet social needs. During the conversation, Will discussed a Center issue brief published earlier this year, “How Are Payment Reforms Addressing Social Determinants of Health?” which he co-authored with Duke-Margolis researchers Hannah Crook, James Zheng, Rebecca Whitaker, Jasmine Masand, and Robert Saunders

Core Faculty Member Frank Wharam joined Charlotte Talks with Mike Collins on WFAE where he and other invited guests discussed the cost of employer-sponsored health plans in the U.S. as part of the show’s ongoing series “The Price We Pay.” Listen to the entire episode here.

Assistant Research Director Nitzan Arad joined The Stigler Center Economics of Healthcare Conference as a panelist for a session entitled “Barriers to Entry in Pharmaceutical Markets.” She is a co-author of an upcoming paper of the same name.
TEAM MEMBER WELCOMES
Gabriele Wurmitzer, PhD, a Duke alumna, joins Duke-Margolis as a new Program Coordinator for our Education and Workforce Development efforts. In her role, Gabi will coordinate the planning, implementation, and operation of student-facing curricular and co-curricular initiatives, including event planning, student outreach, programmatic tracking and assessment, and academic course management. Previously, she was the Project Coordinator for the Duke Reader Project, a cross-disciplinary mentorship initiative, where she facilitated intellectual exchanges between undergraduate students and Duke alumni. Before joining Duke, Gabi gathered extensive administrative experience as admissions and event coordinator at the University of Vermont, where she also was the assistant to the director of a non-profit organization focused on women’s health and professional development. Gabi received her PhD in German Studies from Duke and her Bachelor and Master’s degrees from the University of Vermont. She serves on the Duke Triangle Alumni Executive Board, the Women’s Forum Board, is a member of the Duke Alumni DEI Taskforce, and volunteers with the Thomas Mentor Leadership Academy in Durham.  
Brianna Van Stekelenburg, MPP, another Duke graduate, is a new Research Associate with the Health Care Transformation team. In her role, Brianna will support Center projects in health care delivery and payment reform. Brianna comes to Duke-Margolis from the North Carolina Office of State Budget and Management, where she served as a Senior Analyst on the health and education team. She also worked previously as a Research Analyst for the NC Council for Women. Over the last five years, Brianna also worked part-time as a Senior Research Aide for Duke’s Center for Child and Family Policy, where she conducted home interviews with adolescents. Brianna received her Master's in Public Policy from Duke’s Sanford School of Public Policy at Duke and her Bachelor's degree in International Studies and Spanish from the University of Mississippi.   
We are thrilled to welcome back Adam Aten MPH, MSc, who rejoins the Biomedical Innovation team as a Research Associate after a tour at the Department of Defense. As a Lieutenant in the U.S. Navy Reserves, Adam works as a health administrator and was selected for a 10-month tour at The Pentagon in the Office of the Chief of Naval Operations, which is responsible for the overall command of the Navy’s operating forces. Adam worked in the N31 Department of Current Operations, and his team served as a representative of the Navy’s Surgeon General at The Pentagon. In this role, he supported the development and coordination of the Navy’s COVID-19 response to meet Defense Support of Civil Authorities requirements to reinforce domestic health system capacity as well as international mission requirements. The Secretary of the Navy recognized his efforts and awarded Adam with the Navy and Marine Corps Achievement Medal. We thank Adam for his service and are thrilled to have him back at Duke-Margolis!  
New Duke-Margolis Faculty Member
Duke-Margolis Center Health Equity Policy Fellow Andrea Thoumi has been appointed as an Adjunct Assistant Professor and Core Faculty Member. Andrea’s research interests include health policies to mitigate structural and social determinants of health that create health inequities among Latine/x communities in the US and among women accessing reproductive health prevention, screening, and treatment globally. Andrea serves on the Duke-Margolis Anti-Racism and Equity Committee. She also serves as an instructor on Bass Connections courses and is a research collaborator with LATIN-19RADx-UP, and Women-Inspired Strategies for Healthcare.
Opportunities at Duke-Margolis Center for Health Policy
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.
Submissions Welcome!
Interesting Project? Funding Opportunities? News and Events? 
Awards and Honors? Policy Impact? Op Eds? 

We're looking for ways to highlight your accomplishments and share information.
Email submissions to dukemargolis@duke.edu.