The Duke Margolis Center for Health Policy was established in October 2015 with a $16.5 million gift from Duke medical school alumnus Robert J. Margolis and his wife Lisa, through the Robert and Lisa Margolis Family Foundation. We sat down with DC-based Deputy Director Gregory Daniel, PhD, MPH, to learn more about how the center will connect cutting-edge research with policymakers and policy analysts in DC and beyond.
Duke in DC: What are the primary areas of focus for the Duke-Margolis Center?
Daniel: The center, under the direction of Mark McClellan, MD, focuses on policy that influences healthcare cost, quality, innovation and delivery where desirable outcomes are poorly aligned with healthcare payments and the goals of reform. Everyone agrees that we want measureable higher quality and higher value in healthcare. This requires understanding the incentives embedded in the system, a deep knowledge of how healthcare is delivered across a number of settings, the data systems needed to support high value care, and ensuring that reimbursement supports the policy decisions that will help achieve this larger goal.
Some areas where we think we can provide high-impact policy research include:
- Biomedical innovation and evidence development policies that support the development, regulation, access, and high value uses of drugs, biologics, and medical devices;
- Finance and payment reforms that promote the adoption of value-based payment models, including accountable care organizations (ACOs), bundled payments, performance-based incentives, and shared savings;
- Delivery system reforms that encourage the widespread adoption of practical, evidence-based strategies that improve population health and reduce health care costs;
- International health and payment reform that accelerate the uptake of successful disruptive accountable care payment and delivery reforms.
Influencing policy across these dimensions requires understanding the incentives embedded in the current healthcare system and how they interact with healthcare delivery.
Duke in DC: Given our current political climate, what do you see as the pressing issues in health policy?
Daniel: The immediate challenge is contributing to some of the work that people want to get done before the next election. Timelines right now are changing from aggressive but feasible to impossible. There is always uncertainty at the end of an administration that’s been in place for two terms. Healthcare reform has been such a prominent feature of the Obama administration that health policy issues and payment reform (our main disciplines) are in sharp focus.
Duke in DC: Over the next two years, how do you expect to integrate the work that you did at the Brookings Institution with Duke University’s academic and clinical communities?
Daniel: The Margolis Center offers us an important and timely opportunity to transcend customary disciplinary boundaries and connect clinicians, specialists, economists, policy scholars, legal scholars – truly any field that touches how healthcare is delivered and paid for — around the problems facing patients, providers, systems and populations.
This means that the ways we can approach problems is changing dramatically. The work our group did at Brookings demanded solid health policy skills, relationships, and processes to probe and frame questions that were brought to us from stakeholders in government, industry, and healthcare. We are now part of a continuum that includes computational and social sciences, a world-class academic research organization, a global health institute, one of the nation’s top academic health systems, and schools of medicine, engineering, nursing, business, law, and public policy, and patients. We’re just beginning to explore ways the Duke-Margolis Center can contribute to goals of the Duke community on campus and beyond.
Duke in DC: How are you hoping to engage with various scholars, schools, departments and programs at Duke?
Daniel:We have been overwhelmed by the enthusiasm of the Duke community. Across the entire landscape we’ve encountered people who want to be part of the Duke-Margolis Center, and are prepared to pitch in.
We are at the very beginning of a strategic planning process. It’s hard to say where we’ll end up – because we’re seriously committed to discovering and optimizing connectivity between Duke and Washington, DC. Suffice it to say we are thinking out-of-the-box to identify real ways to generate new value for the Margolis Center, Duke, and the national and international communities we hope to serve. We’re small and trying to be intentional about collaboration, growth and deployment of resources.
It is important that we maintain connectivity from between the Durham campus and Washington, DC – with a significant part of our team located in at the Duke in DC office, we can capitalize on proximity to the FDA, to Capitol Hill, and the community of think tanks and consulting organizations that co-exist with policy makers. The Duke-Margolis Center will be a major contributor to Duke’s visibility and engagement here in the future!]]>