Duke-Robert J. Margolis, MD, Institute for Health Policy

11/21/2025

Policy Research Assistant Montgomery Smith and Assistant Research Director Frank McStay co-authored a paper in the Journal of the American Medical Directors Association that studied stakeholder feedback on the potential development of a home-based primary care practice recognition program: https://duke.is/n/tvd2

Home-based primary care (HBPC), which provides longitudinal interdisciplinary primary care to functionally impaired patients at home, rather than in traditional ambulatory clinics, improves patient outcomes, but remains relatively invisible to key stakeholders and has not scaled. Practice recognitio...

11/18/2025

Don't miss out! Join us this Thursday for our hybrid workshop, "Individualized Therapies on the RISE." In this second installment of the U.S. Food and Drug Administration's Rare Disease Innovation, Science, and Exploration (RISE) workshop series, speakers will explore the emerging science and regulatory environment for individualized medicine programs. Registration closes soon: https://duke.is/m/jxxj

11/14/2025

Mark McClellan discussed how health care leaders can build a more sustainable future during the 2025 Health Evolution Summit. Learn more about Mark's and his fellow speakers' thoughts in the Summit recap: https://duke.is/m/zntv

As Health Evolution's unparalleled community of executives gathered for the 15th Summit, they focused on the changes leaders must make now to build a tech-enabled health care system that’s more proactive, sustainable, and trustworthy by 2040. Leaders reflected on lessons learned, shared strategies...

11/13/2025

Our next event is days away! Home-based primary care (HBPC) offers an essential lifeline for homebound Medicare beneficiaries, improving outcomes and patient experience while reducing avoidable hospitalizations. Join us on November 18 for a webinar that will explore how to build a sustainable, value-driven roadmap for HBPC within Medicare.

Registration closes soon, so don't forget to secure your spot in the conversation: https://duke.is/9/ct26

11/10/2025

Duke-Margolis researchers Katie Huber, Brianna Van Stekelenburg, Alida Austin, and Rebecca Whitaker, and former intern Rebecca Stern, co-authored a paper in the North Carolina Medical Journal to discuss the history of bipartisan support for NC Medicaid, highlight examples of lessons learned and impacts, and offer key considerations for the path forward. Read more here: https://duke.is/r/gge5

11/06/2025

With the homebound population growing, how do we build the roadmap for better home-based primary care? A draft agenda is now available for our upcoming webinar, where speakers will explore solutions to this question. Join us on November 18 for this important conversation: https://duke.is/9/ct26

11/05/2025

Hear from Assistant Research Director Frank McStay next week at the Primary Care Collaborative's 2025 Evidence Report release! On November 12, Frank and his fellow speakers will examine the state of rural primary care as residents of rural communities face new barriers to health coverage. Learn more and register here: https://thepcc.pub/Closing-The-Distance

11/05/2025

In this new Health Affairs Forefront article, Duke-Margolis researchers Val Lehman, Kylie Brown, Wenbo Bai, and Mark McClellan explore opportunities to advance rapid learning for accountable care. In particular, they highlight the potential of collaborative action through efforts like the new West Health Accelerator at Duke-Margolis. Read more here: https://duke.is/r/w5uz

With accountable care more widespread than ever, the potential benefits of rapid learning collaboratives for accountable care have never been greater, both to improve outcomes and performance and to increase the confidence of organizations to participate.

11/04/2025

Duke-Margolis has published an event report for "On the RISE: Controls in Rare Disease Clinical Trials for Small and Diminishing Populations" that summarizes the discussion that took place, offers key takeaways, and outlines next steps. You can read it here: https://duke.is/z/mkv3

10/28/2025

Don't miss your chance to join this conversation! Tomorrow, we are gathering health policy experts and leaders across the public and private sectors to outline and discuss the vision and priorities for accountable care reform, and chart a path toward delivering better health and better care for all. Registration closes soon—secure your spot here: https://duke.is/p/3vx6

10/27/2025

Drug shortages have severely impacted patient care in the U.S. for decades. In our latest white paper, Assistant Research Director Stephen Colvill, Policy Research Associate Thomas Roades, and Institute Director Mark McClellan propose next steps that Congress can take to address the economic root causes of the drug shortage problem and create a more reliable and resilient pharmaceutical supply chain.

Building off of a 2024 Senate Finance Committee Discussion Draft, the white paper proposes how Congress could provide funding and authority to Medicare to implement a payment program to incentivize a shift to a more reliable supply of critical generic drugs. The authors also outline opportunities to simplify the original Senate Finance Committee proposal while retaining and improving upon its original intent: to ensure that patients can access the critical drugs they need.

Read more here: https://duke.is/6/mduj

White Paper Addressing the Root Causes of Drug Shortages: Next Steps for Congress Published date October 27, 2025 Topics Drug Supply Chain, Advancing Biomedical Innovation View Publication (PDF) Executive Summary Severe, chronic shortages of critical generic drugs in recent decades are associated wi...

10/24/2025

Institute Director Mark McClellan and Policy Analyst Sara Debab have co-authored a new Viewpoint article in JAMA Health Forum to outline steps that reduce clinician burnout by modernizing Medicare’s risk adjustment mechanism.

Risk adjustment is a consequential Medicare payment policy, influencing billions of dollars in adjusted payments to account for the health status of beneficiaries. However, risk adjustment continues to rely on fee-for-service claims, which exacerbates burden on clinicians in accountable care programs. The Centers for Medicare & Medicaid Services (CMS) have implemented reforms to alleviate this burden, but the authors recommended that CMS could push their reforms further by shifting risk adjustment to rely on key electronic health data that are already part of quality measurement reform.

Read the article here: https://duke.is/w/tdna

This Viewpoint addresses ways to transition from payment systems relying on clinician effort to systems that achieve more accurate payment without additional clinical effort to avoid potential clinician burnout.