Mark McClellan, MD, PhD
Director, Duke-Margolis Center for Health Policy
Margolis Professor of Business, Medicine, and Health Policy
Duke University
The Duke Margolis Center for Health Policy was established 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.
What do you see as the mission for the health policy center?
Our mission, which arose from a six month strategic planning process, is to improve health and the value of health care by developing and implementing evidence-based policy solutions local, nationally, and globally.
That sounds simple, but successful evidence-based policy is actually enormously complex. We have to address questions like: How is value defined—by payers, providers, patients and policymakers? How do we measure value in a complex system? In the United States, how can we move away from volume-based payment models and align incentives to achieve better health?
What are the policy initiatives you’ll tackle in your first year?
Our strategic plan focuses our research portfolio in three areas:
- Health care delivery reform: drawing on expertise from across Duke University to create the research and data infrastructure necessary for empirical analysis of challenging health care delivery and payment reform questions. Projects in this portfolio range from the very local—supporting Duke Health’s strategy and care redesign—to looking at MACRA and Medicaid reform on a national level, to implementation of accountable care worldwide.
- Biomedical innovation policy and evidence development: evidence aimed at developing policies and approaches that support cost-effective continuous learning to improve safe, high-value use of drugs, devices and other technologies. The primary focus of this work will be on increasing the value of biomedical innovation to patients—including both better health outcomes and lower overall costs. Projects include evaluating economic assistance to address antibiotic-resistant infections, using real-world evidence to advance regulatory and payment reform, and accelerating drug development.
- Education and workforce development: with major changes in both health care and biomedical innovation, the skills required to succeed as a provider, industry leader, or policymaker must change as well. Duke-Margolis will serve as a catalyst to improve knowledge and education for undergraduate, graduate and professional students, and for executive and continuing education programs. Collaborating with organizations inside and outside of Duke, we are looking at creating curricular pathways, building course offerings, and expanding our faculty’s engagement with student research projects as resources and mentors.
How do you see the center impacting the US health care system?
The ability to bridge policy and practice and have them inform each other in tangible ways should position Duke-Margolis and Duke as a whole to be not just a thought leader in health policy, but also a place where policy is piloted, tested, and refined in a real-world setting. This is something that very few other organizations have the depth and breadth to offer.
From your perspective, what is the biggest challenge in health care today?
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. Health care 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.
We’re seeing new collaborations in health care to address cost, quality, and access, such as Accountable Care Organizations. What sort of emerging partnerships in the health sector do you perceive to be the most compelling?
We are really at a crossroads right now. Payment reforms aimed at creating Accountable Care Organizations are a promising approach to the “triple aim” of improving how patients experience care—including quality and satisfaction, improving the health of our population as a whole, and reducing the cost of health care. At the same time, we need to know whether these models will actually achieve these aims and what tradeoffs will be necessary to implement them in the real world. Partnerships that link real world data to value frameworks are the most compelling, and that’s what we are going to do here at Duke.
What would you like your legacy to be?
Health policy is truly a team sport and I hope to be the leader that helps create a model that transcends customary disciplinary boundaries and connect clinicians, specialists, economists, policy scholars, legal scholars—truly any field that touches how Health care is delivered and paid for—around problems facing patients, providers, systems and populations.
If our work makes health care more patient-centric, helps our system and others around the world share best practices and deliver care at a higher level of quality, speeds up biomedical innovations that save lives or create a better quality of life at a lower cost than we have today—these are the kinds of things I hope would be part of a legacy.
About Dr. McClellan
Mark B. McClellan, MD, PhD, is a doctor and an economist whose work has addressed a wide range of strategies and policy reforms to improve health care, including payment reforms to promote better outcomes and lower costs, methods for development and use of real-world evidence, and approaches for more effective drug and device innovation. Dr. McClellan is a former administrator of the Centers for Medicare & Medicaid Services (CMS) and former commissioner of the U.S. Food and Drug Administration (FDA), where he developed and implemented major reforms in health policy.
Dr. McClellan has served as a member of the President’s Council of Economic Advisors and as Deputy Assistant Secretary of the Treasury for Economic Policy. He was also a Senior Fellow at the Brookings Institution and a professor of economics and medicine at Stanford University where he directed the Program on Health Outcomes Research.