5 Game-Changing Health Policy Initiatives From The Duke-Margolis Institute In 2025

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The landscape of American healthcare is perpetually shifting, and at the forefront of driving evidence-based, practical policy change is the Duke-Margolis Institute for Health Policy, which is the evolution of the original Duke Health Policy Center. As of late 2024 and heading into 2025, the Institute is spearheading several major initiatives aimed at transforming care delivery, payment systems, and public health infrastructure across the United States. These efforts, led by a team of physician-economists and policy experts, are setting the agenda for federal and state health reform, with a strong focus on accessibility and value.

The Institute's work in this current period—specifically the 2025 policy cycle—is characterized by a deep engagement with federal agencies like the Centers for Medicare & Medicaid Services (CMS) and the U.S. Food and Drug Administration (FDA). Their research aims to move beyond theoretical concepts, translating complex data into actionable recommendations for policymakers, healthcare organizations, and clinicians. The following sections detail the leadership and the five most significant, current initiatives that are defining the Institute’s impact in 2025.

Leadership Profile: Dr. Mark McClellan, Director of Duke-Margolis

The strategic direction and profound influence of the Duke-Margolis Institute for Health Policy are largely guided by its founding Director, Mark B. McClellan, MD, PhD. Dr. McClellan is a highly respected physician-economist whose career spans high-level government service and academic leadership.

  • Full Title: Director of the Duke-Margolis Institute for Health Policy and the Robert J. Margolis, MD, Professor of Business, Medicine and Health Policy at Duke University.
  • Expertise: Dr. McClellan is renowned for his focus on improving the quality and efficiency of healthcare, including payment reform, risk adjustment, and the use of real-world evidence.
  • Government Service: He previously served as Administrator of the Centers for Medicare & Medicaid Services (CMS) and as Commissioner of the U.S. Food and Drug Administration (FDA). This dual experience provides a unique perspective on both payment and regulatory policy.
  • Academic Role: His position as a Professor across the Schools of Medicine, Business (Fuqua), and Public Policy (Sanford) underscores the interdisciplinary approach of the Institute's research.

The 5 Game-Changing Initiatives of Duke-Margolis in 2025

The Institute's 2025 agenda is ambitious, tackling everything from chronic care management to the existential threat of climate change on public health. These five initiatives represent the most critical, forward-looking work currently underway at Duke-Margolis.

1. Driving the New CMS ACCESS Model for Chronic Care

One of the most significant policy areas for Duke-Margolis in 2025 is the Centers for Medicare & Medicaid Services (CMS) ACCESS Model (Advancing Chronic Care with Effective, Scalable Services). The Institute, under the leadership of Dr. McClellan and experts like Christina Silcox, has been a vocal supporter and key analytical partner for this new model.

The ACCESS Model aims to address the limited access to technology-supported and coordinated care services for people in Original Medicare who are managing chronic conditions. Duke-Margolis is actively working to help patients, clinicians, and policymakers realize the benefits of this model, which include improved patient outcomes and more efficient care delivery through better coordination and the integration of technology.

2. Advancing Biomedical Innovation and Regulatory Policy with the FDA

The Institute maintains a strong focus on Advancing Biomedical Innovation, operating under a cooperative agreement with the U.S. Food and Drug Administration (FDA). This work is vital for modernizing the pathway for new medical products, ensuring that regulatory science keeps pace with technological advancements.

Key areas of research include developing frameworks for evidence generation, especially for new technologies and complex diagnostics. The Institute’s collaboration with organizations like the Clinical Trials Transformation Initiative (CTTI), the Duke Clinical Research Institute (DCRI), and Protas has recently resulted in publications investigating practices to improve the overall evidence generation system in healthcare.

3. Defining the Future of 21st Century Public Health

The COVID-19 pandemic highlighted major systemic weaknesses in the U.S. public health infrastructure. In response, Duke-Margolis has launched a major, cross-cutting initiative to address and inform the future of 21st Century Public Health and Population Health.

This initiative goes beyond infectious disease, encompassing broader determinants of health. The Institute's work in this area involves developing policy solutions for enhancing public health data systems, improving health equity, and strengthening the connection between clinical care and community health services. This focus on preventative and population-level health is a cornerstone of their 2025 research agenda.

4. The 2025 Health Policy Conference and Convening Power

A major event cementing the Institute's role as a national convener is the 2025 Duke-Margolis Health Policy Conference. This annual conference brings together leading policymakers, academic experts, and industry stakeholders from across the public health and healthcare spectrum.

The 2025 conference theme, "Evolving Better Health Care for...", emphasizes the ongoing need for systemic reform and collaboration. These convenings are crucial for disseminating the Institute's evidence-based research and translating it into practical policy recommendations that influence national discourse and legislation.

5. Integrating Health Reform and Climate Change Policy

In a forward-looking move, the Duke-Margolis Institute is actively exploring the intersection of Health Reform and Climate Change. Recognizing that climate change poses a significant and growing threat to public health, the Institute is co-hosting a Duke Climate Collaboration Symposium in late 2025.

This initiative focuses on identifying policy reforms that can both mitigate the health impacts of climate change and improve the resilience of the healthcare system. By linking environmental policy to health outcomes, Duke-Margolis is positioning itself at the leading edge of a critical, emerging policy domain.

Shaping the Future of Health: Key Policy Focus Areas

Beyond the five major initiatives, the Duke-Margolis Institute for Health Policy maintains a robust portfolio across several critical, interconnected policy domains. These areas are the foundation of their topical authority and provide the context for their specific 2025 projects.

  • Health Care Transformation: This core area focuses on identifying and promoting care delivery and payment reforms that make healthcare more affordable, accessible, and high-quality. This includes work on Episode-Based Payment Models and risk adjustment methodologies for Medicare.
  • Real-World Evidence (RWE): The Institute is a leader in advancing the use of real-world data in regulatory and payment decisions, which is essential for rapidly and effectively evaluating new medical products and treatment protocols.
  • Home-Based Primary Care: A clear sign of the move toward decentralized care, the Institute is focusing on building the roadmap for scaling up home-based primary care services, including a scheduled webinar in late 2025 to discuss this model.
  • North Carolina Health Policy: The Institute leverages its local expertise to support efforts to make health care more accessible and innovative within North Carolina, often serving as a model for national policy.

The work of the Duke-Margolis Institute for Health Policy (the new iteration of the Duke Health Policy Center) is more critical than ever. By focusing on evidence-based solutions in areas like chronic care, biomedical innovation, and public health infrastructure, the Institute is not just analyzing the problems of the U.S. healthcare system, but actively collaborating with key stakeholders to implement real, impactful solutions in 2025 and beyond.

5 Game-Changing Health Policy Initiatives from the Duke-Margolis Institute in 2025
duke health policy center
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