August 2014 Newsletter


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The Current Issue of The Milbank Quarterly

The September issue of The Milbank Quarterly features our op-ed contributors and lead articles on financial conflicts of interest and the vaccine debates. The issue also introduces our new "Policy Points," a two- to three-bullet point synopsis of each article's import on explicating or advancing a particular set of health policies. Just as an article's abstract presents, in an abbreviated form, the scholarly design and results of a study, the Policy Points serve to alert legislators, policymakers, and implementers about the ramifications of each of the Quarterly's peer-reviewed studies.

Our op-ed contributors in this issue:

Our September studies:

Financial Conflicts of Interest in FDA Advisory Committees looks at the potential for financial conflicts of interest to influence members of the FDA's advisory committee as they proceed through the drug approval process. (Genevieve Pham-Kanter)

Here Comes the Sun, a commentary on the corrosive effects that conflicts of interest can have on medical professionalism. (David Rothman)

Power and Persuasion in the Vaccine Debates: An Analysis of Political Efforts and Outcomes in the United States, 1998-2012 documents the debate over vaccines by analyzing the political efforts and outcomes of state vaccine legislative efforts between 1998 and 2012. (Denise Lillvis, Anna Kirkland, Anna Frick)

Disability and Care Needs of Older Americans focuses on the disability and care needs of older Americans by analyzing the National Health and Aging Trends Study, a new national panel study of more than 8,000 Medicare enrollees. (Vicki Freedman, Brenda Spillman)

The Dynamics of Community Health Care Consolidation: Acquisition of Physician Practices examines the dynamics of community health care consolidation and the acquisition of physician practices as it played out in Minnesota between the late 1970s to the present. (Jon Christenson, Caroline Carlin, Louise Warrick)

Emerging Lessons from Regional and State Innovation in Value-Based Payment Reform: Balancing Collaboration and Disruptive Innovation presents some of the emerging lessons from regional and state innovation efforts to enact value-based payment reforms in their health care delivery systems. (Douglas Conrad, David Grembowski, Susan Hernandez, Bernard Lau, Miriam Marcus-Smith)

THE VIEW FROM HERE: Transforming Delivery Systems—It's All About Alignment

Christopher F. Koller, President of the Milbank Memorial Fund

How does systemic restructuring happen in health care delivery systems?

It's a given among the health policy intelligentsia that to improve the value of health care in the United States, delivery systems need to "restructure"—to change the people, technology, and processes used to provide medical care. The conventional wisdom is that this restructuring is an even bigger policy challenge than increasing the number of people with access to health care, and that this task will grow even more significant as the US's bill for expanded access comes due.

Fine—so far. But how?

For groups of providers to reorganize and meet the goals of delivering better population-based care more efficiently and in patient-centered ways, the signals sent to providers and patients must be consistent with these goals. Economists have it right: there is no stronger message than finances—we get what we pay for, and in the US, we have rewarded volume and procedural complexity.

So our signals—our payments and our benefit rules—have to change... Read more

What You're Reading

Milbank Reports have been published by the Milbank Memorial Fund for over two decades. Written for policymakers, legislators, decision-makers, and practitioners, these Reports examine the significance of and evidence for specific issues in health care, such as long-term care for the elderly, the future of academic medicine, emergency preparedness, and evolving models of integrating behavioral health and primary care. These Reports often have a shelf life of many years.

Our most popular reports in August were:

Aligning Payers and Practices to Transform Primary Care: A Report from the Multi-State Collaborative (2014)

Evolving Models of Behavioral Health Integration in Primary Care (2010)

Preventing Violence Against Women and Children (1998)


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About the Milbank Memorial Fund

The Milbank Memorial Fund is an endowed operating foundation that works to improve the health of populations by connecting leaders and decision makers with the best available evidence and experience. Founded in 1905, the Fund engages in nonpartisan analysis, collaboration, and communication on significant issues in health policy. It does this work in three ways: publishing high-quality, evidence-based reports, books, and The Milbank Quarterly, a peer-reviewed journal of population health and health policy; convening state health policy decision makers on issues they identify as important; and building communities of health policymakers to enhance their effectiveness.