The Latest

Original Scholarship
August 2025

Advancing Equity: Lean Leader Practices and a Path Forward

By:  Dorothy Y. Hung LILLIAN C. LEVY Thomas G. Rundall ELINA REPONEN WILLIAM HUEN Stephen M. Shortell

Lean management is a sociotechnical approach to quality improvement that aims for consistency in work processes and outcomes. This can be leveraged to reduce inequities by ensuring delivery of high-quality care to meet the needs of patients with diverse backgrounds. Despite recent efforts in the field, there is limited study on how managers implement health equity and workforce diversity goals as strategies to improve patient care. Given the important role of leadership in fostering workplace culture, we examined leader activities and specifically their use of lean management practices to support equity initiatives in health care. More

Open Access
Original Scholarship
August 2025

Measuring Primary Care Productivity in the Era of Interprofessional Team Care: Stakeholder, Scoping Review, and Implementation Perspectives

By:  LISA V. RUBENSTEIN SYDNE J. NEWBERRY ISHITA GHAI ANEESA MOTALA IDAMAY CURTIS PAUL G. SHEKELLE TODD H. WAGNER L. DIEM TRAN STEPHEN D. FIHN KARIN M. NELSON

Current primary care productivity measures do not account for investment in interprofessional primary care teams in relation to primary care goals and thus are insufficient for assessing and improving primary care efficiency and productivity. We explored alternative productivity measurement methods. More

Open Access
Perspective
August 2025

Changing the Story on Health and Racial Equity: Why Public Health Needs an Infrastructure for Building Narrative Power

By:  LORI DORFMAN Sarah E. Gollust MAKANI THEMBA PRITPAL S. TAMBER Anthony Iton

A growing body of scholarship and practice in public health attests to the importance of addressing differences in power as a fundamental determinant of health inequities. To pursue health equity, public health practitioners must move beyond identifying differences in health outcomes among populations (disparities) to articulating why those differences are unfair or unjust (inequities) and then identifying structures, such as laws, policies, practices, and norms, that advantage some and disadvantage others. More

Open Access
Original Scholarship
August 2025

Determinants of When Community Behavioral Health Clinics Partner With Emergency Response Systems: The Role of Capacity in 911 Referral and Co-response Models

By:  Amanda I. Mauri Zoe Lindenfeld Charley Willison THERESE L. TODD Jonathan Purtle DIANA SILVER

Individuals with behavioral health disorders are more likely to experience substantial harm from a police encounter, prompting reforms to minimize encounters between police and people experiencing a behavioral health crisis. One strategy involves expanding partnerships between certified community behavioral health clinic (CCBHC) mobile crisis teams and emergency response systems, often through two models: 911 referral, wherein a CCBHC’s behavioral health practitioner–only team responds to 911 calls, and co-response, wherein a CCBHC clinician joins a police or emergency medical services (EMS) team. More

Original Scholarship
August 2025

County-Level Immigration Policy and Health Insurance Among Latino Adults and Youth

By:  Maria-Elena De Trinidad Young Danielle M. Crookes Sarina Rodriguez Fabiola Perez-Lua Ninez A. Ponce Alexander N. Ortega

Federal and state immigration policies influence access to health insurance for Latino populations. Local jurisdictions also have immigration-related policymaking power, but there has been limited study of their influence on health care access. We examined the relationship between county-level immigration policy contexts and health insurance coverage of Latino adults and youth in California using two measures that capture local-level policy decisions and immigration policy–related social inequity. More

Open Access
Original Scholarship
June 2025

Longitudinal Associations From US State/Local Police and Social Service Expenditures to Suicides and Police-Perpetrated Killings Between Black and White Residents

By:  Devin English Ty A. Robinson Lori S. Hoggard Felix M. Muchomba Sharifa Z. Williams Joel C. Cantor Paul R. Duberstein Brett M. Millar

Reducing police expenditures and increasing housing expenditures may decrease Black–White inequities in years of potential life lost to suicide and police-perpetrated killing. More

Open Access

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Opinions

John E. McDonough
August, 2025

Chief Justice Roberts’ 2012 Ruling Should Undermine Work Requirements

No discernible difference exists between the ACA mandate penalty that was overturned by the US Supreme Court and the mandate penalty in the 2025 OBBBA.  More
Sara Rosenbaum
August, 2025

Nullifying the Affordable Care Act: What the Medicaid Work Requirement Really Is All About

Despite a mountain of evidence showing its deleterious effects, a Medicaid work requirement is now law. The mandate, considered by its supporters to be a centerpiece of the One Big Beautiful Bill Act (OBBBA), is the product of a desperate search to find ways to help offset over $3 trillion in tax losses, coupled with the enduring desire among Affordable Care Act (ACA) opponents to repeal the Medicaid expansion for working-age adults. To accomplish their goal, Medicaid advocates coupled a claim that removing millions of people from Medicaid somehow makes the program more efficient with grossly misleading “research” characterizing Medicaid beneficiaries as healthy adults living off their benefits, with free time on their hands.    More
Beth McGinty
August, 2025

Medicaid Cuts Will Heighten the US Mental Health and Substance Use Crisis

The One Big Beautiful Bill Act (OBBBA)’s cuts to Medicaid will heighten the nation’s behavioral health crisis. Nationally, each year an estimated…  More
Harold A. Pollack
August, 2025

Persons with Down Syndrome Face a 90% Lifetime Dementia Risk–A Reality of Aging That Must Be Addressed  

Joseph, a 45-year-old man with Down syndrome is brought to the emergency department (ED) after he and his mother fell down the stairs. In a phone…  More
Tiffany Joseph
August, 2025

We Are All Immigrants Now: Trump’s One Big Beautiful Bill Decimates Health Care Access for All But a Privileged Few

The GOP Plan to End Obamacare involves fiscally starving it to death rather than an explicit repeal. Trump’s recent signing of the “Big Beautiful Bill” brings us closer to that harsh reality.    More
Jerel M. Ezell
July, 2025

Opioid Settlements, Big Pharma, and Racial Disparities in the Opioid Epidemic

Despite recent overall decreases in drug overdose deaths, racial disparities are persisting. This, coming against the backdrop of sweeping national opioid settlements, offers a reminder of the enduring potency of systemic racism in the face of what is otherwise a demonstrable public health success.  More

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Special Issue

Read the articles

Mental Health and Substance Use Challenges Facing the United States: What Can State Policymakers Do?

In June, The Milbank Quarterly will publish a special issue of articles that address state strategies to improve mental and behavioral health, including approaches to strengthening the behavioral health workforce, leveraging AI to address the overdose crisis, and much more. Individual articles are publishing on a rolling basis.

For Authors

Information, instructions for authors, publication policies, and additional resources for authors interested in submitting manuscripts to The Milbank Quarterly.

Learn More

About The Milbank Quarterly

Continuously published since 1923, The Milbank Quarterly features peer-reviewed original research, policy review, and analysis from academics, clinicians, and policymakers.

Editor

Alan B. Cohen

Publisher

Christopher F. Koller

Managing Editor

Tara Strome

2-year Impact Factor: 6.6
Journal Citation Reports® 2022 Rankings: 3/87 (Health Policy & Services); 8/105 (Health Care Sciences & Services)
5-year Impact Factor: 8.964