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The Milbank Memorial Fund is an endowed operating foundation that publishes The Milbank Quarterly, commissions projects, and convenes state health policy decision makers on issues they identify as important to population health.
From the Editor
Alan B. Cohen Read Bio
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This issue of the Quarterly features opinion pieces from several of our contributing writers as well as invited commentaries from noted guest authors on a broad range of issues:
We are pleased to introduce the Milbank Quarterly Classics, a series of landmark articles published by the journal over the course of its 97‐year history. Each article in the series has withstood the test of time, representing an important contribution to the field at the time of publication, and serving today as a still‐relevant guidepost for contemporary policymakers and practitioners. We intend to post Classic articles on the Fund’s website at three‐month intervals. For each Classic article, commentaries by noted scholars pointing out the key lessons relevant to the current policy environment will appear in the journal, along with a web link to the Classic. The first in the series is a 1996 article by Edward Wagner, Brian Austin, and Michael Von Korff, “Organizing Care for Patients with Chronic Illness.” In separate commentaries, Edward Wagner and Donald Berwick discuss the chronic care model’s widespread adoption and reflect on its role in health care delivery after more than two decades as the gold standard for managing chronically ill patients.
Readers also may be interested in new original research by Russell Glasgow and colleagues. In “An Adaptive, Contextual, Technology‐Aided Support (ACTS) System for Chronic Illness Self‐Management,” they build upon the legacy of the chronic care model to create an integrated, patient‐directed system that takes greater account of a patient’s life context and home/primary care/work‐setting supports.
Accountable Care Organizations (ACOs) typically employ patient engagement strategies in their adult primary care practices, but little is known about the relation of these strategies to patient‐reported outcomes. In “Linking Practice Adoption of Patient Engagement Strategies and Relational Coordination to Patient‐Reported Outcomes in Accountable Care Organizations,” Hector Rodriguez and colleagues find no differential improvements in outcomes among patients of practices with high vs. low adoption of patient engagement strategies or among patients of practices with high vs. low relational coordination. Their findings suggest that ACOs may need to invest more heavily in collecting, monitoring, and analyzing patient‐reported outcome data to ensure that adoption and implementation of patient engagement strategies lead to improved functioning among patients.
Racism is a fundamental cause of health inequities and disease, and cultural systems historically have shaped racial inequities. In “Culture, Race, and Health: Implications for Racial Inequities and Population Health,” Courtney Cogburn examines the influence of cultural barriers and assets in shaping racial inequities in health. She observes that a lack of shared conceptual grounding and language regarding cultural threats to health has hindered the identification and measurement of cultural processes and that building a culture of health to achieve health equity requires meaningful assessment of cultural racism to obtain insights into how population health may eradicate racial disparities in health.
The current crisis of worldwide antibiotic resistance demands policy reforms both locally and globally. Insight into different regulatory systems can inform decision‐making regarding the market entry of new drugs that promotes access while minimizing the risk of antimicrobial resistance. In “Less is More: Norwegian Drug Regulation, Antibiotic Policy, and the ‘Need Clause,’” Bard Hobæk and Anne Lie employ the Norwegian drug regulatory procedures as an example of how national drug regulators can promote innovation of new drugs that meet public health needs by accepting only drugs that add therapeutic value.
Three separate articles pertain to different aspects of Food and Drug Administration (FDA) policies and decision‐making:
Alan B. Cohen became editor of The Milbank Quarterly in August 2018. He currently is a research professor in the Markets, Public Policy, and Law Department at the Boston University Questrom School of Business, and professor of health law, policy and management at the Boston University School of Public Health. He previously directed the Scholars in Health Policy Research Program and the Investigator Awards in Health Policy Research for the Robert Wood Johnson Foundation. Earlier in his career, he held faculty positions at Johns Hopkins University and Brandeis University, and spent 8 years at the Robert Wood Johnson Foundation. He is a member of the National Academy of Social Insurance. He received his BA in psychology from the University of Rochester, and his MS and ScD in health policy and management from the Harvard School of Public Health.
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The Milbank Quarterly’s multidisciplinary approach and commitment to applying the best empirical research to practical policymaking offers in-depth assessments of the social, economic, political, historical, legal, and ethical dimensions of health and health care policy.