Improving the Quality of Clinical and Health Policy Research

For over two decades, DPRG faculty have been at the forefront of efforts to upgrade the quality of research methods (especially research designs) to improve the validity of non-randomized evaluations of large-scale natural experiments that cannot be randomized (e.g., Medicare Part D and nationwide cost-containment policies of national and state health reform). Unfortunately, we know little about the risks and benefits of such interventions, particularly for the poor and the sick.

Mental Health Treatment

DPRG has focused much of its research on patients with psychiatric illnesses and their care, due to these patients’ special vulnerability to disruptions caused by administrative or financial changes, and the substantial heterogeneity in responses of patients to specific psychotropic treatments.

Interventions in Clinical Care

As evidenced in the references below, DPRG has several decades of experience in the conduct of experimental and quasi-experimental studies of interventions to improve clinical care among physicians and large delivery systems in numerous states. Below we highlight a recent example related to the goals of the Affordable Care Act.


Patient Navigator intervention to reduce hospital readmissions among high-risk safety-net patients

Affordability and Burden of Medical and Pharmaceutical Costs

The burden of medical and drug expenditures, especially for the elderly and disabled, is a major theme in DPRG’s policy research.  An example is our unique collaboration with the Center for Medicaid and Medicare Services to create and implement routine measures of cost-related medication nonadherence (CRN) among Medicare beneficiaries.  With NIA funding, DPRG investigators developed and validated measures of CRN and integrated the measures into the annual Medicare Current Beneficiary Survey starting in 2004.  Other investigators have since used similar or identical measures of CRN in numero

Effects of Pharmacy Benefit Limits and Expansions

DPRG faculty have placed major emphasis on investigating the impacts of changes in drug coverage on use of medicines, affordability, and clinical outcomes.  For example, we conducted the first well-controlled studies of the effect of state Medicaid caps on the number of monthly prescriptions, which demonstrated reductions in use of both nonessential and essential medications, as well as increased need for institutional and acute services to treat exacerbations of somatic and mental illnesses.  In addition, DPRG investigators recently showed that a Medicaid policy of requiring drug prior aut

Domestic Health Insurance and Pharmaceutical Policy

New legislative and regulatory initiatives continually shape the US health policy environment.  Policy changes, such as, new health insurance benefit limits or expansions, are intended to guard against overuse of health services control costs, or improve access and quality of healthcare. However, many new policies are not based on convincing evidence of their efficacy in achieving these objectives.

Toni Peters

Corresponding Member of the Faculty

Until her retirement (December 31, 2013), Dr. Peters was an Associate Professor in the Department of Population Medicine (DPM), and the Associate Director of the Academy Center for Teaching and Learning at Harvard Medical School (HMS).  Presently, she is a Lecturer in DPM and a consultant to the HMS Center for Primary Care. She received a BA in Psychology from Pennsylvania State University and a PhD in Educational Psychology from SUNY at Buffalo. From 1986-1991, she was the Associate Director for Educational Research and Evaluation at SUNY/Buffalo. She joined DPM in 1992.

Jeanne Madden


Dr. Madden is a Lecturer in the Department of Population Medicine, working primarily with the Division of Health Policy and Insurance Research. At present, she is leading a qualitative study on the experiences of individuals with bipolar disorder as they navigate complex insurance benefits, within a larger PCORI investigation of the impact of high deductible health plans on individuals with bipolar disorder.  Dr.