Real-world use of a medication out-of-pocket cost estimator in primary care one year after Medicare regulation.







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Publication Info

Sloan, Caroline E, Sarah Morton-Oswald, Valerie A Smith, Anna D Sinaiko, C Barrett Bowling, Jaejin An and Matthew L Maciejewski (2024). Real-world use of a medication out-of-pocket cost estimator in primary care one year after Medicare regulation. Journal of the American Geriatrics Society. 10.1111/jgs.18774 Retrieved from

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Caroline Sloan

Assistant Professor of Medicine

Caroline is a General Internist. Her clinical interests are in primary care for vulnerable populations and patients with multiple chronic conditions. Her research interests focus on the role that money plays in medical decision-making. She currently studies financial barriers to care for patients with multiple chronic conditions, the impact of recent price transparency regulations, and the ways that doctors and patients communicate about and make decisions based on out-of-pocket costs.


Valerie A. Smith

Associate Professor in Population Health Sciences

Valerie A. Smith, DrPH, is an Associate Professor in the Duke University Department of Population Health Sciences and Senior Research Director of the Biostatistics Core at the Durham Veterans Affairs Medical Center's Center of Innovation. Her methodological research interests include: methods for semicontinuous and zero-inflated data, economic modeling methods, causal inference methods, observational study design, and longitudinal data analysis. Her current methodological research has focused on the development of marginalized models for semicontinuous data.

Dr. Smith works largely in collaboration with a multidisciplinary team of researchers, with a focus on health policy interventions, health care utilization and expenditure patterns, program and policy evaluation, obesity and weight loss, bariatric surgery evaluation, and family caregiver supportive services.

Areas of expertise: Biostatistics, Health Services Research, Health Economics, and Health Policy


Christopher Barrett Bowling

Associate Professor of Medicine

I am a geriatrician with research training in population health and chronic disease epidemiology. Through my work, I aim to inform patient-centered care that focuses on optimizing function and quality of life over traditional disease-based approaches. Much of my work has focused on chronic kidney disease, however I have recently broadened the scope of investigation to include other chronic conditions including hypertension and systemic lupus erythematosus. The unifying theme of this work has been applying a geriatric research approach to large studies of chronic disease. As Associate Director of Clinical Programs at the Durham VA Geriatric Research Education and Clinical Center, I have also had the opportunity to partner with nephrologists to develop clinical programs in the VA designed to provide patient-centered, geriatric care for older adults with kidney disease.


Matthew Leonard Maciejewski

Professor in Population Health Sciences

Matt Maciejewski, PhD is a Professor in the Department of Population Health Sciences. He is also a Senior Research Career Scientist and Director of the Non-randomized Design Lab in the Center of Innovation to Accelerate Discovery and Practice Transformation at the Durham VA Medical Center. Matt also holds Adjunct Professor appointments in the Schools of Public Health and Pharmacy at the University of North Carolina at Chapel Hill.

He has received funding from NIDDK, NIDA, CMS, AHRQ, VA HSR&D, and the RWJ Foundation to conduct evaluation of long-term clinical and economic outcomes of surgical interventions, behavioral interventions and Medicare program/policy changes on patients with obesity or cardiometabolic conditions.  He is also interested in methods for addressing unobserved confounding in observational studies.  Matt evaluated the first-ever population-based implementation of value-based insurance design and led the first-ever linkage of lab results and Medicare FFS claims.  He has published over 250 papers in peer-reviewed journals such as JAMA, JAMA Internal Medicine, JAMA Surgery, Annals of Internal Medicine, Health Economics, Medical Care, Health Services Research, Journal of Clinical Epidemiology and Diabetes Care.

Areas of expertise: Health Services Research, Health Economics, Health Policy, Multimorbidity

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