Transforming Neurological Care Delivery: Barbara Vickrey’s SEQUINS Hall of Fame Journey

Barbara Vickrey, MD

The Society for Equity in Neuroscience (SEQUINS) is dedicated to advancing brain health equity by addressing disparities in neurological health outcomes, particularly among underserved and marginalized populations. By fostering a multidisciplinary community, SEQUINS aims to promote scientific exchange and tackle critical questions in the field.

The SEQUINS Hall of Fame, established in 2025, honors individuals who have significantly contributed to advancing equity in neuroscience. Inductees, which will be celebrated at the upcoming SEQUINS Conference on May 15, in Charleston, South Carolina. These individuals are recognized for their leadership, research, and commitment to improving outcomes for underrepresented groups, serving as inspirations within the global neuroscience community.

NeurologyLive connected with the 2025 SEQUINS Hall of Fame inductees to explore the impact of their contributions, their presentations for the upcoming meeting, and their perspectives on advancing brain health equity. Among the honorees is Barbara Vickrey, MD, MPH, professor and chair at the Icahn School of Medicine at Mount Sinai. Vickrey has been a pioneering force in healthcare delivery research, focusing on policy-driven solutions that address disparities in neurological care. Her work on re-engineering care models, particularly for dementia care, has resulted in measurable improvements in care quality and equity, with a recent overhaul of payment models by the Centers for Medicare and Medicaid Services.

NeurologyLive: What does it mean to be named a 2025 SEQUINS Hall of Famer?

Barbara Vickrey, MD, MPH: I am so very deeply honored. This recognition affords the rare opportunity to pause, step back, and reflect on the body of research undertaken over the course of one’s career and understand how others’ view its impact. I find it especially meaningful that this award is also in recognition of mentorship. This is the most joyous part of my academic work - and the most time-consuming!Mentorship of the next generation of researchers in this field ensures that the work will continue until we achieve the ultimate goal of equity in neurological care and health.

What inspired you to pursue a career in neurology, and how has your perspective on the field evolved over the years?

I have a brother with severe developmental delays; entering a field to try to understand the brain, what happens to it in people like my brother, and how to address situations in which it does not work, was my goal since childhood. While initially I planned to study causes of developmental delay, I realize in retrospect that I was also strongly influenced by my parents’ interactions with the healthcare system and the education system, in their efforts to get help for him. Many – most -experiences were very frustrating for them. Undoubtedly motivated by these early experiences, I ended up studying health care delivery and how to improve it, with the ultimate goal of improving the experiences and outcomes for patients and families with neurological disorders.

What went into the topic you choose to present? Give some background on what you plan to present.

Early in my research career, it became evident that the most powerful drivers of change to improve access, quality, and equity in healthcare were policy levers. Subsequently, my research became much more intensively focused on policy-relevant evidence in support of re-engineered models for delivering care for chronic neurological conditions. These models are substantially different than those of ‘usual care’ which is typically fragmented, poorly coordinated with community resources, and challenging to navigate, particularly for those with economic and social disadvantage. How healthcare services are financed drives the way healthcare is delivered. Thus, my research encompasses building and testing new care delivery models via randomized trials, making sure to collect information important to all stakeholders including policy-makers.Our team’s work in re-engineering dementia care delivery produced evidence of substantial and clinically meaningful improvements in care quality and outcomes compared to usual care through care that included social workers as care managers, and that coordinated care delivery across the healthcare system and community agencies. We also found that this coordinated care model achieved equity in dementia care quality, across levels of educational attainment of the caregiver in the patient-caregiver dyad. In concert with persistent advocacy organizations and additional research important to policy-makers (cost offsets, identification of key ingredients, implementation protocols), this research eventually led to a recently rolled out, markedly revised payment model for dementia care by the Centers for Medicare and Medicaid Services. The timeframe was several decades from the trial evidence to policy change, but it happened. This was a huge step in the ultimate goal of research translating to widespread beneficial impact on patient and family outcomes for this devastating disease.

Who have been your most significant mentors or influences in your career, and how did they shape your path in neurology?

The Robert Wood Johnson Clinical Scholars Program at UCLA, a two-year post-residency research fellowship, was foundational for my academic career. During neurology residency, I was fascinated by variations in care I observed in the different care settings in which I trained, but I did not know that care delivery and quality of care were topics that could be studied. I essentially stumbled across the RWJ program through one of the faculty in my residency program, and after a full day of interviews at the UCLA Program, I was amazed and excited to discover that there was an entire field of quality of care research and what eventually became known as implementation science.I was fortunate to match into the UCLA program, where cutting-edge research was being done in primary care by faculty who had appointments at UCLA and affiliations at RAND Corporation. Robert Brook, MD, ScD, directed the RAND Health Program and the UCLA Clinical Scholars Program at that time, and was my primary research mentor. Bob’s mentorship, and the foundational skills and the milieu of a cadre of physician-investigators and social scientists in the UCLA RWJ program was instrumental in acquiring the skills and expertise to conduct highly rigorous work in this field and to apply them to the study of neurological care. A few years later, UCLA was at the forefront of community-partnered research, and I was fortunate to work with and learn from Ms. Loretta Jones, who passed away in 2018.She was an enormously powerful and impactful force and champion for improving health care in underserved communities, through persevering in building genuine partnerships of academics and community.

How have you seen brain health equity neuroscience change during your career, and what work remains to be done?

When I began my career there had been little research on health care delivery, quality of care, access, and disparities for neurological conditions. That has changed exponentially in the past decades. There is now incontrovertible evidence as to the gaps in care and outcomes for most conditions and for the factors driving those gaps. We even have evidence for several chronic neurological conditions as to what models of care delivery are effective in achieving equitable neurological care and brain health. Research on the granular aspects of implementation, adaptation, and broad uptake while maintaining effectiveness, remains a gap in knowledge for many conditions. The translation of that research into changes in health policy is what will accelerate broad change, and we in the research community must be attuned to measuring end points useful to advocacy folks and other decision-makers in order to re-align healthcare financing in ways that improve chronic neurological care.