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Medicare's Quality Improvement Organization Program: Maximizing Potential (2006)

Chapter: Appendix E Committee Biographies

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E Committee Biographies Steven A. Schroeder, M.D., Chair, Main Committee,* is distinguished pro- fessor of health and health care, Division of General Internal Medicine, Department of Medicine, University of California, San Francisco (UCSF), where he also heads the Smoking Cessation Leadership Center. The Center, funded by The Robert Wood Johnson Foundation, works with leaders of American health professional organizations and health care institutions to increase the rate at which patients who smoke are offered help to quit. Between 1990 and 2002 he was president and chief executive officer (CEO) of The Robert Wood Johnson Foundation. During his term of office the foundation made grant expenditures of almost $4 billion in pursuit of its mission of improving the health and health care of the American people. During those 121/2 years the foundation developed new programs in sub- stance abuse prevention and treatment, care at the end of life, and health insurance expansion for children, among others. In 1999, it reorganized into health and health care groups, reflecting the twin components of its mission. Dr. Schroeder graduated from Stanford University and Harvard Medical School, and trained in internal medicine at the Harvard Medical Service of Boston City Hospital and in epidemiology as an Epidemic Intelli- gence Service Officer of the Centers for Disease Control and Prevention (CDC). He held faculty appointments at Harvard, George Washington, and UCSF. At both George Washington and UCSF he was founding medical *Member of the Main Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs. 481

482 APPENDIX E director of a university-sponsored health maintenance organization (HMO), and at UCSF he founded the company's division of general internal medi- cine. Dr. Schroeder has produced more than 260 publications in the fields of clinical medicine, health care financing and organization, prevention, public health, and the workforce. He recently completed his term as chair- man of the American Legacy Foundation and chair of the International Review Committee of the Ben Gurion School of Medicine. He is a member of the editorial board of the New England Journal of Medicine and the Harvard Overseers, and a director of the James Irvine Foundation, the Save Ellis Island Foundation, and the Charles R. Drew University of Medicine and Science. He holds six honorary doctoral degrees and has received nu- merous awards. Stephen M. Shortell, Ph.D., M.P.H., Chair, QIO Subcommittee,* is a prominent researcher in health policy and organization behavior at the Uni- versity of California (UC), Berkeley and is dean of the School of Public Health. Dr. Shortell is known as a leading academic voice advocating re- form of the nation's health system. His research has helped establish deter- minants of health outcomes and quality of care for health care organiza- tions. As Blue Cross of California distinguished professor of health policy and management, Dr. Shortell holds a joint appointment at UC Berkeley's School of Public Health and the Haas School of Business. He also is affili- ated with UC Berkeley's Department of Sociology and UC San Francisco's Institute for Health Policy Studies. Dr. Shortell is an elected member of the Institute of Medicine (IOM) of the National Academies. He has received the Baxter-Allegiance Prize, considered the highest honor worldwide in the field of health services research. He also has received the Distinguished In- vestigator Award from the Association for Health Services Research and the Gold Medal award from the American College of Healthcare Execu- tives for his contributions to the field. He serves on the boards of the Health Research and Educational Trust and the National Center for Healthcare Leadership. Dr. Shortell received his bachelor's degree from the University of Notre Dame; his master's degree in public health from the University of California, Los Angeles; and his Ph.D. in behavioral science from the Uni- versity of Chicago. Before coming to UC Berkeley in 1998, he held teaching and research positions at Northwestern University, the University of Wash- ington, and the University of Chicago. *Member of the Main Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs. Member of the Quality Improvement Organization Subcommittee.

APPENDIX E 483 Anne-Marie J. Audet, M.D., is vice president at The Commonwealth Fund, where she directs the Quality Improvement and Efficiency Program. She joined the Fund in November 2000 to launch this new program. Dr. Audet has worked in the field of quality improvement for more than 15 years and brings a deep understanding of its science, as well as an appreciation of the barriers and enablers that come into play when knowledge must be trans- lated into real-world situations. At the national level, Dr. Audet previously worked in the development of evidenced-based clinical guidelines and policy analysis at the American College of Physicians. At the state level, in 1994 she joined the Massachusetts Peer Review Organization and helped lead the implementation of the state's new Medicare Health Care Quality Improve- ment Program contract. Before joining the Fund, Dr. Audet served as direc- tor of the Office for Clinical Effectiveness/Process Improvement at Beth Israel Deaconess Medical Center in Boston, where she was responsible for the development of quality measurement systems, physician profiles of qual- ity and efficiency, educational programs, and institutionwide medication safety initiatives. She also participated in a number of quality improvement programs within Caregroup, an integrated network of care. While at the Beth Israel Medical Center, she was coeditor of "Clinical Crossroads," a series published monthly in the Journal of the American Medical Associa- tion. She has published on such topics as quality improvement, practice guidelines, physicians and quality of care, use of information technologies, and public health. She sits on the Board of the Massachusetts Medical Soci- ety and Alliance Charitable Foundation. In addition to her M.D., Dr. Audet holds a bachelor of science degree in cell and molecular biology, a master of science in epidemiology and statistics from McGill University, and a mas- ters of science in health policy and management from Harvard University. Bobbie Berkowitz, Ph.D., R.N., F.A.A.N.,* is alumni endowed professor of nursing at the University of Washington (UW) School of Nursing and ad- junct professor in the School of Public Health and Community Medicine. She directs the Turning Point initiative funded by The Robert Wood Johnson Foundation and the Center for the Advancement of Health Disparities Re- search funded by the National Institute of Nursing Research. She serves on the board of directors as vice-chair of Qualis Health, the Quality Improve- ment Organization (QIO) of Washington State. Before joining UW, Dr. Berkowitz was deputy secretary of health for the Washington State Depart- ment of Health. She is a member of the board of trustees for Group Health *Member of the Main Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs. Member of the Quality Improvement Organization Subcommittee.

484 APPENDIX E Cooperative, a fellow in the American Academy of Nursing, and a member of the Institute of Medicine (IOM). She served as cochair of the IOM Com- mittee on Using Performance Monitoring to Improve Community Health and as vice-chair of the IOM/Transportation Research Board Committee on Physical Activity, Health, Transportation, and Land Use. She holds a Ph.D. in nursing science from Case Western Reserve University. Donald M. Berwick, M.D., M.P.P.,* is president and CEO of the Institute for Healthcare Improvement (IHI), a not-for-profit organization helping to accelerate the improvement of health care throughout the world. He is clini- cal professor of pediatrics and health care policy at the Harvard Medical School and professor of health policy and management at the Harvard School of Public Health. He is also a pediatrician, an associate in pediatrics at Boston's Children's Hospital, and a consultant in pediatrics at Massa- chusetts General Hospital. Dr. Berwick has published over 110 scientific articles in numerous professional journals on subjects relating to health care policy, decision analysis, technology assessment, and health care qual- ity management. He serves on the IOM's Governing Council, and the IOM's Board on Global Health. He is also a member of several editorial boards, including that of the Journal of the American Medical Association. A summa cum laude graduate of Harvard College, Dr. Berwick holds a master of public policy degree from the John F. Kennedy School of Government and an M.D. cum laude from the Harvard Medical School. Bruce E. Bradley, M.B.A.,* is Director of Health Care Strategy and Public Policy, Health Care Initiatives, for General Motors Corporation in Pontiac, Michigan. He is responsible for health care­related strategy and public policy with a focus on quality measurement and improvement, consumer engagement, and cost-effectiveness. General Motors provides health care coverage for over 1.1 million employees, retirees, and their dependents, with an annual expenditure of $5.2 billion. Mr. Bradley joined General Motors in June 1996 after 5 years as corporate manager of Managed Care for GTE Corporation. In addition to his health care management experi- ence at GTE, he spent nearly 20 years in health plan and HMO manage- ment. From 1972 to 1980 he was executive director of the Matthew Thornton Health Plan, Nashua, New Hampshire. From 1980 to 1990 he was president and CEO of the Rhode Island Group Health Association in Providence, Rhode Island, a staff model HMO. He was cofounder of the HMO Group (now the Alliance of Community Health Plans), a national *Member of the Main Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs.

APPENDIX E 485 corporation of 15 nonprofit, independent group practice HMOs, and the HMO Group Insurance Co., Ltd. Mr. Bradley has gained recognition for his work in achieving health plan quality improvement and for his efforts in developing the Health Plan Employer Data and Information Set (HEDIS) measures and processes. He is a board member of the National Quality Forum, past member of the board of the Foundation for Accountability, board member of the American Board of Internal Medicine Foundation, past board member of the Academy for Health Services Research and Policy, and founding member and past chair of the Leapfrog Group board. A na- tive of Pelham, New York, Mr. Bradley holds a bachelor's degree in psy- chology from Yale University (1967) and a master's degree in business and health care administration from the Wharton School at the University of Pennsylvania (1972). Janet M. Corrigan, Ph.D.,* is president and CEO of the National Commit- tee for Quality Health Care (NCQHC), a nonprofit, nonpartisan education and research institute. Prior to joining NCQHC in June 2005, she was se- nior board director at the IOM, where she was responsible for the Board on Health Care Services' portfolio of initiatives on quality and safety, health services organization and financing, and health insurance issues. She pro- vided leadership for the IOM's Quality Chasm series, which includes 10 reports produced during her tenure, among them To Err Is Human: Build- ing a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century. Prior to joining the IOM in 1998, Dr. Corrigan was executive director of the President's Advisory Commission on Con- sumer Protection and Quality in the Health Care Industry. She serves on the boards of the Baldrige Board of Overseers and the National Center for Healthcare Leadership. She received her doctorate in health services research and a master of industrial engineering degree from the University of Michi- gan, and master's degrees in business administration and community health from the University of Rochester. Jack L. Cox, M.D., M.M.M., is a physician executive consultant in health care quality improvement. Former group vice president, Product Planning, and chief medical officer for Premier, Inc., a national health care alliance of over 1,500 not-for-profit hospitals, Dr. Cox led the clinical product and technology evaluation team for Group Purchasing Services. He was respon- sible for providing clinical support/leadership to Group Purchasing Services, *Member of the Main Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs. Member of the Quality Improvement Organization Subcommittee.

486 APPENDIX E Supply Chain Consulting, Informatics/Performance Services, and the Safety Institute. Dr. Cox's broad background includes over 20 years of clinical experience, 13 years in teaching and research with faculty appointments to five medical schools, and over 18 years as a health care executive. He is a board-certified family physician, a fellow of the American Board of Family Practice, and a fellow of the American College of Physician Executives, and holds a master's degree in medical management from Tulane University. Prior to joining Premier, Dr. Cox was regional medical director for Inter- mountain Healthcare in Utah and served on its corporate board of trustees. He has published and spoken nationally and internationally on various as- pects of health care, including preventive care, quality improvement, health care management, and safety. Karen Davis, Ph.D.,* is president of The Commonwealth Fund, a national philanthropy engaged in independent research on health and social issues. A nationally recognized economist, she has had a distinguished career in public policy and research. She served as deputy assistant secretary for health policy in the U.S. Department of Health and Human Services from 1977 to 1980 and holds the distinction of being the first woman to head a U.S. Public Health Service agency. Prior to her government career, Dr. Davis was a senior fellow at the Brookings Institution in Washington, D.C., a visiting scholar at Harvard University, and an assistant professor of eco- nomics at Rice University. She was chair of health policy and management at the Johns Hopkins Bloomberg School of Public Health from 1981 to 1992. She also serves on the board of Geisinger Health System. She is the recipient of the 2000 Baxter-Allegiance Foundation Prize for Health Ser- vices Research, and the 2006 Academy Health Distinguished Investigator Award. She is a former president of Academy Health. Dr. Davis received her doctorate in economics from Rice University and was awarded an hon- orary doctorate in humane letters from The Johns Hopkins University in 2001. Nancy-Ann Min DeParle, J.D.,* is a senior advisor to JPMorgan Partners, LLC, and adjunct professor of health care systems at the Wharton School of the University of Pennsylvania. From 1997 to 2000, she served as adminis- trator of the Health Care Financing Administration (HCFA), now the Cen- ters for Medicare and Medicaid Services (CMS). Before joining HCFA, Ms. DeParle was associate director for health and personnel at the White House Office of Management and Budget. From 1987 to 1989 she served as the *Member of the Main Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs.

APPENDIX E 487 Tennessee commissioner of human services. She has also worked as a law- yer in private practice in Nashville, Tennessee, and Washington, D.C. She is a member of the Medicare Payment Advisory Committee; a trustee of The Robert Wood Johnson Foundation; and a board member of Cerner Corpo- ration, DaVita Guidant Corporation, Triad Hospitals, and the National Quality Forum. Ms. DeParle received a bachelor's degree from the Univer- sity of Tennessee; bachelor's and master's degrees from Oxford University, where she was a Rhodes Scholar; and a J.D. degree from Harvard Law School. Elliott S. Fisher, M.D., M.P.H.,* is Professor of Medicine and Community and Family Medicine, where he is director of the Institute for the Evalua- tion of Medical Practice at the Center for the Evaluative Clinical Sciences, Dartmouth Medical School, Hanover, New Hampshire, and senior associ- ate of the VA Outcomes Group, Veterans Administration Medical Center, White River Junction, Vermont. He is a general internist and former Robert Wood Johnson clinical scholar with broad expertise in the use of adminis- trative databases and survey research methods in health systems evaluation. His research has focused on exploring the causes and consequences of varia- tions in clinical practice and health care spending across U.S. regions and among health care providers. Richard G. Frank, Ph.D.,* is Margaret T. Morris professor of health eco- nomics in the Department of Health Care Policy at Harvard Medical School. He is also a research associate with the National Bureau of Economic Re- search. Dr. Frank is a member of the IOM. He advises several state mental health and substance abuse agencies on issues related to managed care and financing of care. He also serves as coeditor for the Journal of Health Eco- nomics. Dr. Frank was awarded the Georgescu-Roegen prize from the Southern Economic Association for his collaborative work on drug pricing, the Carl A. Taube Award from the American Public Health Association for outstanding contributions to mental health services and economics research, and the Emily Mumford Medal from Columbia University's Department of Psychiatry. In 2002 Dr. Frank received the John Eisenberg Mentorship Award from National Research Service Awards. Robert S. Galvin, M.D.,* is director of global health care for General Elec- tric (GE). He is in charge of the design and performance of GE's health programs, totaling over $3 billion annually, and oversees the 1 million pa- *Member of the Main Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs.

488 APPENDIX E tient encounters that take place in GE's 220 medical clinics in more than 20 countries. Drawing on his clinical expertise and training in Six Sigma, Dr. Galvin has been an advocate and leader in extending the benefits of this methodology to health care. He has focused on issues of market-based health policy and financing, with a special interest in promoting transpar- ency and reforming the payment system. He is a past member of the Strate- gic Framework Board of the National Quality Forum and is currently on the board of the National Committee for Quality Assurance. He is a co- founder of the Leapfrog Group, the founder of Bridges to Excellence, and a member of the Advisory Group of the Council on Health Care Economics and Policy. Dr. Galvin is widely published on issues affecting the purchaser side of health care. He is professor adjunct of medicine at Yale, where he directs the seminar series on the private sector for the Robert Wood Johnson Clinical Scholars fellowship. He is a fellow of the American College of Physicians. David H. Gustafson, Ph.D.,* is a research professor at the University of Wisconsin, Madison, where he directs the Center of Excellence in Cancer Communications (designated by the National Cancer Institute) and the Network for the Improvement of Addiction Treatment (supported by The Robert Wood Johnson Foundation and the federal government's Center for Substance Abuse Treatment). His research focuses on the use of systems engineering methods and models in individual and organizational change. Much of his research centers on the development and evaluation of health systems to support people facing serious health problems such as cancer. His randomized controlled trials and field tests have helped in understand- ing the acceptance, use, and impact of e-health on quality of life, behavior change, and health service utilization. His research has also contributed to organizational improvement, with particular attention to models that pre- dict and explain organizational change. Dr. Gustafson is a fellow of the Association for Health Services Research and of the American Medical Informatics Association and a fellow and past vice-chair of the board of IHI. He also chaired the recent Federal Science Panel on Interactive Com- munications in Health and is chair of the eHealth Institute. He is a member of the University of Wisconsin Athletic Board. *Member of the Main Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs. Member of the Quality Improvement Organization Subcommittee.

APPENDIX E 489 Jeff Kang, M.D., M.P.H., is chief medical officer for CIGNA HealthCare and is responsible for the company's medical strategy and policy. This in- cludes evidence-based coverage decisions, benefit design, consumer deci- sion support, disease management, case management, utilization manage- ment, quality measurement and improvement, and pharmacy. Before joining CIGNA HealthCare, Dr. Kang was chief clinical officer for CMS and direc- tor of its Office of Clinical Standards and Quality. There he was responsible for Medicare technology assessment and coverage policy. His responsibili- ties also encompassed setting quality standards for Medicare participating hospitals and facilities; leading CMS's quality measurement, improvement, and patient safety activities; managing Medicare's Peer Review Program; and leading CMS's overall clinical direction and purchasing initiatives. His experience in Washington, D.C., began in 1994, when he joined the na- tional health care reform debate as a White House fellow. Currently, Dr. Kang is cochair of the National Quality Forum's Steering Committee for Standardizing Ambulatory Care (physician) Performance Measurement and a member of the eHealth Initiative Leadership Council. He is board certi- fied in internal medicine and geriatrics and was on the Clinical Faculty at Harvard Medical School. He received an M.D. degree from the University of California, San Francisco, and an M.P.H from the University iof Califor- nia, Berkeley. Mary Anne Koda-Kimble, Pharm.D.,* is dean of the School of Pharmacy at the University of California, San Francisco (UCSF), where she teaches and has cared for patients at the UCSF Diabetes Center. She holds the Thomas J. Long Endowed Professorship and previously served as chair of the De- partment of Clinical Pharmacy. Dr. Koda-Kimble received her Pharm.D. from UCSF and joined its faculty in 1970, where she was involved in devel- oping an innovative clinical pharmacy curriculum. She is a member of the United States Pharmacopoeia board of trustees and was vice-chair of the Accreditation Council of Pharmaceutical Education Board of Directors. She is past president of the American Association of Colleges of Pharmacy and has served on the California State Board of Pharmacy, the Food and Drug Administration's (FDA) Nonprescription Drugs Advisory Committee, and many other boards and task forces of national professional associations. Dr. Koda-Kimble is frequently invited to address national and international groups and has produced many publications, the best known of which is Applied Therapeutics, a text widely used by health professional students and practitioners throughout the world. *Member of the Main Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs. Member of the Quality Improvement Organization Subcommittee.

490 APPENDIX E Alan R. Nelson, M.D.,* is an internist­endocrinologist who was in private practice in Salt Lake City, Utah, until becoming CEO of the American Soci- ety of Internal Medicine (ASIM) in 1992. Following the merger of ASIM with the American College of Physicians (ACP) in 1998, Dr. Nelson headed the Washington Office of ACP­ASIM until his semiretirement in January 2000; he currently serves as special advisor to the executive vice president/ CEO of the College. He was president of the American Medical Association and currently serves as a member of the Medicare Payment Advisory Com- mission, which advises Congress on Medicare issues. A member of the IOM, he was chair of the IOM Committee on Ethnic and Racial Disparities in Health Care and is a coeditor of the study report, Unequal Treatment: Con- fronting Racial and Ethnic Disparities in Health Care. Dr. Nelson attended Utah State University and received his M.D. from Northwestern University in 1958. Gregg Pane, M.D., M.P.A., was recently appointed by Mayor Anthony Williams as the District of Columbia Acting Director of Health. In this role, he will direct a $1.5 billion, 1,400-employee agency responsible for Medic- aid, health safety net issues, public health, and hospital bioterrorism pre- paredness. He previously served as vice president for clinical quality and medical director of the Office of Public Policy Initiatives of the Henry Ford Health System, serving as the System's chief quality officer and leading ini- tiatives in the quality and public financing of health care. He has also been chief policy and planning officer for the Veterans Health Administration in Washington, D.C. He was among the key senior executives who reengi- neered the Veterans Administration's infrastructure and helped set the stan- dard for national quality initiatives in health care. Barbara R. Paul, M.D., is senior vice president and chief medical officer of BEI, a leading provider of elder care headquartered in Fort Smith, Arkan- sas. She was previously director of CMS's Quality Measurement and Health Assessment Group. While at CMS, she led the launch of U.S. Department of Health and Human Services Secretary Tommy G. Thompson's Nursing Home Quality Initiative and Home Health Quality Initiative and played a key role in the agency's overall quality measurement and public reporting work. She represented the agency on the boards of the National Quality Forum and the Leapfrog Group. Dr. Paul is an internist who was in full- time practice in Napa, California, from 1987 to 1999 in a small group *Member of the Main Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs. Member of the Quality Improvement Organization Subcommittee.

APPENDIX E 491 practice affiliated with Queen of the Valley Hospital and with Kaiser Permanente. She served as director of women's health services and chair of the Department of Medicine at Queen of the Valley Hospital and was active with the California Medical Association, where she chaired its Council on Ethical Affairs and served on its board of trustees. Dr. Paul earned a bach- elor of science degree in biochemistry from the University of Wisconsin, Madison, and an M.D. from the Stanford University School of Medicine. Norman C. Payson, M.D.,* having completed his turnaround assignment, retired as chairman and CEO of Oxford Health Plans, Inc. in November 2002. Oxford Health Plans is a prominent greater New York health plan with 1.5 million members. Dr. Payson was recruited to the CEO position in 1998 after Oxford experienced severe operational and financial challenges and then led its successful turnaround. Prior to joining Oxford, he was cofounder and CEO of Healthsource, Inc., from its inception in 1985 until its sale to CIGNA Corporation in 1997. During his tenure, Healthsource grew to 3 million members in 15 states. Dr. Payson is a graduate of the Massachusetts Institute of Technology and received his M.D. at Dartmouth Medical School. William A. Peck, M.D.,* became Alan A. and Edith L. Wolf distinguished professor of medicine and director of the Washington University Center for Health Policy in 2003. From 1989 to 2003 he served as dean of Washing- ton University School of Medicine and vice chancellor for medical affairs (executive vice chancellor from 1993 to 2003), and president of the Wash- ington University Medical Center. Dr. Peck was awarded an honorary doc- tor of science degree from the University of Rochester in 2000. His academic activities include original investigations in bone and mineral metabolism and extensive clinical teaching, as well as patient care experience. His major scientific contributions include the first method for studying directly the structure, function, and growth of bone cells; demonstration of mechanisms whereby hormones regulate bone cell function; and examination of the causes of osteoporosis. Dr. Peck was founding president of the National Osteoporosis Foundation. He serves on the boards of Allied Health Care Products, Angelica Corporation, TIAA-CREF Trust Company, and Re- search!America (vice-chair), and is a trustee of the University of Rochester. Dr. Peck is past chairman of the American Association of Medical Colleges. *Member of the Main Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs. Member of the Quality Improvement Organization Subcommittee.

492 APPENDIX E He has served on many editorial boards and was a consultant for major pharmaceutical companies. Eric D. Peterson, M.D., M.P.H., is an associate professor of medicine and associate vice-chair for quality at Duke University Medical Center. He is also codirector of Cardiovascular Research, as well as the director of CV Outcomes Research and Quality at the Duke Clinical Research Institute. His formal research training includes an M.P.H. from Harvard University, with special emphasis in biostatistics. Dr. Peterson received a Paul Beeson Faculty Scholar Research Award in geriatric cardiology. He has a strong record of funding from the National Institutes of Health (NIH) and cur- rently oversees two active NIH R01 awards. He has authored more than 150 peer-reviewed publications, multiple book chapters, and invited edito- rials. He is principal investigator for the Data Coordinating Centers for the Society of Thoracic Surgeons' National Cardiac Surgery Database, the American College of Cardiology's National Cardiac Database, the American Heart Association's Get with the Guidelines Database, and the CRUSADE National Quality Improvement Initiative. He sits on multiple national committees for the American Heart Association, the American Col- lege of Cardiology, and the Veterans Health Administration and cochaired the Working Group on Outcomes Research of the National Heart, Lung, and Blood Institute. Neil R. Powe, M.D., M.P.H., M.B.A.,* is professor of medicine, professor of health policy and management, and professor of epidemiology at the Johns Hopkins University School of Medicine and the Johns Hopkins Bloomberg School of Public Health. He also is director of the Welch Center for Prevention, Epidemiology and Clinical Research, an interdisciplinary research and training center at the Johns Hopkins Medical Institutions fo- cused on population-based and health services research. Dr. Powe's research has involved clinical epidemiology, technology assessment, patient outcomes research, and health services research in many areas of medicine. He has also studied physician decision making and other determinants of the use of medical practices, including payers' decisions about insurance coverage for new medical technologies; the effect of financial incentives on the use of technology; efficiency and outcomes in for-profit versus nonprofit health care institutions; and the relationships among hospital volume, technology, and outcomes. He has extensive experience in developing and measuring *Member of the Main Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs. Member of the Quality Improvement Organization Subcommittee.

APPENDIX E 493 outcomes and quality of care for chronic kidney disease and is author of more than 250 articles. Dr. Powe received his M.D. from Harvard Medical School, M.P.H. from Harvard School of Public Health, and M.B.A. from the University of Pennsylvania. He completed his residency at the Hospital of the University of Pennsylvania, where he was also a Robert Wood Johnson Clinical Scholar and fellow in the Division of General Internal Medicine. Dr. Powe is a member of the American Society of Clinical Inves- tigation, the Association of American Physicians, and the American Society of Epidemiology. Christopher Queram, M.A.,* has been president/CEO of the Wisconsin Collaborative for Healthcare Quality (WCHQ) since November 2005. The Collaborative is a nonprofit, 501c3, voluntary consortium of organiza- tions learning and working together to improve the quality and cost- effectiveness of health care for the people of Wisconsin. The Collaborative develops and reports comparative measures of healthcare performance; de- signs and promotes quality improvement initiatives; and advocates for en- lightened policy to support its work. Prior to joining WCHQ, Mr. Queram served as CEO of the Employer Health Care Alliance Cooperative (the Alli- ance) of Madison, Wisconsin, a health care purchasing cooperative owned by more than 160 member companies in south central Wisconsin. In addi- tion to his responsibilities at WCHQ, Mr. Queram is a board member of the Joint Commission on Accreditation of Healthcare Organizations and Delta Dental of Wisconsin, a member of the "Principals" for the Hospital Quality Alliance (HQA), and a member of the steering committee for the Wisconsin Hospital Association's CheckPoint quality reporting initiative. Previously, he served as board member of the Leapfrog Group and the Na- tional Quality Forum, as well as a member of the IOM's Committee on the Consequences of Uninsurance and President Clinton's Advisory Commis- sion on Consumer Protection and Quality in the Health Care Industry. Mr. Queram holds a master of arts degree in health services administration from the University of Wisconsin, Madison, and is a fellow in the American Col- lege of Healthcare Executives. Robert D. Reischauer, Ph.D.,* is president of the Urban Institute, a non- profit, nonpartisan policy research and education organization that exam- ines the social, economic, and governance problems facing the nation. He served as director of the Congressional Budget Office (CBO) between 1989 and 1995 and was CBO's assistant director for human resources and deputy *Member of the Main Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs.

494 APPENDIX E director during 1977 to 1981. Dr. Reischauer has been a senior fellow in the Economic Studies Program of the Brookings Institution (1986­1989 and 1995­2000) and senior vice president of the Urban Institute (1981­ 1986). He is an economist with an undergraduate degree from Harvard and a Ph.D. in economics and a master's in international affairs from Columbia University. Dr. Reischauer is a member of the Harvard Corporation and serves on the boards of several educational and nonprofit organizations. He is vice-chair of the Medicare Payment Advisory Commission and served as chair of the National Academy of Social Insurance's project "Restructuring Medicare for the Long Term" from 1995 through 2004. William C. Richardson, Ph.D.,* is president and CEO emeritus of the W. K. Kellogg Foundation of Battle Creek, Michigan. Before joining the founda- tion in August 1995, Dr. Richardson was president of The Johns Hopkins University, a position he had held since 1990. He was also professor of health policy and management at the university. Dr. Richardson is a mem- ber of the IOM, a fellow of the American Academy of Arts and Sciences, and a member of the American Public Health Association. He has served on the boards of the Council of Michigan Foundations and the Council on Foundations (trustee and chair). He also serves on the board of directors of the Kellogg Company, CSX Corporation, the Bank of New York, and Exelon Corporation. Dr. Richardson is a graduate of Trinity College and the University of Chicago. Cheryl M. Scott, M.H.A.,* is currently president emerita for Group Health Cooperative (GHC), one of the the nation's largest consumer-governed, nonprofit health care systems. From 1997 to 2004, she was GHC's presi- dent and CEO. Prior to assuming her position in 1997, she served as GHC's executive vice president/chief operating officer. Ms. Scott is a clinical pro- fessor in the Department of Health Services at the University of Washington. At the national level, she served on the board of the Alliance of Community Plans (trustee and chair) and the board of America's Health Insurance Plans. She currently serves as board chair for the Health Technology Center and is a trustee for the Washington State Life Sciences Discovery Fund. Ms. Scott received a bachelor's degree in communications and a master's degree in health administration from the University of Washington. Shoshanna Sofaer, D.P.H., is Robert P. Luciano professor of health care policy at the School of Public Affairs, Baruch College, New York City. She *Member of the Main Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs. Member of the Quality Improvement Organization Subcommittee.

APPENDIX E 495 received master's and doctoral degrees in public health from the University of California, Berkeley. She has served on the faculties of the University of California, Los Angeles, School of Public Health and the George Washing- ton University Medical Center. Her primary research interests include pro- viding information to consumers and patients on the performance of the health care system; assessing the impact of quality, cost, and other com- parative information on consumers, patients, providers, and systems; devel- oping consumer-relevant performance measures; and assessing the effec- tiveness of multistakeholder efforts such as coalitions, partnerships, and collaboratives in improving health and health care. She is an expert in evalu- ation research, with particular emphasis on appropriate designs for forma- tive and summative assessments of both the implementation and outcomes of innovative programs. She specializes in the use of qualitative and mixed methods in health services and policy research. Dr. Sofaer served as a mem- ber of the IOM Committee on the Consequences of Uninsurance; she chaired the subcommittee that produced the committee's sixth and final report, which addressed principles and recommendations. Samuel O. Thier, M.D.,* is professor of medicine and professor of health care policy at Harvard Medical School. He was president and CEO of Part- ners HealthCare System from 1996 to 2002. From 1994 to 1997 he was president of the Massachusetts General Hospital; he was Brandeis Univer- sity's president during the previous 3 years. He served 6 years as president of the IOM and 11 years as chair of the Department of Internal Medicine at Yale University School of Medicine, where he was Sterling professor. Dr. Thier is an authority on internal medicine and kidney disease and is also known for his expertise in national health policy, medical education, and biomedical research. Born in New York, he attended Cornell University and received his medical degree from the State University of New York at Syracuse in 1960. He served on the medical staff of Massachusetts General Hospital as an intern, resident, chief resident in medicine, and chief of the renal unit, and held a faculty appointment at Harvard. Prior to joining the faculty of Yale in 1975, he was professor and vice-chair of the Department of Medicine at the University of Pennsylvania. He has received several hon- orary degrees and the UC Medal of the University of California, San Fran- cisco. He has served as president of the American Federation of Clinical Research and chair of the American Board of Internal Medicine and is a master of the American College of Physicians, a fellow of the American Academy of Arts and Sciences, and a member of the American Philosophi- cal Society. Dr. Thier is a director of Charles River Laboratories, Inc., The *Member of the Main Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs.

496 APPENDIX E Commonwealth Fund (chair), the Federal Reserve Bank of Boston, and Merck & Co., Inc., and a member of the Board of Overseers of TIAA-CREF and the Board of Overseers of Cornell University Medical College. Gail R. Wilensky, Ph.D.,* is a senior fellow at Project HOPE, an interna- tional health education foundation, where she analyzes and develops poli- cies relating to health reform and to ongoing changes in the medical mar- ketplace. Dr. Wilensky testifies frequently before congressional committees; acts as an advisor to members of Congress and other elected officials; and speaks nationally and internationally before professional, business, and con- sumer groups. From 2001 to 2003, she cochaired the President's Task Force to Improve Health Care Delivery for Our Nation's Veterans, which ad- dressed health care for both veterans and military retirees. From 1997 to 2001 she chaired the Medicare Payment Advisory Commission, which ad- vises Congress on payment and other issues relating to Medicare, and from 1995 to 1997 she chaired the Physician Payment Review Commission. Pre- viously, she served as deputy assistant to President G. H. W. Bush for policy development, advising him on health and welfare issues. Prior to that, she was administrator of HCFA, overseeing the Medicare and Medicaid pro- grams. Dr. Wilensky is an elected member of the IOM and its Governing Council, serves as a trustee of the Combined Benefits Fund of the United Mineworkers of America and the American Heart Association, and is on the Advisory Board of the National Institute of Health Care Management. She is an advisor to The Robert Wood Johnson Foundation and The Com- monwealth Fund, immediate past chair of the Board of Directors of Acad- emy Health, and a director on several corporate boards. Dr. Wilensky re- ceived a bachelor's degree in psychology and a Ph.D. in economics at the University of Michigan. INSTITUTE OF MEDICINE STAFF BIOGRAPHIES Rosemary A. Chalk is director of the Board on Children, Youth and Fami- lies (BCYF) and also serves as director of the Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs (PPPI) project at the IOM. She has been a senior staff member of the IOM and the Division on Behavioral and Social Sciences and Education of the National Academies for almost 19 years, directing studies on vaccines and immunization finance, educational finance, family violence, child abuse and neglect, and research ethics. She took on the role of BCYF director in Sep- *Member of the Main Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs.

APPENDIX E 497 tember 2003 and began directing the PPPI project in April 2005. For 3 years (2000 to 2003), Ms. Chalk was a half-time study director at the IOM and also directed the child abuse/family violence research area at Child Trends, a nonprofit research center in Washington, D.C., where she con- ducted studies on the development of child well-being indicators for the child welfare system. Over the past decade, Ms. Chalk has directed a range of projects sponsored by the William T. Grant Foundation, the Doris Duke Charitable Foundation, the Carnegie Corporation of New York, The David and Lucile Packard Foundation, and various agencies within the U.S. De- partment of Health and Human Services. Earlier in her career, Ms. Chalk was a consultant and writer for a broad array of science and society re- search projects. She has authored publications on issues related to child and family policy, science and social responsibility, research ethics, and child abuse and neglect. She was the first program head of the Committee on Scientific Freedom and Responsibility of the American Association for the Advancement of Science from 1976 to 1986 and is a former section officer for that organization. She served as a science policy analyst for the Congres- sional Research Service at the Library of Congress from 1972 to 1975. She has a bachelor's degree in foreign affairs from the University of Cincinnati. Karen Adams, Ph.D., M.T. (A.S.C.P.), is senior program officer at the IOM. She is currently lead staff member on the Performance Measurement and Pay for Performance Subcommittees of the IOM's congressionally mandated study Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs. Her prior work at the IOM includes serving as study director of the Committee on Priority Areas for National Action: Transforming Health Care Quality and co-study director of the 1st Annual Crossing the Quality Chasm Summit: A Focus on Communities. Before joining the IOM, she held the rank of assistant professor in the De- partment of Medical and Research Technology, University of Maryland School of Medicine, and was also academic coordinator of the undergradu- ate medical technology program. Dr. Adams received an undergraduate degree in medical technology from Loyola College, a master's degree in management from the College of Notre Dame, and a doctorate in health policy from the University of Maryland. During her doctoral studies she was awarded an internship at the Agency for Healthcare Research and Qual- ity, during which she researched more than 30 years of innovations in medi- cal informatics. She is also certified as a medical technologist by the Ameri- can Society of Clinical Pathologists. Samantha M. Chao, M.P.H., is senior health policy associate for the IOM's Board on Health Care Services. She completed a master's degree in health policy at the University of Michigan School of Public Health. As part of her

498 APPENDIX E studies, she interned with both the Michigan Department of Community Health and the American Heart Association to promote the study of chronic disease and disease prevention. Contessa Fincher, Ph.D., M.P.H., joined the IOM's Board on Health Care Services in 2004 as a program officer. She is a recent graduate of the Uni- versity of Alabama at Birmingham, where she studied administration­health services, with a focus on outcomes research. She has an M.P.H. from the University of Texas School of Public Health at Houston, with a concentra- tion in health services research. Her postdoctoral work was completed at Wyeth Research in the Department of Global Health Outcomes and Phar- macoeconmic Assessment, where she designed cost-effectiveness models as part of her work in cardiovascular disease. Before joining the IOM, she worked briefly as a pharmacoeconomist at the Food and Drug Administra- tion and Abt Associates, a government and pharmaceutical consulting com- pany. Dr. Fincher has published articles in such journals as the New En- gland Journal of Medicine, the American Journal of Cardiology, and Ethnicity and Disease. Tracy A. Harris, D.P.M., M.P.H., joined the IOM's Board on Health Care Services in 2004 as a program officer. Her work background includes clini- cal experience and health policy work. Previously, she was trained in podi- atric medicine and surgery and spent several years in private practice. In 1999, Dr. Harris was awarded a Congressional Fellowship with the Ameri- can Association for the Advancement of Science. She spent 1 year working in the U.S. Senate on many issues, including elder fraud, telemedicine, a national practitioners data bank, health professional shortage areas, stem cell research, and malpractice caps. While earning a master's degree, she worked on various projects, including Medicaid disease management and the uninsured. She has a doctor of podiatric medicine degree from the Temple University School of Podiatric Medicine and a master of public health degree with a concentration in health policy from The George Wash- ington University. Dianne Miller Wolman, M.G.A., is currently lead staff on a Congression- ally mandated evaluation of the Quality Improvement Organization Pro- gram of Medicare, part of the IOM's Redesigning Health Insurance Project. Prior to this she co-directed a 3-year study of the Consequences of Un- insurance, which produced a series of six reports: Insuring Health. Prior to that she directed the study that resulted in the IOM report, Medicare Labo- ratory Payment Policy: Now and in the Future, released in 2000. She joined the Health Care Services Division of the Institute of Medicine in 1999 as a senior program officer. Her previous work experience in the health field has

APPENDIX E 499 been varied and focused on finance and payment in insurance programs. She came from the General Accounting Office, where she was a senior evalu- ator on studies of the Health Care Financing Administration and its man- agement capacity. Previously, she was a policy specialist at a national asso- ciation representing nonprofit providers of long-term care services. Her earlier positions included policy analysis and management with: the office of the secretary, DHHS; a peer review organization; a governor's task force on access to health care; and a third-party administrator for very large health plans. In addition, she was policy director for a state Medicaid rate setting commission. She has a master's degree in government administration from Wharton Graduate School, University of Pennsylvania.

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Medicare's Quality Improvement Organization Program is the second book in the new Pathways to Quality Health Care series. Focusing on performance improvement, it considers the history, role, and effectiveness of the Quality Improvement Organization (QIO) program and its potential to promote quality improvement within a changing health care delivery environment that includes standardized performance measures and new data collection and reporting requirements. This book carefully examines the QIOs that serve every state as well as the national program that guides and supports them. In addition, it highlights the important roles that a national program with private organizations in each state can play in promoting higher quality care. Medicare's Quality Improvement Organization Program looks closely at the technical assistance role of the QIO program and the need to encourage and support providers to improve their performance. By providing an in-depth assessment of the federal experience with quality improvement and recommendations for program improvement, this book helps point the way for those who strive to create higher quality and better value in health care. Intended for multiple audiences, Medicare's Quality Improvement Organization Program is essential reading for members of Congress, the federal executive branch, the QIOs, health care providers and clinicians, and stakeholder groups.

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