Appendix A

Committee and Staff Biographies

Frank A. Sloan, Ph.D. (Chair), is the J. Alexander McMahon Professor of Health Policy and Management and professor of economics at Duke University since 1993. He is also the director of the Center for Health Policy, Law, and Management at Duke that originated in 1998. Professor Sloan did his undergraduate work at Oberlin College and received his Ph.D. in economics from Harvard University. Before joining the faculty at Duke in July 1993, he was a research economist at the RAND Corporation and on the faculties of the University of Florida and Vanderbilt University. He was chair of the Department of Economics at Vanderbilt from 1986–1989. His current research interests include alcohol use prevention, long-term care, medical malpractice, and cost-effectiveness analyses of medical technologies. Professor Sloan also has a long-standing interest in hospitals, health care financing, and health manpower. He has served on several national advisory public and private groups. He is a member of the Institute of Medicine of the National Academy of Sciences and was recently a member of the Physician Payment Review Commission.

M. Roy Wilson, M.D., M.S. (Vice Chair), served as Chancellor of the University of Colorado Denver (UC Denver) from July 2006 until June 30, 2010, and is now Chancellor Emeritus. UC Denver consists of a general academic campus with eight schools and colleges and a health sciences campus with five schools and colleges and serves approximately 28,000 students. He is an elected member of the Institute of Medicine of the National Academies, the American Ophthalmological Society, and the Glaucoma Research Society. In addition to the board of the University of Colorado Hospital, for which he has been the chairman, Dr. Wilson has served on the governing boards of the Denver Children’s Hospital, Auraria Higher Education Center, Fitzsimons Redevelopment Authority, Institute of International Education, Colorado Bioscience Association, Association of Academic Health Centers, and the Association of Public and Land Grant Universities. Dr. Wilson was an initial advisory council member of the National Center on Minority Health and Health Disparities of the National Institutes of Health (NIH) and served four years as chair of its Strategic Plan subcommittee. Dr. Wilson received his medical degree from Harvard Medical School and his master of science in epidemiology at the UCLA School of



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Appendix A Committee and Staff Biographies Frank A. Sloan, Ph.D. (Chair), is the J. Alexander McMahon Professor of Health Policy and Management and professor of economics at Duke University since 1993. He is also the director of the Center for Health Policy, Law, and Management at Duke that originated in 1998. Professor Sloan did his undergraduate work at Oberlin College and received his Ph.D. in economics from Harvard University. Before joining the faculty at Duke in July 1993, he was a research economist at the RAND Corporation and on the faculties of the University of Florida and Vanderbilt Univer- sity. He was chair of the Department of Economics at Vanderbilt from 1986–1989. His current research interests include alcohol use prevention, long-term care, medical malpractice, and cost- effectiveness analyses of medical technologies. Professor Sloan also has a long-standing interest in hospitals, health care financing, and health manpower. He has served on several national advisory public and private groups. He is a member of the Institute of Medicine of the National Academy of Sciences and was recently a member of the Physician Payment Review Commission. M. Roy Wilson, M.D., M.S. (Vice Chair), served as Chancellor of the University of Colorado Denver (UC Denver) from July 2006 until June 30, 2010, and is now Chancellor Emeritus. UC Denver consists of a general academic campus with eight schools and colleges and a health sciences campus with five schools and colleges and serves approximately 28,000 students. He is an elected member of the Institute of Medicine of the National Academies, the American Ophthalmological Society, and the Glaucoma Research Society. In addition to the board of the University of Colorado Hospital, for which he has been the chairman, Dr. Wilson has served on the governing boards of the Denver Children’s Hospital, Auraria Higher Education Center, Fitzsimons Redevelopment Authority, Institute of International Education, Colorado Bioscience Association, Association of Academic Health Centers, and the Association of Public and Land Grant Universities. Dr. Wilson was an initial advisory council member of the National Center on Minority Health and Health Disparities of the National Institutes of Health (NIH) and served four years as chair of its Strategic Plan subcommittee. Dr. Wilson received his medical degree from Harvard Medical School and his master of science in epidemiology at the UCLA School of 149

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150 GEOGRAPHIC ADJUSTMENT IN MEDICARE PAYMENT Public Health. He performed both his ophthalmology residency and glaucoma fellowship at the Massachusetts Eye and Ear Infirmary, Harvard Medical School. Dr. Wilson was named president of the Texas Tech University Health Sciences Center in 2003. In 1998, he was appointed dean of the School of Medicine at Creighton University, and then served as both dean and vice president for Health Sciences from 1999–2003. Prior to that time, he was dean of the School of Medicine at Charles R. Drew University of Medicine & Science. Dr. Wilson’s major scientific contributions have been in bridging the fields of epidemiology and ophthalmology. He has delivered more than 200 invited lectures, many of these internationally, and has published more than 300 articles, book chapters, and abstracts. Dr. Wilson was selected in “Best Doctors in America” for consecutive years from 1996 to 2008. Among his many awards are the Distinguished Physician Award from the Minority Health Institute, the Honored Alumnus Award from the Mass Eye and Ear Infirmary, the Senior Achievement Award from the American Academy of Ophthalmology, the Gold Citation from Allegheny College, and the Association of American Medical College’s Herbert W. Nickens Award. Jon B. Christianson, Ph.D., is professor and James A. Hamilton Chair in Health Policy and Management in the Division of Health Policy & Management at the University of Minnesota School of Public Health. His research interests include competition and competitive health care markets, health insurance, financial incentives in health care, public reporting, employer strategies for purchasing health care, implementation of evidence-based treatment processes in health care organizations, and tracking change in health care markets. He is a member of the Synthesis Project Advisory Group at the Robert Wood Johnson Foundation; holds current editorial appointments at Medical Care Research and Review, Journal of Health Administration Edu- cation, and the American Journal of Managed Care; and was recently appointed to the Consumer Operated and Oriented Plan (CO-OP) Advisory Board (HHS, OCIIO). Previously, he was chair of the 2007 Academy Health Annual Research Meeting, co-chairperson, Seventh Biennial Research Conference on the Economics of Mental Health, and a member of the IOM Subcommittee on Maximizing the Value of Health Investments, Committee on Quality of Health Care in America. Dr. Christianson received his Ph.D. in Economics from the University of Wisconsin-Madison. Stuart Guterman, M.A., is vice president for The Commonwealth Fund’s program on Pay- ment and System Reform, based in Washington, DC. He is responsible for the fund’s research agenda on the use of payment incentives to elicit changes in health care delivery that can achieve high performance; the development, management, and review of grants to be funded under the program; and analyses related to the current performance and future improvements in the payment system and the health system overall. Mr. Guterman was director of the Office of Research, Development, and Information at the Centers for Medicare and Medicaid Services from 2002 to 2005. Prior to that he was a senior analyst at the Congressional Budget Office, a principal research associate in the health policy center at The Urban Institute, and deputy director of the Medicare Payment Advisory Commission (and its predecessor, the Prospective Payment Assessment Commission) from 1988 through 1999. Previously, Mr. Guterman was chief of institutional studies in the Health Care Financing Administration’s Office of Research, where he directed the evaluation of the Medicare Prospective Payment System for inpatient hospital services and other intramural and extramural research on hospital payment. He holds an A.B. in economics from Rutgers College and an M.A. in economics from Brown University, and did further work toward a Ph.D. in economics at the State University of New York at Stony Brook.

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151 APPENDIX A Judith K. Hellerstein, Ph.D., received her Ph.D. from Harvard University in 1994 and joined the University of Maryland faculty in 1996. She is also a faculty associate of the Maryland Popu- lation Research Center and a research associate of the National Bureau of Economic Research. The focus of much of her research is labor market outcomes across gender, race, and ethnicity. Publications include such works as: “Workplace Segregation in the United States: Race, Ethnic- ity, and Skill,” Review of Economics and Statistics, 2008; “Spatial Mismatch or Racial Mismatch?” Journal of Urban Economics, 2008; “New Evidence on Sex Segregation and Sex Differences in Wages from Matched Employee-Employer Data,” Journal of Labor Economics, 2003; “Market Forces and Sex Discrimination,” Journal of Human Resources, 2002. She serves as a reviewer for numerous journals and has received multiple awards for excellence in teaching. Previously, she was a member of the IOM Committee on Developing Biomarker-Based Tools for Cancer Screening, Diagnosis, and Treatment. Carlos R. Roberto Jaén, M.D., Ph.D., FAAFP, has special interests that include improving preventive care for individuals of all ages, preventing complications from chronic diseases like diabetes, high blood pressure, and heart disease. He is passionate about building and studying high performance primary care offices. He is co-director of the Center for Research in Family Medicine and Primary Care and holds an endowed professorship at the University of Texas Health Science Center at San Antonio. Over the last 18 years, the center has studied almost 500 mostly independent, community-based primary care practices and recently completed the evaluation of the American Academy of Family Physicians’ national demonstration project of the patient-centered medical home in 36 practices. He served on the panels that published smoking cessation guidelines in 1996 and 2000 and was co-chair of the panel that published an update in May 2008. In 2005, he was appointed to a three-year term on the National Advisory Council to the Agency for Healthcare Research and Quality (AHRQ). He received a Generalist Physi- cian Faculty Scholar Award from the Robert Wood Johnson Foundation and a Cancer Control Career Development Award for Primary Care Physicians from the American Cancer Society. He is a practicing family physician and has been selected to the “Best Doctors in America” yearly since 2002. His interests include building a healthier San Antonio through efforts in community wellness. He obtained a B.S. and M.S. from Niagara University in Lewiston, New York, and an M.D./Ph.D. in epidemiology and community health from the State University of New York in Buffalo. He completed a Family Medicine Residency and a Primary Care Research Fellowship at Case Western Reserve University in Cleveland, Ohio. Previously, he has served as medical director at the Niagara Family Health Center and has been in private practice in Ohio. Jack Kalbfleisch, Ph.D., is a professor of biostatistics and statistics, and he serves as director of the Kidney Epidemiology and Cost Center at the University of Michigan’s School of Public Health. He served as chair of the Department of Biostatistics from 2002 to 2007. He received his Ph.D. in statistics in 1969 from the University of Waterloo. He was an assistant professor of statistics at the State University of New York at Buffalo (1970–1973) and on faculty at the Uni- versity of Waterloo (1973–2002). At Waterloo, he served as chair of the Department of Statistics and Actuarial Science (1984–1990) and as dean of the faculty of Mathematics (1990–1998). He has held visiting appointments as professor at the University of Washington, the University of California at San Francisco, the University of Auckland, Fred Hutchinson Cancer Research Center, and the National University of Singapore. He has interests in and has published in various areas of statistics and biostatistics including life history and survival analysis, likelihood methods of

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152 GEOGRAPHIC ADJUSTMENT IN MEDICARE PAYMENT inference, bootstrapping, and estimating equations, mixture and mixed effects models, and medical applications. Dr. Kalbfleisch is a Fellow of the American Statistical Association and the Institute of Mathematical Statistics. He is also an elected member of the International Statistical Institute, a Fellow of the Royal Society of Canada, and a Gold Medalist of the Statistical Society of Canada. Meridean Maas, Ph.D., R.N., FAAN, is professor emerita and co-director of the John A. Hartford Center of Geriatric Nursing Excellence at the College of Nursing of the University of Iowa. Dr. Maas is currently conducting research with electronic clinical data, including standard- ized nursing data, to assess the cost-effectiveness of nursing interventions on outcomes for older persons hospitalized with congestive heart failure and pneumonia. She has been co-principal Investigator of the Iowa Geriatric Education Center grant funded by HRSA, co-director of the Gerontological Nursing Interventions Research Center (GNIRC), and director of its Regional Research Training Core. Her funded programs of research include: testing the effects of Family Involvement in Care interventions on family members of institutionalized Alzheimer’s patients, staff caregivers, and persons with AD, and Nursing Outcomes Classification research to develop, classify, and validate patient outcomes that are sensitive to nursing interventions. Dr. Maas received the Gerontological Society of America Doris Schwartz Gerontological Nursing Research Award in 2006. She currently serves on four editorial boards and is a reviewer for five journals, has numerous peer-reviewed journal articles and book chapters in print, and has authored or edited several books. Dr. Maas has taught in undergraduate and graduate programs and has advised several pre-doctoral and post-doctoral students and fellows in nursing administration and in aging and received the Regents Award for Faculty Excellence at the University of Iowa in 1996/1997. She earned her doctorate in sociology of organizations from Iowa State University in 1979 and joined the University of Iowa faculty in 1983. Prior to joining the faculty, she held a number of positions in hospitals and long-term care, including administrative and clinical practice roles. Dr. Maas currently consults with schools of nursing in gerontological nursing education, in the development of faculty programs of research, and with others regarding innovative and best nursing practices for care of older persons. Marilyn Moon, Ph.D., is a nationally known expert on Medicare, having served as a senior fellow at the Urban Institute and as a public trustee for the Social Security and Medicare trust funds. She is also an expert on health care financing and benefits and has increasingly worked in the area of patient information and engagement. As senior vice president and director of the Health Program at the American Institute of Research, Dr. Moon is responsible for ensuring client satisfaction with all aspects of the Health Program’s research and development activities and products. In addition, she provides overall direction of the Health Program, supervising 120 staff members. She also leads strategic planning efforts and supervises senior-level researchers, unit directors, research assistants, and support staff. Dr. Moon is responsible for overseeing the allocation of resources for 50 currently active projects, with a total annual value of more than $30 million. Other duties include serving as corporate monitor on two Centers for Medicare and Medicaid Services (CMS) IDIQ contracts, and as project director on one Agency for Healthcare Research and Quality (AHRQ) IDIQ contract, while continuing to conduct research on a range of health policy issues. In addition to a long list of awards and honorary positions, Dr. Moon has a large number of peer-reviewed journal articles, books and book chapters, other publications, testimonies, and professional presentations to her credit.

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153 APPENDIX A Cathryn Nation, M.D., is the associate vice president for health sciences in the University of California’s Office of the President. She completed her undergraduate studies at UC Davis, earning honors in political science/public policy and Spanish. She earned her medical degree from UC San Francisco in 1989. Her university duties include: leadership and coordination of health sciences academic affairs; liaison with deans and faculty involving educational policy and program planning; development of enrollment plans for UC’s 16 health sciences schools; monitoring of health workforce needs; and representation of UC health sciences programs internally and externally. She oversees the university’s anatomical materials programs and directs the system-wide Academic Geriatric Resource Program—a state-funded, multi-campus program in geriatrics. Dr. Nation has extensive knowledge of undergraduate and graduate medical education; medical school admissions; health professions workforce issues; and matters related to health sciences instruction and institutional accreditation. In 2008, she was appointed as a commissioner on the California Healthcare Workforce Policy Commission—a statewide body established by statute to promote primary care training and workforce diversity. Within the UC, she has primary responsibility for coordinating new initiatives in telemedicine supported by $200M in voter-approved bond funding. Dr. Nation has authored numerous reports and studies addressing medical and health sciences education and was invited by the Institute of Medicine to serve as a lead author of a national review of health professions admissions practices. This study identifies best practices in admissions and was published in 2004 by the National Academies in a book entitled In the Nation’s Compelling Interest: Ensuring Diversity in the Health-Care Work- force. Dr. Nation continues to lead efforts with UC medical schools to develop new PRograms in Medical Education (PRIME), which provide specialized training to prepare future graduates to meet the needs of the underserved. Five programs are offered, each involving a unique area of focus; program-specific standards for admission; specialized coursework; structured clinical experiences; independent study; and faculty mentoring. Areas of focus include: rural health and telemedicine (Davis); Latino health (Irvine); diverse and disadvantaged communities (Los Angeles); promotion of health equity (San Diego); and the urban underserved (San Francisco). Joanne M. Pohl, Ph.D., ANP-BC, FAAN, FAANP, is a health services researcher with 30 years of clinical experience as a nurse practitioner. Dr. Pohl’s research has focused on health care quality and outcomes, cost of care in nurse-managed health centers, disparities, and health informatics in safety net practices, and has been funded by the Agency for Healthcare Research and Quality, the Health Resources and Services Administration, and private foundations. At the University of Michigan, she served as associate dean for community partnerships from 2001–2008 and directed the Adult Nurse Practitioner Program from 1992–2001. From 2003–2008, she was a research fellow with the Michigan Public Health Institute. She is a recent past president of the National Organization of Nurse Practitioner Faculties (NONPF), a member of the Expert Advi- sory Panel of the Health Professional Workforce Initiative of the Bipartisan Policy Center, and a member of the Advisory Board for the Nursing Alliance for Quality Care. She also has been involved in Quality and Safety Education for Nurses and is actively involved in policy related to primary care and nurse practitioners. She earned her Ph.D. from the University of Michigan, her M.S.N. from Wayne State University, and her B.S. from Southern Connecticut State University. Dr. Pohl has received many awards, including a Lifetime Achievement Award from NONPF and a President’s Leadership Award from the Michigan Council of Nurse Practitioners. She is a fellow in the American Academy of Nursing and the American Academy of Nurse Practitioners.

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154 GEOGRAPHIC ADJUSTMENT IN MEDICARE PAYMENT Thomas C. Ricketts III, Ph.D., M.P.H., is professor of health policy and management and social medicine at the University of North Carolina Gillings School of Global Public Health and the UNC School of Medicine. In 2008, he was named Gillings Visiting Professor at the École des Hautes Études en Santé Publique in Paris and Rennes, France. He is also co-director of the American College of Surgeons (ACS) Institute for Health Policy Research. His work with the ACS focuses on the future supply of surgeons and access to surgical care. Dr. Ricketts works actively in health workforce policy making and research and has developed national and state policies to influence the distribution of health care practitioners, including the development of a new approach to designating primary care and dental health professional shortage and medically underserved areas. From 2001–2010, he chaired the Scientific Advisory Committee for the United Health Foundation’s America’s Health RankingsTM. In 2008, he was appointed to the Secretary of Veterans’ Affairs Rural Advisory Committee. He previously served on the Secretary’s National Advisory Committee on Rural Health and Human Services (HHS). In 1997, Dr. Ricketts received the Distinguished Rural Health Researcher award from the National Rural Health Association, and in 1998, the Cecil G. Sheps Distinguished Investigator award from the University of North Carolina at Chapel Hill. He is a member of the North Carolina Institute of Medicine and serves as an advisor to national and state health policy organizations. Dr. Ricketts is editor of the North Carolina Medical Journal, having previously served as editor of the Journal of Rural Health from 1990 until 1996. Dr. Ricketts has authored many scientific articles, book chapters, and monographs and edited texts on rural health and geographic methods in health services research. Jane E. Sisk, Ph.D., M.A., is the director of the Division of Health Care Statistics for the National Center for Health Statistics at the Centers for Disease Control and Prevention. This division collects data from health care providers in different settings, including physicians, hos- pitals, and long-term care facilities. Dr. Sisk has been a professor in the Department of Health Policy, Mount Sinai School of Medicine, New York City, and before that at the Mailman School of Public Health, Columbia University, New York City. While a senior associate at the Congres- sional Office of Technology Assessment, she directed studies on Medicare payment for physician services and measures of the quality of hospital and physician care. Her research has focused on interventions to improve the quality of care, especially to reduce disparities among popula- tion subgroups; evaluation of Medicaid managed care; and the cost-effectiveness of health care interventions, including pneumococcal and influenza vaccination for elderly people. At Mount Sinai, she led randomized controlled trials in Harlem on the effectiveness and cost-effectiveness of nurse-management interventions for heart failure and hypertension. Dr. Sisk holds a Ph.D. in economics from McGill University, an M.A. in economics from George Washington University, and a B.A. with a major in international relations from Brown University. She serves on edito- rial boards for Health Services Research, Medical Decision Making, and the International Journal of Technology Assessment in Health Care. Dr. Sisk has been elected a fellow of AcademyHealth; a fellow of the New York Academy of Medicine; and a member of the Institute of Medicine of the National Academies. Bruce Steinwald, M.B.A., is an independent consultant in Washington, DC, who focuses on health policy, health economics and financing, and Medicare payment issues. Prior to this, he was director of Health Care at the U.S. Government Accountability Office (GAO). There, he testi- fied before the Congress on Medicare payment systems and other health care financing issues,

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155 APPENDIX A supervised the preparation of health policy analyses, testimony, and reports to the Congress, and he met routinely with congressional staff to advise, inform, and instruct on health policy, financing, and payment issues. Prior to joining GAO, he served with the National Health Policy Forum of George Washington University, Covance Health Economics and Outcomes Services, Inc., and as deputy director of ProPAC. He has served as an expert panelist/presenter at policy institutes and other organizations. He has a B.A. in business from Johns Hopkins University and an M.B.A. in hospital administration from the University of Chicago. David Vlahov, Ph.D., R.N., is dean and professor, University of California, San Francisco School of Nursing. Previously, he was senior vice president for research and director of the Center for Urban Epidemiologic Studies at The New York Academy of Medicine. He has been professor of clinical epidemiology at the Mailman School of Public Health at Columbia University, and adjunct professor in epidemiology at the Johns Hopkins Bloomberg School of Public Health. Dr. Vlahov has conducted studies of urban populations in Baltimore for over 20 years, including several longitudinal cohort studies for which he received the NIH MERIT Award. He brings expertise in epidemiology, infectious diseases, substance abuse, and mental health, and he has served on the National Advisory Council on Drug Abuse. More recently, Dr. Vlahov led epidemiologic studies in Harlem and the Bronx, which have served as a platform for subsequent individual- and community-level intervention studies and community-based participatory research (involving partnerships with residents, community-based organizations, and academic and public health departments) to address social determinants of health. This work has contributed information on racial/ethnic disparities in health, and approaches to address such disparities. Dr. Vlahov led population-based studies after September 11, 2001, on mental health and substance abuse in New York City residents following the attacks on the World Trade Center. Uniting all of these interests, Dr. Vlahov initiated the International Society for Urban Health (www.isuh.org), serving as its first president. The society brings together an interdisciplinary and international group of scientists to examine the health effects of urbanicity (in developed countries) and urbaniza- tion (in both developed and developing countries). He is a visiting professor at the Medical School in Belo Horizonte, Brazil, to develop their programs in urban health, and he is working with the World Health Organization’s Urban Health Center in Kobe, Japan. Dr. Vlahov is the editor-in-chief of the Journal of Urban Health and serves as an editor for the American Journal of Epidemiology and Epidemiology. He has edited three books on urban health; he has published over 600 scholarly papers. Dr. Vlahov received a baccalaureate and masters in nursing from the University of Maryland and his doctorate in epidemiology at the Johns Hopkins School of Hygiene and Public Health. Barbara O. Wynn, M.A., is a senior policy analyst at RAND Corporation where she has been principal investigator on a variety of studies involving Medicare issues, such as studies examin- ing differences in Medicare patient characteristics, cost and quality of procedures performed in multiple ambulatory settings, and an evaluation of severity-adjusted patient classification systems and relative weight methodologies. She also conducts research related to financing of graduate medical education and federal support for safety net hospitals. She has led cost and quality studies for the California workers’ compensation system, TRICARE, the Veterans Admin- istration, and the State of Qatar. Prior to coming to RAND in 1999, Ms. Wynn spent 24 years with the Health Care Financing Administration (HCFA) (the predecessor agency to the Centers for Medicare and Medicaid Services). As deputy director of the Bureau of Policy Development

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156 GEOGRAPHIC ADJUSTMENT IN MEDICARE PAYMENT and later director of the Plan and Provider Purchasing Policy Group, she was responsible for the full range of Medicare payment and coverage issues. Ms. Wynn led major Medicare regulatory initiatives, including the Medicare hospital inpatient capital prospective payment system, the hospital outpatient prospective payment system, the resource-based practice expense for phy- sician services, and implementation of the Medicare+Choice program. For a number of years, she directed HCFA’s Division of Hospital Payment Policy and was responsible for the policies and annual updates to the Medicare prospective payment system for inpatient hospital services. Alan M. Zaslavsky, Ph.D., is a professor of health care policy (statistics) in the Department of Health Care Policy at Harvard Medical School. His methodological research interests include surveys, census methodology, microsimulation models, missing data, hierarchical modeling, small-area estimation, and applied Bayesian methodology. His health services research focuses primarily on developing methodology for quality measurement of health plans and providers and understanding the implications of these quality measurements. An important part of his work concerns the development, implementation, and analysis of the Consumer Assessments of Healthcare Providers and Systems (CAHPS) survey, a comprehensive program involving a survey instrument for eliciting enrollee reports and ratings of their health plans and the care they receive through them, a standard analysis package, and methods for reporting results to potential enrollees and purchasers. As a statistical leader in the implementation of the CAHPS survey for the Medicare population, he has studied individual characteristics affecting responses to the survey, the main dimensions of quality measured by the survey, the contributions of the health plan and geographical location to CAHPS-measured quality, comparisons of traditional Medicare to Medicare Advantage, and risk selection among health plans. In collaboration with Dr. Ronald Kessler, he leads analyses of the National Comorbidity Survey-Adolescent (NCS-A), a large study of mental health in U.S. adolescents aimed at validation and improvement of the CIDR-A (Composite International Diagnostic Review-A) instrument and estimation of mental disorder for small geographic areas and schools. He also collaborates with Dr. Kessler on analyses for the World Mental Health Surveys and for the STARRS study of suicides in the armed forces. Another of Dr. Zaslavsky’s areas is methodology for measuring racial and ethnic disparities in care and determining their causes. Finally, Dr. Zaslavsky is part of the Statistical Coordinating Center of the CanCORS (Cancer Care Outcomes Research and Surveillance) consortium, a major study sponsored by the National Cancer Institute to study process-outcomes relationships and sources of disparities in cancer care. He is developing methods of integrating cancer registry data with surveys and medical record reviews to better detect such relationships. Dr. Zaslavsky earned his A.B. from Harvard College, his M.S. in statistics and computer science from North- eastern University, and his Ph.D. in applied mathematics, with a specialty in statistics, from the Massachusetts Institute of Technology. He is a fellow of the American Statistical Association, an elected member of the International Statistical Institute, and a National Associate of the National Academy of Sciences. He has served on numerous panels on decennial census methodology, small-area estimation, and measurement of race for health and health services research, and health care quality reporting for the Institute of Medicine and the Committee on National Sta- tistics (CNSTAT) of the National Academy of Sciences, of which he is a member. Stephen Zuckerman, Ph.D., is a senior fellow in the Health Policy Center of The Urban Institute. He received his doctorate in economics from Columbia University in 1983. During his

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157 APPENDIX A 25 years as a health economist, he has studied issues related to physician payment, insurance coverage and market reforms, and the health care safety net. His current research is focused on Medicare physician payment, the development of “medical homes,” Medicare benefit design, the tax treatment of employer-sponsored health insurance premiums, and health care among undocumented immigrants. He recently co-authored a study examining the determinants of geographic differences in Medicare spending across individuals. Dr. Zuckerman’s research on Medicare physician payment includes several studies that developed the geographic practice cost indices used in the fee schedule for physician services, estimated the extent of the volume offset in the market for physician services, analyzed the growth in the volume and intensity of physician services, and outlined an approach to Medicare assignment that could avoid manda- tory assignment of all claims yet protect low-income beneficiaries. He has also studied hospital rate setting, Medicaid managed care, state coverage expansions for adults, the Indian Health Service, the effects of the State Children’s Health Insurance Program on private insurance cover- age, state budget problems and their impact on health policies, and medical malpractice. He directed the health care component of the National Survey of America’s Families (NSAF)—the Assessing the New Federalism’s household survey. Dr. Zuckerman used the NSAF to study the effects of modifying health insurance survey questions like those used in the Current Popu- lation Survey by including a question confirming that those who did not report coverage were actually uninsured. Results from this study were cited as part of the justification for including a confirmation question at the end of the Current Population Survey insurance coverage sequence. Prior to joining The Urban Institute, he worked at the American Medical Association’s Center for Health Policy Research. RTI INTERNATIONAL CONSULTANTS Walter Adamache, Ph.D., received his Ph.D. in economics from Vanderbilt University in 1982. His more than 25-year career in health economics includes both behavioral and policy-related research. His hospital research includes studies on hospital costs, hospital labor markets, capital costs, investment, closures, and mergers. He examined geographic variation of prices paid by hospitals and physicians for labor and non-labor input prices and suggested to HCFA (now CMS) a methodology to smooth out intertemporal changes in IPPS area wage index values. During the 1990s, he submitted recommendations to HCFA regarding updating the physician malpractice insurance component of the Medicare Geographic Practice Cost Index. Recent work includes examining alternative methods for configuring payment localities for the Medicare Physician Fee Schedule and an examination of the relative merits of BLS versus hospital-specific wage data for the IPPS area wage index. He is currently evaluating the impact of the alignment of hospital and physician incentives on hospital costs. Justine L. E. Allpress is a research geographic information systems (GIS) analyst in RTI Inter- national’s Environmental Health and Safety Division (EHSD). Ms. Allpress has extensive experi- ence in working with clients and production and editorial staff to coordinate the production of mapping for reports and major projects. She is responsible for the development and production of automated mapping in support of survey and statistical projects. Her technical skills include data manipulation, map preparation, map production and design, and the development of software and tools to automate complicated mapping and analysis tasks.

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158 GEOGRAPHIC ADJUSTMENT IN MEDICARE PAYMENT Kathleen Dalton, Ph.D., has experience in health care finance that spans the roles of man- agement, industry consultant, trustee, and researcher. Following a 20-year career in health care finance, she earned her doctorate in health policy from the School of Public Health at the University of North Carolina. After completing a CMS-funded dissertation on payments to teaching hospitals under the Medicare prospective payment system, she remained at UNC for 5 years as a research faculty member and also a fellow at the Cecil G. Sheps Center for Health Services Research. Her work focused on hospital reimbursement, financial performance, and Medicare payment policy, including two studies of geographic wage variation in hospitals and in skilled nursing facilities. Since joining RTI in 2005, she has continued to focus on Medicare payment policy, financial performance of hospitals and post-acute care providers, and the effects of reimbursement incentives on care delivery. She is a quantitative analyst specializing in secondary data modeling and a recognized expert in prospective payment systems, and she has extensive experience in analysis of Medicare claims data and cost reports. Deborah Healy, Ph.D., is a senior economist in RTI’s Health Care Financing and Payment Pro- gram. Dr. Healy’s experience in health care spans roles in government, consulting, and research. Dr. Healy began her career at Compass Lexecon working on hospital antitrust cases, after which she earned her doctorate in economics from the University of Chicago. After completing her dissertation on competition in managed care plans, Dr. Health worked as an economist in the Antitrust Division at the U.S. Department of Justice where she focused on competition in health care markets. Since joining RTI, Dr. Healy has shifted her focus to competitive bidding, Part D, and Medicare payment policies and their impacts. Brieanne Lyda-McDonald, M.S.P.H., joined RTI in June 2008 as a public health analyst. She has a strong background in health science and public health, with a concentration in health policy. Ms. Lyda-McDonald has health research experience assisting with the preparation and training of health care providers for a congressionally mandated post-acute care functional assessment, developing and implementing an assessment for outpatient therapy providers in an effort to develop payment alternatives, and surveying Title X family planning grantees on their data reporting burden, among other topics. She earned a master of science in public health from the University of North Carolina at Chapel Hill. Gregory C. Pope, M.S., directs RTI’s Health Care Financing and Payment Program based in Waltham, Massachusetts. Mr. Pope has more than 25 years of experience in health economics and health policy research, after completing his graduate education in economics at the Massachusetts Institute of Technology. Much of Mr. Pope’s work has focused on design and evaluation of provider payment methods for the Medicare program. Mr. Pope is a co-developer of the Geographic Practice Cost Index used in Medicare physician payment and has conducted analyses of Medicare’s hospital wage index for CMS and MedPAC. He has led the development and refinement of the Centers for Medicare and Medicaid Services’ Hierarchical Condition Categories (CMS-HCC) system for risk adjustment of managed care capitation payment. A current focus of Mr. Pope’s work is developing shared savings payment methods for Medicare accountable care organizations. Elizabeth Seeley, Ph.D., M.P.H., is a health policy researcher at RTI. She has more than a decade of research and practical work experience in both domestic health policy and interna-

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159 APPENDIX A tional health policy issues. While at the London School of Economics, her research focused on pharmaceutical purchasing efficiency, through which she constructed sophisticated pharma- ceutical price indices in order to conduct international pharmaceutical price comparisons. As a manager of policy analysis at the Massachusetts Hospital Association, Dr. Seeley worked directly on Medicare hospital wage index issues as well as on other issues relevant to hospital pricing, including helping hospital managers develop fair pricing guidelines for low-income populations. At the Center for Studying Health System Change and as an independent consultant, Dr. Seeley has led site visits to multiple states, where she has gained insight on geographic differences in health system delivery. Dr. Seeley has a doctorate in social policy from the London School of Economics, a master’s degree in health policy and management from the Harvard School of Public Health, and a bachelor’s degree in economics from Boston College. Nathan West, M.P.A., is a health research analyst for RTI. Mr. West has nearly 15 years’ experi- ence in health services and health policy research after completing his undergraduate education in public policy from the University of North Carolina at Chapel Hill and graduate education in public administration from NC State University. Much of Mr. West’s work has focused on the evaluation of Medicare demonstration programs related to quality measurement, quality improvement, and payment reform. He assisted with the analyses of Medicare’s hospital wage index for MedPAC in 2006–2007. Alton Wright, B.S., joined RTI in 2009 as a public health analyst in RTI’s Health Care Financ- ing and Payment Program. Before joining RTI, Mr. Wright attended the University of North Carolina at Chapel Hill, where he completed his degree in health policy and administration. While completing his degree, he worked for the North Carolina Office of Emergency Medical Services as a research assistant for a cost study of the State Medical Response System. Since joining RTI, Mr. Wright has served as project coordinator for various projects. In this role he has assisted project managers by monitoring achievement milestones, drafting meeting notes and progress reports, and coordinating the logistics of team meetings and interviews with stakeholders and experts. INSTITUTE OF MEDICINE STAFF Margaret Edmunds, Ph.D., director of the Institute of Medicine (IOM) Study of Geographic Adjustment Factors in Medicare Payment, is a health policy analyst with a clinical background in disease management. She has designed, implemented, and evaluated initiatives on health care coverage and access, health information technology adoption, health information exchange, and consumer health communications for federal and state government, foundations, and associations. Previously, she was a vice president of The Lewin Group, adjunct associate profes- sor of health policy and management at the Johns Hopkins Bloomberg School of Public Health, and a senior associate on the Health IT team at Booz Allen Hamilton, where she co-authored white papers on meaningful use of electronic health records and public health informatics. She also served as study director for previous IOM studies on the State Children’s Health Insurance Program and quality assurance for managed behavioral health care. Dr. Edmunds chairs the Public Policy Committee of the American Medical Informatics Association, chaired the Health IT Interest Group for AcademyHealth from 2007 to 2010, and is a Fellow and former member of the Board of Directors of the Society of Behavioral Medicine. Her published work also includes two books

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160 GEOGRAPHIC ADJUSTMENT IN MEDICARE PAYMENT for the National Academies Press, book chapters, journal articles, white papers, technical reports, media backgrounders, and online commentary. She began her health care career as a Research and Clinical Fellow at the Johns Hopkins School of Medicine and as a member of the affiliate staff at the Johns Hopkins Hospital. Dr. Edmunds completed her doctoral degree in human develop- ment at The Pennsylvania State University and completed post-doctoral fellowships at the Johns Hopkins School of Medicine and School of Hygiene and Public Health. Kathleen Haddad, Ph.D., senior program officer for the IOM Study of Geographic Adjust- ment Factors in Medicare Payment, is a health services researcher with extensive background in Medicare claims data analysis, Medicare payment systems, Medicare quality, chronic disease management, health insurance policy, and geriatric mental health. In addition, Dr. Haddad has a background in journalism and communications. She came to the IOM from the Centers for Medicare and Medicaid Office of Policy, where she designed a standardized and risk-adjusted database of all Medicare claims and a set of composite quality measures based on four con- sensus-based measure sets for use in small area variation studies. She directed a Robert Wood Johnson–funded research group on chronic care at Johns Hopkins Bloomberg School of Public Health, where she received her Ph.D. in health services research. Dr. Haddad served as director of health policy at Families USA, senior associate for policy at the American College of Physi- cians, and director of communications in the Office of the New York State Assembly Majority Leader. She began her career in Albany, New York, as health writer for the Albany Times Union, reporting on and writing about public health and health care financing issues emerging from the state Department of Health and state legislature. Her published work also includes journal articles and numerous reports on Medicare, Medicaid, and private health insurance policy. She is a reviewer for the American Public Health Association Dissertation Awards Committee and a former member of the Board of the New York State Mental Health Association. In addition to completing her Ph.D., Dr. Haddad also completed an M.S. degree at the Columbia University Graduate School of Journalism. Serina S. Reckling, M.P.H., joined the IOM in August 2010 as a research associate for the Board of Health Care Services study on Geographic Adjustment Factors in Medicare Payment. Her previous experience includes work in community health in Santa Cruz, and Watsonville, California, and Monte Christi, Dominican Republic. Prior to joining the IOM, she interned at the Insure the Uninsured Project in Los Angeles, where she assisted staff in collecting health care reform literature and analyzing the impact of health insurance exchanges on California. Ms. Reckling also interned for Grantmakers in Health in Washington, DC, where she conducted research on program and policy initiatives among grantees. She developed a passion in health policy after working with uninsured patients in a small community hospital in a rural area of California and serving as a community health promoter in the Peace Corps. She is a member of the Delta Omega Honorary Society in Public Health and an associate member of the National Academy of Social Insurance. She earned a master’s in public health in health services policy from the University of California, Los Angeles School of Public Health, and a B.A. in sociology from the University of California, Santa Cruz. She is fluent in Spanish and a native speaker of German. Sara Spizzirri, M.P.A., joined the IOM in August 2010 as a research assistant on the Board on Health Care Services. She provides research and administrative support to her team members working on the study of Geographic Adjustment Factors in Medicare Payment for the Centers

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161 APPENDIX A for Medicare and Medicaid Services of the Department of Health and Human Services. Previ- ously, Ms. Spizzirri supported a variety of programmatic and administrative activities at the Proceedings of the National Academy of Sciences. She also completed internships with the British Parliament and a general practice law firm in upstate New York. Sara graduated from Ithaca College in 2008 with a B.A. in politics and a minor in biology. She earned her M.P.A. with a double concentration in non-profit management and science policy from American University in May 2010. Joi D. Washington is a research assistant for the IOM Board on Health Care Services. Prior to joining the IOM in May 2008, Ms. Washington held the position of registrar at the National Minority AIDS Council in which she oversaw the registration process for two large national con- ferences. Ms. Washington received her B.S. in public and community health from the University of Maryland, College Park, in 2007 and is currently pursuing a dual master’s degree in health care administration and business administration from the University of Maryland, University College. Ashley McWilliams, B.S., joined the IOM in September 2008 as a senior program assistant for the Board on Health Care Services and the National Cancer Policy Forum. Besides assist- ing on the Geographic Adjustment Factors project, she is working on the Breast Cancer and the Environment: The Scientific Methodology, Research Findings, and Future Directions study funded by the Susan G. Komen for the Cure®, Defining and Revising an Essential Health Benefits Package for Qualified Health Plans, and the Expert Panel on Access to Medicare Part D Routine Vaccines project. She has also worked with the IOM’s Roundtable on Evidence-based Medicine and the Office of Reports and Communication. Prior to joining the IOM, Ms. Williams gradu- ated in 2008 magna cum laude and Phi Beta Kappa from Howard University with a degree in biology. During college, she was co-president of the Health Professions Society, an inductee into Who’s Who Among Students at American Colleges and Universities, and a member of several honor societies. She has also participated in summer research programs at the University of Cali- fornia, San Francisco; Massachusetts Institute of Technology; and Virginia Polytechnic and State University; as well as in a summer health careers program at Case Western Reserve University. John C. Bailar III, M.D., Ph.D., is a professor emeritus at the University of Chicago and founding chair of the Department of Health Studies there. A retired commissioned officer of the U.S. Public Health Service, Dr. Bailar worked at the National Cancer Institute in Bethesda for 22 years, and since then he has held academic appointments at Harvard and McGill Universities. Dr. Bailar’s research interests focus on the interpretation of statistical evidence in medicine, with special emphasis on cancer. For 6 years, Dr. Bailar was editor-in-chief of the Journal of the National Cancer Institute. For 11 years he was the statistical consultant for the New England Journal of Medicine, and more recently he has been a member of the editorial board of that journal. Dr. Bailar is a member of the Institute of Medicine and earned his M.D. from Yale in 1955 and his Ph.D. in statistics from American University in 1973. Roger C. Herdman, M.D., is director of the IOM Board on Health Care Services. He received his undergraduate and medical school degrees from Yale University. Following an internship at the University of Minnesota and a stint in the U.S. Navy, he returned to Minnesota, where he completed a residency in pediatrics and a fellowship in immunology and nephrology and also served on the faculty. He served as professor of Pediatrics at Albany Medical College until 1979.

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162 GEOGRAPHIC ADJUSTMENT IN MEDICARE PAYMENT In 1969, Dr. Herdman was appointed director of the New York State Kidney Disease Institute in Albany, New York, and shortly thereafter was appointed deputy commissioner of the New York State Department of Health (1969–1977). In 1977, he was named New York State’s director of public health. From 1979 until joining the U.S. Congress Office of Technology Assessment (OTA), he served as a vice president of Memorial Sloan-Kettering Cancer Center in New York City. In 1983, Dr. Herdman was named assistant director of OTA, where he subsequently served as director from 1993 to 1996. He later joined the IOM as a senior scholar and directed studies on graduate medical education, organ transplantation, silicone breast implants, and the Veterans Administration national formulary. Dr. Herdman was appointed director of the IOM/National Research Council National Cancer Policy Board from 2000 through 2005. From 2005 until 2009, he directed the IOM National Cancer Policy Forum. In 2007, he was also appointed director of the IOM Board on Health Care Services. During his work at the IOM, Dr. Herdman has worked closely with the U.S. Congress on a wide variety of health care policy issues.