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Appendix H
Biographies of Committee Members

JEROME H. GROSSMAN, M.D., is the Chairman and Chief Executive Officer of New England Medical Center, Inc. He is also Chairman of the Institute for the Advancement of Health and Medical Care and Associate Professor of Medicine at Tufts University School of Medicine. He serves as Trustee/Director of several corporations and institutions, including The Boston Private Industry Council, Tufts Associated Health Plan, Wellesley College, and Arthur D. Little, Inc. Dr. Grossman joined the staff of Massachusetts General Hospital in 1966, where he served in a variety of positions. He came to the New England Medical Center in 1979. Dr. Grossman was one of the original staff of the Harvard Community Health Plan, where he developed the world's first automated medical record system, known today as COSTAR. From 1982 to 1987 Dr. Grossman served as Program Director of the Commonwealth Fund Task Force on Academic Health Centers. He is a member of the Institute of Medicine.

HOWARD L. BAILIT, D.M.D., Ph.D., is Vice President for Healthcare Management at AEtna Life & Casualty. From 1967 to 1983, Dr. Bailit was on the faculty of the University of Connecticut Health Center, where he served as Associate Dean and Professor and Head of the Department of Behavioral Sciences and Community Health. From 1983 to 1986, he was head of the Division of Health Administration at the School of Public Health, Columbia University. He was a consultant to the Rand Health Insurance Experiment and has served on many professional and governmental committees, including the National Center of Health



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Page 293 Appendix H Biographies of Committee Members JEROME H. GROSSMAN, M.D., is the Chairman and Chief Executive Officer of New England Medical Center, Inc. He is also Chairman of the Institute for the Advancement of Health and Medical Care and Associate Professor of Medicine at Tufts University School of Medicine. He serves as Trustee/Director of several corporations and institutions, including The Boston Private Industry Council, Tufts Associated Health Plan, Wellesley College, and Arthur D. Little, Inc. Dr. Grossman joined the staff of Massachusetts General Hospital in 1966, where he served in a variety of positions. He came to the New England Medical Center in 1979. Dr. Grossman was one of the original staff of the Harvard Community Health Plan, where he developed the world's first automated medical record system, known today as COSTAR. From 1982 to 1987 Dr. Grossman served as Program Director of the Commonwealth Fund Task Force on Academic Health Centers. He is a member of the Institute of Medicine. HOWARD L. BAILIT, D.M.D., Ph.D., is Vice President for Healthcare Management at AEtna Life & Casualty. From 1967 to 1983, Dr. Bailit was on the faculty of the University of Connecticut Health Center, where he served as Associate Dean and Professor and Head of the Department of Behavioral Sciences and Community Health. From 1983 to 1986, he was head of the Division of Health Administration at the School of Public Health, Columbia University. He was a consultant to the Rand Health Insurance Experiment and has served on many professional and governmental committees, including the National Center of Health

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Page 294 Services Research Study Section. Dr. Bailit has been a member of the Institute of Medicine since 1984. ROBERT A. BERENSON, M.D., is a practicing internist with an office in Washington, D.C., and is cofounder and medical director of the National Capital Preferred Provider Organization. Prior to entering private practice in 1981, he served on the White House Domestic Policy Staff in the Carter Administration. Dr. Berenson is on the faculty of the George Washington University and Georgetown University Schools of Medicine. He has written extensively about health policy, particularly on issues related to physician payment and managed care. JOHN M. BURNS, M.D., is Vice President, Health Management of Honeywell, Inc. From 1965 to 1981, Dr. Burns was engaged in private practice in St. Paul, Minn. He is board-certified in internal medicine and nephrology. He served as medical adviser to Northwestern Bell Telephone Company from 1967 to 1981. He was President of the Ramsey County (St. Paul, Minn.) Medical Society in 1982. Dr. Burns joined Honeywell in 1981. RICHARD H. EGDAHL, M.D., Ph.D., is Academic Vice President for Health Affairs at Boston University, Director of the Boston University Medical Center, and until May 1989, was an active endocrine surgeon. As Academic Vice President he serves as the chief academic officer for the university's four health schools-the Schools of Medicine (including Public Health), Graduate Dentistry, Social Work, and Sargent School for Allied Health Professions. Since 1976, Dr. Egdahl has been the director of the Boston University Health Policy Institute and the Center for Industry and Health Care. He writes and speaks widely on industry's crucial role in changing the nation's health care delivery system. Dr. Egdahl is a member of many professional societies including the American Society for Clinical Investigation, American Surgical Association, American College of Surgeons, and Society of Medical Administrators. A member of the Institute of Medicine, he served on its Governing Council from 1981 to 1985. He serves on the editorial boards of a number of professional journals including the New England Journal of Medicine. JOHN M. EISENBERG, M.D., M.B.A., is Sol Katz Professor of General Internal Medicine and Chief of the Section of General Internal Medicine at the University of Pennsylvania. He is also a Senior Fellow of the University of Pennsylvania's Leonard Davis Institute of Health Economics. He has served as President of the Society for General Internal Medicine and Vice President of the Society for Medical Decision Making. Dr. Eisenberg is a member of the Institute of Medicine and a commissioner on the Congressional Physician Payment Review Commission. He is presently Chairman of the American College of Physicians' Health Care Financing

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Page 295 Subcommittee, is a member of its Health and Public Policy Committee, and has served as a member of the College's Board of Regents. He has served as a member of the editorial boards of Medical Care, Health Services Research, the Journal of General Internal Medicine, the Journal of Gerontology, and Medical Decision Making. He also serves as consultant to the Annals of Internal Medicine. Dr. Eisenberg has published on topics such as physicians' practices, test use and efficacy, medical education, and clinical economics. His book, Doctors' Decision and the Cost of Medical Care, was published by Health Administration Press in 1986. DEBORAH ANNE FREUND, Ph.D., is Professor of Health Economics and Chair of the Health Sciences and Administration Division in the School of Public and Environmental Affairs and Adjunct Professor of Medicine at Indiana University. She also serves as Director of Indiana University's Health Services Research Center. She is an expert on Medicaid case management programs and has written extensively on this topic as well as on HMOs and alternative reimbursement strategies. She is the chairperson of the Medical Care Section of the American Public Health Association, and also serves on the Board of Directors of the Association of University Programs in Health Administration. She serves as a member of three editorial boards: Medical Care, Inquiry, and Health Policy. PAUL M. GERTMAN, M.D., is Chief Executive Officer of Clinical Information Advantages, Inc., a new company developing voice-entry, expert system software for practicing physicians. Dr. Gertman also is Chairman of the Board of U.S. Quality Systems, Inc., and of Health Systems Advantages, Inc. Prior to his current position, Dr. Gertman was Associate Professor of Medicine and Chief of Health Care Research at the Boston University School of Medicine, then Founder and President of the Health Data Institute, Inc., and most recently, Vice Chairman of the Board and Chief Scientist at Caremark, Inc. His principal scientific interests focus on measurement of quality and efficiency of medical care and on use of information systems technology in health care. ALICE G. GOSFIELD, J.D., is an attorney from Philadelphia who has been working with hospitals and physicians on utilization management, quality assurance, and peer review issues since 1973. She has been a public member of the Statewide Professional Standards Review Council and a consultant to state and federal regulatory agencies on health law issues. She has lectured widely on PROs, PSROs, utilization management, and quality assurance for various organizations, including the National Health Lawyers Association, the American Medical Association, the American Academy of Hospital Attorneys, the American Medical Peer Review Association, the Blue Cross and Blue Shield Association, and the American

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Page 296 Bar Association. A member of the Executive Committee of the National Health Lawyers Association, she is Program Chairman for their seminar ''Utilization Management, PROs and Quality Assurance: The Legal Pitfalls'' and on the Planning Committee for the first National Health Lawyers Association-American Medical Association program on physician legal issues. Ms. Gosfield has published a book on PSROs and numerous articles on utilization management and quality assurance topics and is the editor of the 1989 Annual Health Law Handbook, published by Clark Boardman, Ltd. MICHAEL E. HERBERT, M.B.A., is President and Chief Executive Officer of Physicians Health Services, Inc., the holding company that owns Physicians Health Services of Connecticut, Inc., and Physicians Health Services of New York, Inc. Prior to becoming President of Physicians Health Services, he was Vice President of InterStudy, the national health policy research firm. Mr. Herbert is Treasurer and Director of the American Medical Care and Review Association, the national group that represents IPA HMOs, and is President of the Association of Connecticut HMOs. He is also a consultant to the federal government's Office of Prepaid Health Care, reviewing HMO applications for federal qualification and performing HMO compliance reviews. NATHAN HERSHEY, LL.B., is Professor of Health Law in the Graduate School of Public Health, University of Pittsburgh, and has been a member of the Institute of Medicine since 1972. He is counsel to two law firms, Markel, Schafer & Means, Pittsburgh, Pa., and Post & Schell, Philadelphia, Pa. In 1986, he authored Fourth-Party Audit Organizations: Practical and Legal Considerations, which appeared in Law, Medicine & Health Care, and examined a variety of questions regarding the impact of private utilization management organizations on relationships among patients, providers, and payers. NEIL HOLLANDER is Vice President of Corporate Health Strategies at Blue Cross of Western Pennsylvania. Prior to joining Blue Cross in Pittsburgh, Mr. Hollander was a Vice President and Executive Director with the Blue Cross and Blue Shield Association; Director, Bureau of Program Development, Division of Medical Assistance, New York State Department of Social Services; a senior Research Associate at the National Academy of Public Administration in Washington, D.C.; Assistant to the Representative for the Ford Foundation in Cairo, Egypt; and Program Planner for North American Rockwell. He is a member of the Editorial Advisory Board of Same-Day Surgery; Chairman, Managed Healthcare Services Committee for the Pittsburgh Program for Affordable Health Care. Mr. Hollander also serves on the boards of the Alpha Center in Washington, D.C., and

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Page 297 Keystone Health Plan West, is a Consultant to the World Bank, and is a Panel Member of the American Arbitration Association. KAREN IGNANI, M.B.A., directs the activities of the American Federation of Labor and Congress of Industrial Organizations (AFL-CIO) on health care, pensions, and social security. Prior to joining the AFL-CIO, Ms. Ignani served as a professional staff member on the U.S. Senate's Labor and Human Resources Committee. Ms. Ignani also served as Research Director and then Assistant Director for the Committee for National Health Insurance and was a Health Care Research Analyst for the U.S. Department of Health, Education and Welfare. Ms. Ignani has authored a number of articles about organized labor's position on employee benefits issues and has represented the AFL-CIO on numerous panels all over the country. CAROL ANN LOCKHART, Ph.D., is Executive Director of the Greater Phoenix Affordable Health Care Foundation. She is a member of the Physician Payment Review Commission, which is responsible for recommending changes to the Congress in the way Medicare pays physicians. Dr. Lockhart is a fellow in the American Academy of Nursing and has been involved in national and local manpower issues. She is coauthor of two books on labor relations in health care and is on the editorial boards of Health Care Management, University Press, West Yorkshire, England, and Home Health Care Nurse. She was previously a director in the Arizona Department of Health Services and Senior Research Associate at Boston University School of Public Health, as well as a Pew Foundation Fellow at Brandeis University. ARNOLD MILSTEIN, M.D., M.P.H., is a Managing Director of the Wm. M. Mercer component of Marsh and McLennan and President of its National Medical Audit (NMA) subsidiary. NMA is a national physician-based consulting group that specializes in the design and evaluation of medical cost management programs for Fortune 500 companies and large carriers. Dr. Milstein is also the medical director of SuperPRO Project of the Health Care Financing Administration. He has published multiple book chapters and articles on health care control methods and is the editor of a nationally published column on utilization review decision-making. In 1987, Business Insurance selected him as one of 20 people who made a difference in employee benefits management in the past 20 years. Dr. Milstein is a board-certified psychiatrist and an associate clinical professor at the University of California, San Francisco. ALAN R. NELSON, M.D., is a private practitioner of internal medicine and endocrinology in Salt Lake City, Utah, and was named President of the American Medical Association in June 1989. A graduate of Northwestern

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Page 298 University School of Medicine, Dr. Nelson is a Fellow of the American College of Physicians, and a member of the Endocrine Society. He is also active in clinical teaching and is Associate Clinical Professor of Medicine at the University of Utah School of Medicine. Throughout much of his career, he has been involved in medical peer review and quality assurance. He organized a statewide peer review program for the Utah Medical Association, and served as a consultant for the National Center for Health Services Research. In 1975, he was elected to the Institute of Medicine, and served on its Governing Council from 1984 to 1987. He was also a Commissioner of the Joint Commission of Accreditation of Hospitals from 1982 to 1986, and he has authored numerous papers and several book chapters on medical peer review. He was a member of the National PSRO Council from 1973 to 1977. ROBERT PATRICELLI, LL.B., is President of Value Health, Inc., a managed health care company based in Avon, Conn. Value Health provides a range of cost-containment and quality assurance services in such areas as mental health and substance abuse, prescription drugs, podiatry, and review of high-cost medical and surgical procedures. From 1977 to 1987, he was Senior Vice President of Connecticut General Life Insurance Company and then Executive Vice President of CIGNA Corp. and President of its Affiliated Businesses Group, which included CIGNA's $1 billion health care businesses (HMOs, utilization review, and rehabilitation services). He also spent 8 years in the federal government, including service as Deputy Under Secretary for Policy in the U.S. Department of Health, Education and Welfare from 1969 to 1971. Mr. Patricelli served from 1984 to 1988 as Chairman of the U.S. Chamber of Commerce's Health Care Council and is currently Chairman of its Subcommittee on Mandated Benefits. He is a Member of the Board on Health Care Services of the Institute of Medicine, the Board of Directors of the Institute of Living (the nation's largest private psychiatric hospital), and the Board of the American Pharmaceutical Institute and is on the editorial advisory boards of Health Affairs, Health Week, and The American Druggist. He is a graduate of the Harvard Law School. CYNTHIA L. POLICH, M.A., Vice President, United HealthCare Corp., a health services and supply company based in Minnetonka, Minn. Until July 1989, she was President of InterStudy, a nonprofit health care research firm in Excelsior, Minn. Her work has focused on identifying and developing innovative and effective methods to organize, deliver, and finance health and long-term care for the elderly. She is the author of many publications in the areas of long-term care financing, Medicare enrollment in HMOs, case management, and home health care. She is Past President of The Women's Health Leadership Trust, Past President of the Minnesota

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Page 299 Gerontological Society, a Board Member of Quality Quest, and Chair of Senator David Durenberger's long-term care advisory group. DONALD M. STEINWACHS, Ph.D., is Director of the Johns Hopkins Health Services Research and Development Center and is Professor of Health Policy and Management in the School of Hygiene and Public Health. The Center is an interdisciplinary research group involving faculty principally from the School of Hygiene and Public Health and the School of Medicine. Dr. Steinwachs is also Director of the recently established Center on Organization and Financing of Care to the Severely Mentally Ill. His research has addressed a wide range of issues involving the effects of organization, financing, manpower, and technology on utilization, cost, and patient outcomes from care. He has a particular interest in the role of management information systems as a source of data for examining patterns of ambulatory and inpatient care, cost, and indicators of quality in defined populations. Dr. Steinwachs is currently President of the Association for Health Services Research and serves as a consultant to federal agencies and private foundations. BRUCE S. WOLFF, LL.B., is a partner in the New York and Washington, D.C., offices of the law firm of Proskauer Rose Goetz & Mendelsohn, where he specializes in health care transactional and nonprofit institutional matters. From 1977 through 1979, he was Deputy Assistant Secretary for Legislation at the U.S. Department of Health, Education and Welfare and Special Assistant to the Secretary. He is a Past Chairman of the Committee on Medicine and Law of the Association of the Bar of the City of New York and of the Citizens Advisory Committee to the Medicaid Program of the District of Columbia. He is a frequent speaker on health care delivery and public policy matters.

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