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APPENDIX B Contributors GERARD F. ANDERSON is the director of the Center for Hospital Finance and Management, Johns Hopkins Medical Institutions, co-director of the Program for Medical Technology and Practice Assessment, and an associate professor of health policy and management, Johns Hopkins University. He teaches graduate level courses in international health, statistics, and health care financing in the School of Hygiene and Public Health. Dr. Anderson is currently conducting research on comparative insurance systems in developing countries, medical edu- cation, hospital payment reform, technology diffusion, capital, and capitated sys tems. He has published over 60 articles in the New England Journal of Medicine, Journal of the American Medical Association, Inquiry, Health Affairs, Medical Care, Health Care Financing Review, Review of Economics and Statistics, South- ern Economic Journal and many other journals. Dr. Anderson has recently com- pleted two books on health care payment policy. One book, published by the Johns Hopkins University Press, examines how academic medical centers are being affected by changes in the competitive environment and how they must alter their behavior to cope with changes in the financing for uncompensated care, graduate medical education, biomedical research, and patient care services. A second book, also published by the Johns Hopkins University Press, describes and analyses the impact of the myriad of public and private cost containment efforts launched over the past 15 years and sets forth long range policy proposals for the future. Prior to coming to Johns Hopkins in 1983, Dr. Anderson held various posi- tions in the Office of the Secretary, U.S. Department of Health and Human Ser 206

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CONTRIB UTORS 207 vices. He worked primarily on health care financing issues. One of his major activities was the development of major aspects of the Medicare Prospective Payment legislation. RUTH E. BROWN is a research associate with Battelle's Medical Technology and Policy Research Center, Washington, D.C. office. She holds master's de- grees in microbiology and health policy and planning and has had more than 14 years experience in the biomedical/health fields. At Battelle, she has been the principal investigator for several projects and has had considerable experience in managing clinical studies. She has participated in studies of chronic mental disease outcomes and evaluations of quality of life for AIDS, cancer and renal dialysis patients. She has directed studies of cost-effectiveness to prevent such diseases as Hepatitis B and childhood diseases and directed health policy projects related to reimbursement criteria for off-label and immunosuppressive drugs, developing options for reducing the volume of unnecessary services provided to Medicare beneficiaries, and analyzing the utilization of technology assessment in decision-making by health care providers and payers. She is co-author of papers appearing in Hospital and Community Psychiatry, Quality Review Bulletin, Qual- ity of Life Research, Journal of Clinical Epidemiology, Morbidity and Mortality Weekly Report, and Post Marketing Surveillance. Before coming to Battelle, Ms. Brown was a researcher at the Walter Reed Army Institute of Research. KATHLEEN A. BUTO, in her current position, directs the policy development bureau of the Health Care Financing Administration. Her organization's respon- sibilities span a wide range of Medicare coverage, payment, and eligibility policy issues. These include developing Prospective Payment System rates for hospi- tals, physician fee schedules, Medicare coverage rules for technologies and pro- cedures, and conditions of participation for hospitals, nursing homes and home health agencies. Ms. Buto has held positions in the Health Care Financing Ad- ministration since 1982. From 1976-1982, she served on the immediate staff of three Secretaries of the Department of Health and Human Services and with the Public Health Service's Review Panel on New Drug Evaluation. She holds a B.A. in American Studies from Douglass College and an M.P.A. from Harvard University. HOLLY V. DAWKINS is a research assistant in the Divisions of Health Care Services and of Biobehavioral Sciences and Mental Disorders at the Institute of Medicine. Since joining the Institute of Medicine in June 1988, she has worked on over a dozen IOM projects, ranging from the IOM program on technological innovation in medicine to two studies evaluating the development and use of clinical practice guidelines. Current studies she is working on address substance abuse and mental health issues in federal AIDS research; the Health Care Financ- ing Administration's evaluation of its peer review organization program; and

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208 CONTRIB UTORS preventing nicotine dependency in children and youths. In 1991, she received the Institute of Medicine staff award for her work on the Institute of Medicine study to evaluate the artificial heart program of the National Heart, Lung, and Blood Institute. Holly earned her A.B. with honors in English from Brown University in 1986. A. MARK FENDRICK is an assistant professor of internal medicine and an assistant professor of health services management and policy at the University of Michigan. Dr. Fendrick's research focuses on the economic assessment of medi- cal interventions with special attention to the study of the diffusion of emerging technologies. He completed his bachelor's degree in health economics and chem- istry with highest honors from the University of Pennsylvania and received his medical education at Harvard University. He interrupted medical school for one year to be a Charles A. Dana Foundation research scholar at the University of Pennsylvania School of Medicine, where he received training in clinical research methodology, computer sciences, and health care policy. Dr. Fendrick complet- ed his residency in internal medicine at the Hospital of the University of Pennsyl- vania. Immediately following his residency, Dr. Fendrick spent a year as a visiting scholar divided between the Swedish Council for Medical Technology Assessment and the Ecole Polytechnique in Paris, where he studied issues related to the diffusion and policy impact of medical innovation. Upon return, Dr. Fen- drick spent two years as a Robert Wood Johnson Clinical Scholar, where he completed his postgraduate training in health services research, medical technol- ogy diffusion, and physician decisionmaking. SUSAN BARTLETT FOOTE was formerly an associate professor of business and public policy at the Walter A. Haas School of Business, University of Cali- fornia, Berkeley. She is now senior health policy advisor to Senator Dave Du- renberger (R-MN); Senator Durenberger serves both on the Senate Finance and Senator Labor Committees. Ms. Foote has responsibility for issues of health reform and medical technology that are within the committees' jurisdiction. She has written widely in the field of safety regulation and business-government relations, with a special emphasis on medical devices. Ms. Foote's work has appeared in the Journal of Health Policy, Politics and Law, Milbank Quarterly, and numerous law and business journals. Her book on the influence of public policy on medical device innovation, Managing the Medical Arms Race, was published by the University of California Press in 1992. Ms. Foote is a member of the Institute of Medicine (IOM) Committee on Technological Innovation in Medicine and served on the IOM Forum on Drug Development. She served as a consumer representative for the Office of Device Evaluation at the Food and Drug Administration and contributed to reports of the Office of Technology As- sessment of the U.S. Congress. She holds a J.D. degree from Boalt Hall, Univer

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CONTRIB UTORS 209 sity of California, Berkeley. In 1990-1991, she was a Robert Wood Johnson health policy fellow working on issues of medical technology in the U.S. Senate. ALAN M. GARBER is an associate professor in the Departments of Medicine, Economics, and Health Research and Policy at Stanford University. He is also a staff physician and health services research and development senior research associate of the Department of Veterans Affairs, and research associate and di- rector, Health Care Program, of the National Bureau of Economic Research, Inc. (NBER). He graduated from Harvard College summa cum laude, and received his Ph.D. in economics from Harvard and an M.D. with research honors from Stanford. His fellowships and awards include a National Science Foundation Graduate Fellowship, Christopher Walker Research Fellowship, John Harvard Scholarship, Henry J. Kaiser Family Foundation Faculty Scholarship in General Internal Medicine, and the Young Investigator Award of the Association for Health Services Research. He has served as a consultant to the Institute of Medicine, the Office of Technology Assessment, and the Clinical Efficacy As- sessment Project of the American College of Physicians, and is a member of the Blue Cross and Blue Shield Association Medical Advisory Panel. He is a fellow of the American College of Physicians and a National Councillor of the Ameri- can Federation for Clinical Research. Dr. Garber's research is directed toward methods for improving health care while limiting its costs. It includes two complementary areas: developing meth- ods for determining the cost-effectiveness of health interventions and structuring incentives to ensure that cost-effective care is actually delivered. His ongoing research includes both methodological and applied work in cost-effectiveness analysis in health care, studies of the role of financial incentives in the utilization of hospital and nursing home care among the elderly, projections of health ex- penditures, and international comparisons of health care financing and health outcomes. ANNETINE C. GELI,INS is associate director, The Habif Center for Surgical Studies, and assistant professor, the Department of Surgery and the School of Public Health, Columbia University. Prior to joining the Columbia faculty, Dr. Gelijns was director of the Program on Technological Innovation in Medicine at the Institute of Medicine (IOM) and editor of the series Medical Innovation at the Crossroads. Before joining the IOM, she was senior researcher for the Project on Future Health Care Technology, in The Hague, The Netherlands, which was cospon- sored by the European office of the World Health Organization (WHO) and the Dutch government. From 1983 to 1985, Dr. Gelijns worked for the Steering Committee on Future Health Scenarios, where she helped develop models for long-term health planning in the areas of cancer, cardiovascular disease, and

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210 CONTRIB UTORS aging; she also had a joint appointment to the Staff Bureau for Health Policy Development, Department of Health, the Netherlands. Dr. Gelijns has been a consultant to various national and international orga- nizations, including the WHO and the Organization for Economic Cooperation and Development. She is an officer of the board of the International Society on Technology Assessment in Health Care. Her research focuses on the factors shaping the rate and direction of medical innovation, as well as on the economic assessment of surgical interventions. She received the LL.M. degree from the University of Leyden and her Ph.D. from the University of Amsterdam. SUSAN GLEESON is the executive director of Medical and Quality Manage- ment for the Blue Cross and Blue Shield (BCBS) Association. In this capacity Ms. Gleeson is responsible for two technology evaluation programs: the Medical Necessity Program and the Technology Evaluation and Coverage Program. Both programs determine the appropriate uses of technologies. Program information is used by Blue Cross and Blue Shield Plans for coverage decisions, utilization review activities, and monitoring quality. Ms. Gleeson is director of the Association's recently created Center for Qual- ity Healthcare. In this capacity she is responsible for coordinating the develop- ment of programs that support BCBS Plans' activities to assess, monitor, and promote quality care for their subscribers. The Center also sponsors demonstra- tion projects to evaluate new quality management approaches. Ms. Gleeson joined the Association in 1977 and she has been responsible for technology management programs since 1980. Prior to joining the Association, Ms. Gleeson was active in health care delivery and administration. PAUL D. LAIRSON is the former central office physician liaison of the Perma- nente Medical Groups; he had held that position since October 1981. Dr. Lairson received both his B.A. and M.D. degrees from the University of Michigan. He joined Kaiser Permanente in 1966 as an internist in the Northwest Region, later holding positions of medical director of the extended care facility, director of a medical office, and associate regional medical director. From 1975 to 1977, Dr. Lairson served as medical director of the Georgetown University Community Health Plan. In 1978, he helped organize the Kaiser/Prudential Health Plan and the Permanente Medical Association of Texas in Dallas, and the next year be- came the medical director there. In 1981, he moved to Oakland as the medical advisor to Kaiser Permanente Advisory Services and physician liaison in the Central Office. Dr. Lairson served as the liaison between the medical directors and the cen- tral office and was the director of the Permanente Medical Groups Interregional Services. He also served as chair of the Interregional New Technologies Com- mittee, Garfield Memorial Fund Committee, Interregional AIDS Committee, In

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CONTRIB UTORS 211 terregional Committee on Aging, and Interregional Quality Assurance Commit tee. GERALD D. LAUBACH holds a B.A. from the University of Pennsylvania and a Ph.D. in organic chemistry from the Massachusetts Institute of Technology. He is formerly president of Pfizer, Inc., and chair of the IOM Committee on Techno- logical Innovation in Medicine. Dr. Laubach is a research chemist by training and served as a laboratory scientist in his early years at Pfizer. He is a member of the Institute of Medicine and the National Academy of Engineering, and served on the now disbanded IOM Council on Health Care Technology. His current activities also include membership on the executive committee of the Council on Competitiveness (successor group to the President's Commission on Industrial Competitiveness), the board of the Food and Drug Law Institute, the Corporation of the Rockefeller University Council, the Carnegie Institution of Washington, the National Committee for Quality Health Care, the Medical Center Advisory Board, the New York Hospital-Cornell Medical Center, and the Corporation Committee for Sponsored Research at the Massachusetts Institute of Technolo- gy; he is a director of CIGNA Corporation of Philadelphia and the Millpore Corporation of Bedford, Massachusetts. Previously, Dr. Laubach served as chair of the Pharmaceutical Manufacturers Association from 1977 to 1978 and as a board member until April 1989. He has received honorary doctorates in humane letters from the City University of New York, in law from Connecticut College, and in science from lIofstra University. LUCIAN L. LEAPE is a graduate of Cornell University and Harvard Medical School. Following his residencies in surgery at the Massachusetts General Hos- pital and pediatric surgery at Boston Childrens Hospital, he spent a year as a pediatric surgical registrar at the Alder Hey Hospital in England. He then joined the faculty of the University of Kansas School of Medicine, where he was ap- pointed a Markle Scholar. In 1973, Dr. Leape was appointed professor of sur- gery at Tufts University School of Medicine and chief of pediatric surgery at the New England Medical Center Hospital. In 1986-87, he spent a year as a Pew health policy fellow at the RAND/UCLA Center for Health Policy Study, and then joined the faculty of the Harvard School of Public Health, where he is currently lecturer on health policy in the Department of Health Policy and Man- agement. He is also a consultant at RAND. While an academic surgeon, Dr. Leape pursued research interests in burns, lye injury, parenteral nutrition, gastroesophageal reflex, Wilms' tumor, and lap- aroscopy in children. He chaired the organizing committee that founded the American Pediatric Surgical Association, and organized the Kiwanis Pediatric Trauma Center at New England Medical Center. Recent work has focused on unnecessary surgery, the assessment of quality of health care, development of practice guidelines, and the prevention of injury. At RAND, he has been co-PI of

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212 CONTRIB UTORS the RAND/Academic Medical Center Consortium Appropriateness Initiative. At Harvard, he has participated in the medical practice study of malpractice and the resource based relative value study. Dr. Leape is a member of Alpha Omega Alpha, Sigma Xi, and numerous professional societies. He is the author of over 100 original papers, 25 book chapters, and a textbook of pediatric surgery. He recently served on the AHCPR Health Services Research Review Committee and is a member of the Institute of Medicine Committee on Technological Innovation in Medicine. BRYAN R. LUCK is a senior research scientist and director of Battelle's Center for Public Health Research and Evaluations (CPHRE) at Arlington, Virginia. As director, Dr. Luce is responsible for numerous research projects for both govern- ment and industrial clients and is principal investigator for a large multi-year economic research support contract with the Centers for Disease Control and a research center for the Health Care Financing Administration, as well as a num- ber of other health policy and cost-effectiveness studies. He is also responsible for the MEDTAP Europe office located in London. Before coming to Battelle, Dr. Luce was director of the Office of Research and Demonstration, Health Care Financing Administration. Earlier, he worked as senior analyst in the Office of Technology Assessment of the U.S. Congress. Dr. Luce has co-authored three textbooks in health economic methodology and technology assessment, and has published articles in a number of scientific health-related journals. Dr. Luce has adjunct appointments with Georgetown University Medical School and the George Washington University. He is also a lieutenant colonel in the Medical Service Corps, U.S. Army Reserves. He did his undergraduate and master's training at the Universities of Vermont and Massachusetts and his doctoral train- ing at the University of California, Los Angeles. ANN K. M. MARSHALL is director, Product Planning, Abbott International. In this capacity, she is responsible for commercial and strategic assessment of Abbott's developmental products for major overseas markets. Previously, Ms. Marshall was manager, Corporate Strategic Planning, at Abbott Laboratories, a role in which she managed a range of strategic issues and assessed business and technology acquisition opportunities. Prior to joining Abbott, Ms. Marshall was a management consultant at KPMG Peat Marwick, where she specialized in stra- tegic planning and financial management consulting. Before that, she was a faculty lecturer at the University of Michigan, as well as director and founder of REALM, Inc., a diversified educational services firm. Ms. Marshall did her undergraduate training at Syracuse University and the University of London, U.K. She received her Ph.D. in philosophy and her M.B.A., concentrating in finance and corporate strategy, from the University of Michigan. WILLIAM T. McGI\TNEY is vice president, Clinical Evaluation and Research,

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CONTRIBUTORS 213 for JEtna Health Plans. This unit is responsible for evaluating medical technolo- gies, developing clinical guidelines, and establishing coverage policy. Prior to joining JEtna in June of 1991, Bill spent 10 years with the American Medical Association, most recently serving as director of the Division of Health Care Technology. Bill received his Ph.D. in pharmacology from the University of North Caro- lina Medical School and then completed a postdoctoral fellowship in the Depart- ment of Psychiatry at Harvard Medical School. He is a nationally recognized expert in the area of drug and device regulation and coverage and reimbursement policy. In 1989, he was recognized for this expertise and his contributions to drug and device policy development with the Food and Drug Administration Commissioner's Medal of Appreciation. Bill has served on numerous national committees including the board of directors of the United Network for Organ Transplantation, the nation's transplant policy board. LEE N. NEWCOMER is vice president, Health Services Operations, for United HealthCare Corporation. His responsibilities for the company include develop- ment of technology assessments and medical guidelines, oversight of medical policy for the company's health plans and specialty companies, and assisting with health services research within the organization. Dr. Newcomer received his medical degree in 1976 from the University of Nebraska College of Medi- cine. He completed a residency in internal medicine at the same institution in 1979. He was a fellow in medical oncology at Yale University until 1981. Dr. Newcomer practiced as a medical oncologist for nine years and he is board certi- fied in both internal medicine and medical oncology. Following completion of a master's degree in health administration from the University of Wisconsin in 1990 he joined United HealthCare Corporation as their national medical director in 1991. Dr. Newcomer has published several articles about medical policy and medical oncology in the medical literature and the lay press. DOUGLAS K. OWENS is a health services research and development service research associate at the Department of Veterans Affairs Medical Center, Palo Alto, and an assistant professor of medicine and an assistant professor of health research and policy at Stanford University. He received a bachelor of science in biology from Stanford University in 1978, and subsequently attended medical school at the University of California, San Francisco. He completed residency training in internal medicine at the University of Pennsylvania, followed by a postdoctoral research fellowship in Health Care Research and Health Policy at Stanford University. In 1991 he received a master of science degree in health services research from Stanford. Dr. Owens is interested in technology assessment and the application of decision theory to clinical and health policy problems. His research focuses on assessment of diagnostic and screening strategies, as well as related policy ques

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214 CONTRIB UTORS lions. He has a particular interest in policy questions related to disease caused by the human immunodeficiency virus, and is currently studying screening and oth- er interventions designed to reduce transmission of HIV infection. He also is developing methods for producing normative model-based practice and screen- ing guidelines. J. SANFORD SCHWARTZ is associate professor of medicine and senior schol- ar in clinical epidemiology in the School of Medicine, associate professor of health care systems in the Wharton School, Robert D. Filers professor of health management and economics, and executive director of the Leonard Davis Insti- tute, the University of Pennsylvania's multidisciplinary center for health policy and health services research. Sandy graduated from the University of Rochester with an A.B. in history and received his M.D. degree from the University of Pennsylvania. Following a residency in internal medicine at the Hospital of the University of Pennsylvania, he was a Robert Wood Johnson Foundation clinical scholar, during which he completed the M.B.A. program in health care adminis- tration at the Wharton School of the University of Pennsylvania and obtained additional formal training in biostatistics, epidemiology, legal aspects of health care, and public policy of health care at the Schools of Law and Public Policy at the University of Pennsylvania. Following completion of his fellowship in 1977, Sandy joined the faculty in the School of Medicine at the University of Pennsylvania. The focus of Sandy's research has been the evaluation of medical practices and medical decisionmak- ing, including evaluating the tradeoffs among cost, quality, and outcomes in health care, and optimizing the value of clinical information. His work in these areas has been widely published in clinical and health services research journals, as well as in text- and other books. Sandy has received fellowship awards from the U.S. Public Health Service, the Hospital and Research Educational Trust, the American College of Physicians, and the W.K. Kellogg Foundation. His re- search has been supported by the National Center for Health Services Research, Agency for Health Care Policy and Research, National Institutes of Health, Na- tional Library of Medicine, Centers for Disease Control, Health Care Financing Administration, Henry J. Kaiser Family Foundation, John A. Hartford Founda- tion, Robert Wood Johnson Foundation, W.K. Kellogg Foundation, and several pharmaceutical and medical device manufacturers. In 1981, Sandy developed and then served as the first director of the American College of Physicians' Clinical Efficacy Assessment Project. He has been an advisor and consultant to a wide variety of government and private sector groups, including the Centers for Disease Control, Department of Defense, Health Care Financing Administration, Institute of Medicine, National Institutes of Health, U.S. Congress Office of Technology Assessment, U.S. Pre- ventive Services Task Force, Veterans Administration, World Health Organiza- tion, Blue Cross and Blue Shield Associations of America, the John A. Hartford,

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CONTRIB UTORS 215 Henry J. Kaiser, Robert Wood Johnson and W.K. Kellogg Foundations, and a broad range of pharmaceutical, medical technology and health care delivery cor- porations. Sandy is a member of the Health Services Research Study Section of the Agency for Health Care Policy and Research, the editorial board of the Jour- nal of General Internal Medicine, and a former member of the editorial board of Medical Decision Making. Sandy has held a variety of leadership positions in academic and research societies. He is past president and member of the board of trustees and former Eastern section chair of the American Federation for Clinical Research, a member of the Council of Academic Societies of the Association of American Medical Colleges, chair of the Technology Assessment Committee of the Society for General Internal Medicine, and former president of the Society for Medical Decision Making. EARL P. STEINBERG is professor of medicine at the Johns Hopkins School of Medicine with a joint faculty appointment in the Department of Health Policy and Management at the Johns Hopkins School of Hygiene and Public Health. Dr. Steinberg is also director of the Johns Hopkins Program for Medical Tech- nology and Practice Assessment, a member of National Blue Cross/Blue Shield's Medical Advisory Panel, and a member of the federal Physician Payment Review Commission. His research focuses on technology assessment, the cost and effec- tiveness of alternative patterns of medical practice, evaluation of the quality of medical care, and the clinical and economic impacts of health care payment . . Innovations. Dr. Steinberg received his A.B. degree from Harvard College, his M.D. from Harvard Medical School, and a master of public policy degree from the Kennedy School of Government at Harvard. His residency training in internal medicine was performed at the Massachusetts General Hospital. Dr. Steinberg has received numerous awards, including the A.B. degree sum- ma cum laude. In July 1984, Dr. Steinberg received a Henry J. Kaiser Family Foundation faculty scholar award in general internal medicine, an award given "to support exceptionally talented young faculty in general internal medicine," and in 1988 Dr. Steinberg received the Outstanding Young Investigator Award from the Association for Health Services Research. BURTON A. WEISBROD is Johns Evans professor of economics and director of Northwestern University's Center for Urban Affairs and Policy Research. He was, until July, 1990, Evjue-Bascom professor of economics at the University of Wisconsin, where he had been on the faculty since 1964, and where he had founded and directed the Center for Health Economics and Law. He was born in Chicago, receiving his undergraduate degree in management from the University of Illinois, and his M.A. and Ph.D. degrees in economics from Northwestern University. Professor Weisbrod has held visiting faculty appointments at Bran- deis, Harvard, Princeton, and Yale Universities, and abroad at the Australian

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216 National University and the Un CONTRIB UTORS iversity Autonoma de Madrid, in addition to be- ing a senior staff member of the Council of Economic Advisers to Presidents John F. Kennedy and Lyndon B. Johnson. Professor Weisbrod's elected positions include: fellow of the American Association for the Advancement of Science, member of the Institute of Medi- cine of the National Academy of Sciences, member of the executive committee of the American Economic Association and president of the Midwest Economic Association. He is the author or co-author of 9 books, editor of 4, and author of more than 100 articles in professional journals and books. His research has focused on public policy analysis in the areas of economics of education, health, medical research, manpower, public interest law, the military draft, benefit-cost analysis and, most recently, philanthropy, voluntarism, and the nonprofit sector. In addition to consulting widely for governments, foundations, nonprofit organi- zations, and private firms in the United States, Europe, and Asia, Professor Weis- brod has also served on numerous national and international study and confer- ence committees, and has been on the editorial boards of six journals. His biography is listed in such publications as Who's Who in Science, Who's Who in U.S. Writers, Editors and Poets, Who's Who in America, and Who's Who in the World.