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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
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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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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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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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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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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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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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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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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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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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National University and the Un
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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.
Representative terms from entire chapter:
care financing
