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--> Appendix A Biographies of Committee Members and Speakers Saralynn H. Allaire, Sc.D., R.N., C.R.C., is Assistant Research Professor of Medicine, Boston University Arthritis Center. She holds a doctorate in rehabilitation counseling from Boston University in addition to a masters in nursing. Dr. Allaire's scholarly publications have focused on disability associated with rheumatoid arthritis and rehabilitation programs to overcome it. She is a Trustee of the Massachusetts Chapter of the Arthritis Foundation, and sits on the Education and Services Committee of the National Arthritis Foundation and the Medical and Scientific Advisory Board of Scleroderma Federation, Inc. for which she also writes a health information and exchange column. William J. Arnold, M.D., F.A.C.P., has been Chairman of the Department of Medicine at Lutheran General Hospital since 1986. He directs the faculty practice plan for the 100 full-time faculty in the Department of Medicine as well as the overall activities of the Department of Medicine at Lutheran General Hospital. Prior to become Chairman, he was Director of the Section of Rheumatology at Lutheran General Hospital from 1977 to 1986. Dr. Arnold remains a practicing Rheumatologist with clinical and research interests in the application of arthroscopy to the management of patients with arthritis. Dr. Arnold practices in an arthritis center with seven other rheumatologists who are members of a 262-physician multispecialty group, the Advocate Medical Group, S.C. Dr. Arnold is a native Chicago an who received his undergraduate education at the University of Illinois in Champaign-Urbana and went to medical school at the University of Illinois College of Medicine in Chicago. He received his training in Internal Medicine and Rheumatology at Duke
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--> University Medical Center in Durham, North Carolina. Dr. Arnold has been a member of the Board of Governors of the American Board on Internal Medicine and is finishing a six-year term as a representative of the American Board of Internal Medicine on the Residency Review Committee for Internal Medicine. Dr. Arnold has previously been active in the American College of Rheumatology, most recently serving as a member of the Board of Directors. In addition, he serves as a member of the Board of Directors for two large integrated-delivery systems: the Advocate Health Care Network in Oak Brook, Illinois, and the Allina Health System in Minneapolis, Minnesota. Elizabeth M. Badley, Ph.D., is an epidemiologist and health services researcher, who specializes in the epidemiology of chronic and disabling conditions, particularly musculoskeletal disorders. She is currently the Director of the Arthritis Community Research and Evaluation Unit (ACREU), Toronto, Canada. ACREU receives funding from the Ontario Ministry of Health to carry out research in partnership with The Arthritis Society, Ontario Division. She is a senior staff scientist at the Wellesley Hospital Research Institute. She has an appointment as Associate Professor in the Department of Preventive Medicine and Biostatistics at the University of Toronto, with cross-appointments to the Departments of Physical Therapy, Occupational Therapy and Medicine (Division of Rheumatology), University of Toronto. Prior to moving to Canada in 1989, she was Deputy Director of the Arthritis and Rheumatism Council Epidemiology Research Unit, University of Manchester, Manchester, UK. She has published widely on the epidemiology of rheumatic disorders and their impact in the population including use of health service, and on the assessment of impairments, disabilities and handicaps. Her research includes a major population survey, estimating the impact of musculoskeletal disorders through the analysis of large scale data sets, and applied research directed towards the development and evaluation of services for people with arthritis. She is a consultant to the World Health Organization on the classification of disablement, and has served on a number of international, national and local expert panels and committees concerned with health and welfare service delivery and community-based research. Teresa J. Brady, Ph.D., is the Director of Chronic Disease Services for the Fairview Health System in Minneapolis. She is the project director for an internally funded demonstration project: Primary Care/Care Coordinator Partnership in Chronic Disease Management. She has 20 years of experience in health care for individuals with chronic diseases in a variety of roles and settings. Dr. Brady is active with the National Chronic Care Consortium. She is also a member of the Fairview Health System's Care Council, and Chronic Care Systems Committee, two internal groups that are developing the models, protocols, and structures necessary to provide effective and appropriate care to
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--> individuals with chronic disease in the new health care environment. Dr. Brady has a Ph.D. in Psychology from the University of Minnesota and a B.S. in Occupational Therapy from the University of North Dakota. Leigh F. Callahan, Ph.D., is Associate Director of Thurston Arthritis Research Center and is a Research Associate in Rheumatology, and adjunct Assistant Professor of Epidemiology. She joined the School of Medicine faculty of the University of North Carolina at Chapel Hill in September, 1995. Prior to joining the Center, she was the Arthritis Epidemiologist in the Aging Studies Branch at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia for 2 1/2 years. Dr. Callahan received her Ph.D. in Public Policy in 1992 from Vanderbilt University where she was a Research Associate in the Division of Rheumatology since 1981. She is currently the editor of Arthritis Care and Research, the official journal of the Association of Rheumatology Health Professionals (ARHP) and is a former President of the ARHP and sits on several committees for the American College of Rheumatology (ACR). Dr. Callahan presently serves as a of the National Arthritis Foundation and is a member of the Board of Trustees. She has served on numerous National and State committees and boards for the Arthritis Foundation for ten years. Carolyn Clancy, M.D., is a general internist with research interests in the impact of financial incentives on physicians' decisions, womens' health and physicians' use of preventive services. She attended the University of Massachusetts Medical School (M.D., 1979), did a residency in internal medicine at Worcester Memorial Hospital (Massachusetts), and was a Kaiser Fellow in General Internal Medicine at The University of Pennsylvania from 1982–84. From 1984 through 1990 she was an assistant professor in the Department of Medicine at The Medical College of Virginia in Richmond. In November 1990, she came to the Agency for Health Care Policy and Research (AHCPR) in the Division of Primary Care, and is currently Director of the Center for Primary Care Research, as well as Acting Director of the Center for Outcomes and Effectiveness Research. While at AHCPR, she developed the curriculum for the Public Health Service Primary Care Policy Fellowship, for which she has served as Co-director (1992–94) and principal faculty (1992-present), and has published multiple papers on primary care and the effects of financing on access to care. She holds a clinical appointment in the Department of Health Care Sciences at George Washington University. Karen Davis, Ph.D., is president of The Commonwealth Fund, a national philanthropy engaged in independent research on health and social policy issues. Ms. Davis assumed the presidency of the fourth oldest private
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--> foundation in the country on January 1, 1995. Established by Anna M. Harkness in 1918 with the broad charge to enhance the common good, the Fund seeks ways to help Americans live healthy and productive lives, giving special attention to those groups with serious and neglected problems. Karen Davis is a nationally recognized economist, with a distinguished career in public policy and research. Before joining the Fund, she served as chairman of the Department of Health Policy and Management at the School of Hygiene and Public Health at The Johns Hopkins University, and held an appointment as professor of economics. She served as deputy assistant secretary for health policy in the Department of Health and Human Services from 1977 to 1980. and was the first woman to head a U.S. Public Health Service agency. Prior to her government career, Ms. Davis was a senior fellow at the Brookings Institution in Washington, D.C., a Visiting Lecturer at Harvard University, and an assistant professor of economics at Rice University. A native of Oklahoma, she received her doctoral degree in economics from Rice University, which recognized her achievements with a Distinguished Alumna award in 1991. Ms. Davis has published a number of significant books, monographs, and articles on health and social policy issues, including the landmark books, Health Care Cost Containment, Medicare Policy, National Health Insurance. Benefits, Costs, and Consequences, and Health and the War on Poverty: A Ten-Year Appraisal. She is the president of the Association of Health Services Research and a member of the National Academy of Sciences Institute of Medicine, the Kaiser Commission on the Future of Medicaid, and the Comptroller General's Health Advisory Committee, General Accounting Office. She serves on the Board of Directors of the Somatix Therapy Corporation and the Mount Sinai Medical Center. John M. Eisenberg, M.D., M.B.A., is Chairman of the Department of Medicine, Physician-in-Chief, and Anton and Margaret Fuisz Professor of Medicine at Georgetown University Medical Center. Dr. Eisenberg is a graduate of Princeton University (1968) and Washington University School of Medicine, St. Louis (1972). After his residency in Internal Medicine at the Hospital of the University of Pennsylvania, Dr. Eisenberg was a Robert Wood Johnson Foundation Clinical Scholar and earned a Master of Business Administration degree at the Wharton School. He served as Chief of the Division of General Internal Medicine at the University of Pennsylvania from 1978–1992 and was Sol Katz Professor of General Internal Medicine. Dr. Eisenberg was a Commissioner on the Congressional Physician Payment Review Commission from 1986 through 1995 and was Chairman from 1993–1995. He has served in various capacities in the arena of health outcomes and health economics, including: President of the Society for General Internal Medicine, Vice President of the Society of Medical Decision
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--> Making; and the first physician to be elected President of the Association for Health Services Research. He has been elected to a number of honorary societies, including the Institute of Medicine of the National Academy of Sciences, the American Society for Clinical Investigation, and the Association of American Physicians. Since 1992 Dr. Eisenberg has been Program Director of the Robert Wood Johnson Foundation's Generalist Physician Faculty Scholars Program. Dr. Eisenberg is the author of two books and over 200 articles and chapters on topics such as physicians' practices, test use and efficacy, medical education and clinical economics. Alan M. Fogelman, M.D., is the William S. Adams Professor of Medicine and Executive Chairman, Department of Medicine at the University of California, Los Angeles School of Medicine from which he also graduated. He is also the Director of the UCLA Atherosclerosis Research Unit in the UCLA Division of Cardiology. He has served as a member of the NIH Metabolism Study Section and of the NHLBI Program Project Review Committee. He is the Editor of Arteriosclerosis, Thrombosis and Vascular Biology and has served as Editor-in-Chief of the Journal of Lipid Research. He has been a member of the editorial committee of the American Society for Clinical Investigation and served as President of the Western Society of Clinical Investigation. He is a member of the Board of Directors of the American Board of Internal Medicine and a member of the Board of Directors of the Association of Professors of Medicine. Deborah Freund, M.P.H., Ph.D., has served as Vice Chancellor for Academic Affairs at Indiana University Bloomington (IUB) since January, 1994 and Director of The Bowen Research Center since 1990. She received her A.B. in classical languages from Washington University in St. Louis in 1973, plus an M.P.H. in medical care organization in 1975, an M. A. in applied economics in 1975 and a Ph.D. in economics in 1980, all from The University of Michigan. Dr. Freund is the author of two books and over I00 articles and chapters. She has also been the principal investigator or Co-P.I. on $32 million in research grants and has served on many study sections for various agencies and major private foundations. Included was the Patient Outcome Research Team on Knee Arthritis on which she was the principal investigator. She is particularly noted for her research on Medicaid, health care outcomes and pharmaceuticals. She is credited with being one of the founders of the field of pharmacoeconomics. She has been on the editorial board of 9 journals in her fields of health economics and health services research. For her efforts, she has been awarded three research prizes, from the American Public Health Association, The Association of Public Policy Analysis and Management and The Wisconsin Medical Society. Her research
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--> has also resulted in the enactment of public policies in the United States and in Australia. Bradford H. Gray, Ph.D. (Yale University, 1973), is Director of the Institution for Social and Policy Studies and the Program on Non-Profit Organizations at Yale University, and Professor (Adjunct) of Research in Public Health at the Yale School of Medicine. He also holds an appointment in Yale's Department of Sociology. He is author of The Profit Motive and Patient Care: The Changing Accountability of Doctors and Hospitals (Harvard University Press, 1991) and Human Subjects in Medical Experimentation (NY: Wiley, 1975) and editor of The New Health Care for Profit (Washington, National Academy Press, 1983), For-Profit Enterprise in Health Care (Washington, National Academy Press, 1986), and (with Marilyn J. Field) Controlling Costs and Changing Patient Care? The Role of Utilization Management (Washington, National Academy Press, 1989). He came to Yale in 1989 from the Institute of Medicine, National Academy of Sciences, where he was the director and primary author of six major reports. In Washington, he also served on the staffs of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research and the President's Commission for the Study of Ethical Problems in Medicine and Research. He directed national studies of the conduct and regulation of research involving human subjects for both commissions and was also the primary author of reports by both bodies. Prior to going to Washington, he taught at the University of North Carolina at Chapel Hill (1971–1975). He has chaired several committees of the American Sociological Association and the American Public Health Association and serves on the advisory boards of the Bibliography of Bioethics, IRB: A Journal of Human Studies, and Lyceum Books. He has served as a consultant to several governmental agencies, foundations, trade associations, and the National Academy of Sciences. Jerome H. Grossman, M.D., F.A.C.P., is the Chairman and CEO of a newly formed corporation, Health Quality, Inc., and of The Lion Gate Foundation. He is also Professor of Medicine at Tufts University School of Medicine. A graduate of the Massachusetts Institute of Technology in 1961, Dr. Grossman received his M.D. from the University of Pennsylvania School of Medicine in 1965. He joined the staff of Massachusetts General Hospital in 1966, where he served in a variety of positions including Director of Ambulatory Care, Associate Physician, and Assistant Professor of Medicine at Harvard Medical School. From 1979 through 1995, Dr. Grossman served at New England Medical Center as President and subsequently Chairman and Chief Executive Officer, and has recently been elected Chairman Emeritus. Dr. Grossman is known for his leadership in the evolving role of the academic
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--> health center in American medicine. From 1966 to 1972, he was one of the original staff of the Harvard Community Health Plan Health Maintenance Organizational (HMO), where he developed the world's first automated medical record system, known as COSTAR, to support the HMO's patient care and academic missions. In 1981 he was one of the founders of the Tufts Associated Health Plan, a network based IPA HMO. Dr. Grossman has served as Program Director of the Commonwealth Fund Task Force on Academic Health Centers; as an Administrative Board member of the Association of American Medical Colleges and subsequently as chairman of its Council of Teaching Hospitals; and as Chairman of the Academic Medical Center Consortium, a cooperative of twelve leading Academic Medical Centers that pioneered the use of health services research techniques to develop and implement effective and efficient health care delivery strategies. Dr. Grossman founded The Health Institute of New England Medical Center in 1988 for the purpose of expanding the Medical Center's research capacity to include the social sciences as well as natural sciences. The work of The Center involves research and development programs and practical applications in the areas of medical outcomes, functional health status, the organization and operation of the health care system, and the relationship of health status to other non-biological factors in society at large, such as income and education. In recent years, Dr. Grossman has worked to encourage development of strategies to reform the health care system at both the local and national level. In Massachusetts, he is a founding director of the Health Action Forum of Greater Boston, a member of the Health Care Committee of the Massachusetts Business Roundtable, and he served as Co-Chairman of the Health Care Industry Task Force of the Governor's Council on Economic Growth and Technology. He is spending 1996 as a Scholar-in-Residence at the Institute of Medicine studying public policy and lawmaking at the federal level. Bevra H. Hahn, M.D., is Professor of Medicine and Chief of the Division of Rheumatology at the School of Medicine, University of California, Los Angeles, a position she has held since 1983. A summa cum laude graduate of Ohio State University, Dr. Hahn received her medical degree from Johns Hopkins and did an internship and residency in medicine in St. Louis at Barnes Hospital, Washington University. She is a Fellow of the American College of Rheumatology, and is currently serving on its Board of Directors for the second time. She was elected Treasurer of that organization for 1994–95, and President of the Central (1981–83) and Western (1994–95) Regions. Among her many awards are the Dunlop-Dottridge Award of the Canadian Rheumatism Association for research in rheumatology, the Joseph Bunim Medal and Prize of the American College of Rheumatology, the Holley Research prize in Rheumatology, the Southern California Arthritis Foundation's Klinenberg Medal for Arthritis Research, the Carol-Nachman
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--> Award for Rheumatology Research, and the Jane Wyman Humanitarian Award for 1996. Dr. Hahn has authored close to 80 peer-reviewed research papers and over 40 book chapters or reviews as well as serving as co-editor of an influential textbook on lupus erythematosus. She is on the editorial boards of both the Journal of Clinical Investigation and the Annals of Internal Medicine. Her current research on the pathogenesis and treatment of lupus is funded by grants from the National Institutes of Health, Baxter Healthcare Corporation, the Arthritis Foundation (National and Southern California Chapters), and the Lupus Foundation of America, and support from the Bertram Maltz, M.D. Laboratory of Molecular Rheumatology and the Jeramie Dreyfuss Laboratory for Lupus Research at UCLA. William R. Hazzard, M.D., is Director of the J. Paul Sticht Center on Aging at the Bowman Gray School of Medicine of Wake Forest University and Chairman of the Department of Internal Medicine at that institution. A native of Ann Arbor, Michigan and a product of the Ann Arbor public schools, Dr. Hazzard received his undergraduate education at Cornell University and graduated from its medical school in 1962. His postgraduate medical education included a medical internship at the New York Hospital and residency at the University of Washington Affiliated Hospitals in Seattle, where he also completed a fellowship in Endocrinology and Metabolism prior to joining the faculty at that institution (1969–1982). He then moved to Johns Hopkins University Medical School in Baltimore, where he was Associate Director of the Department of Medicine and charter director of the Center on Aging at that institution (1982–1986) prior to moving to Winston-Salem in 1986. Throughout his professional career his enduring intellectual interest has been in issues related to sexual dimorphism, notably in the sex steroid-mediated gender differential in lipoprotein metabolism and cardiovascular disease and, more recently, the sex differential in longevity and the medical and social problems of older persons, notably women. Halsted R. Holman, M.D., is Guggenheim Professor of Medicine at the Stanford University School of Medicine. He served as Chairman of the Department of Medicine for more than a decade, and is now Program Director for the Carnegie-Commonwealth and Robert Wood Johnson Foundation Clinical Scholar Training Program as well as Co-Chief of the Division of Family and Community Medicine. Since 1977 Dr. Holman has also served as Program Director for the Stanford Multi-Purpose Arthritis Center. Among the many awards he has received since receiving his medical degree from Yale have been Kaiser awards for Excellence in Clinical Teaching (from Stanford students) and for outstanding innovative contributions to medicine education (from Stanford School of Medicine faculty). He received the Laureate award
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--> from the Northern California Chapter of the American College of Physicians, and was selected as Master by the American College of Rheumatology and Fellow by the American Association for the Advancement of Science. Formerly president of the Western Association of Physicians and the American Society for Clinical Investigation, he now serves on the Advisory Committee for the Kaiser Health Plan Project on chronic care coordination. Debra R. Lappin, Esq., currently serves as Chair of the National Arthritis Foundation. Over the past decade she has worked with the Arthritis Foundation as Senior Vice Chair, Secretary, and Vice Chair of the Board of Trustees, Chair of the Rocky Mountain Chapter, and in numerous committee positions. Her work, which includes frequent public appearances on behalf of the Foundation, is focused in the areas of public policy and advocacy, research and programs especially as they relate to preserving the quality of life for people with arthritis, and access to care for people with arthritis within changing healthcare systems. Ms. Lappin served as a member of the NIAMS Advisory Council from 1991 to 1995. Professionally, Ms. Lappin has served as a partner with the national law firm of Mayer, Brown & Platt, as General Counsel for the U.S. operations of Dome Petroleum Corp., and as an associate with the Denver law firm, Dufford and Brown. Her professional and civic activities have included membership in the American Arbitration Association, the Board of Governors of the Colorado Bar Association, the Board of Advisors of the National Center for preventive Law, and the Colorado Association of Commerce and Industry, Blueprint for Colorado, Health Care Task Force. Norman G. Levinsky, M.D., is Chairman of the Department of Medicine at Boston University Medical Center and serves as Chief of Medicine both at Boston City Hospital and at the Boston University Medical Center Hospital. A graduate of Harvard College and Harvard Medical School, he received postgraduate training in internal medicine at Beth Israel Hospital. He served as a fellow in renal physiology in the laboratory of Robert W. Berliner at the National Institutes of Health, and as a fellow in nephrology at Boston University Medical Center under Dr. Arnold S. Relman. Dr. Levinsky's initial academic pursuits were in clinical nephrology and renal physiology. He has published research and clinical studies of the regulation of sodium excretion in the kidney, the concentration of the urine, and acute renal failure. In addition, Dr. Levinsky has published numerous book chapters and reviews in these and other scientific and clinical areas. During much of this period in his career, Dr. Levinsky served as Chief of the Renal Section at Boston University Medical Center. In 1968 Dr. Levinsky became Chief of the Boston University Medical Service at Boston City Hospital and in 1972 was appointed Wade Professor and Chairman of the Department of Medicine at Boston University
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--> and Chief of Medicine at University Hospital. Under his leadership, the Department of Medicine has greatly expanded in size, has established an outstanding medical residency program, and maintains a vigorous research program which involves specialized research departments both at Boston University Medical Center and Boston City Hospitals. Dr. Levinsky's recent academic interests include medical ethics, rationing, and medical education. He has written numerous articles in these areas and has appeared on regional and national panels and programs discussing these issues. From 1988 to 1990 he served as Chairman of the Institute of Medicine's Committee to Study the Medicare End-Stage Renal Disease Program. He is currently serving as Chair of the Institute of Medicine's Committee on Xenotransplantation: Ethical Issues and Public Policy. Dr. Levinsky is a member of numerous academic societies, including the American Society for Clinical Investigation, the American College of Physicians, and the Association of American Physicians. He has served as secretary-treasurer and president of the Association of Professors of Medicine. He has been awarded a Mastership of the American College of Physicians and in 1992 received its Distinguished Teacher Award. Dr. Levinsky lives in Newton, Massachusetts with his wife. They are the parents of three children. Matthew H. Liang, M.D., M.P.H., is Professor of Medicine at Harvard Medical School and Professor of Health Policy and Management at the Harvard School of Public Health. He is the Director of the Robert B. Brigham Multipurpose Arthritis and Musculoskeletal Diseases Center at the Brigham and Women's Hospital, a multidisciplinary research group performing studies on outcome, technology assessment, clinical decision making, clinimetrics, and the epidemiology of rheumatic disease disability and modifiable risk factors for high risk populations with rheumatic and musculoskeletal diseases. He is an Attending Physician in the Division of General Medicine and the Division of Rheumatology and Immunology at the Brigham and Women's Hospital, the Medical Director of Rehabilitation Services at Brigham and Women's Hospital, and the Medical Director of the Mariner at Longwood Subacute Rehabilitation Center in Boston. He is one of the principal faculty of the Clinical Effectiveness Program at the Harvard School of Public Health which teaches clinical research methods to clinician scientists and runs the clinical research training program in the Division of Rheumatology and Immunology and has trained over 30 individuals ranging from Instructor to Professor. Dr. Liang has served on a number of national committees for the Arthritis Foundation, the National Institutes of Health, the VA Hospitals, the Canadian Arthritis Society. He is on the Editorial Boards of a number of publications and a member of the Board of the Medical Foundation and the Arthritis Foundation. He directed the development of the guidelines for arthritis and musculoskeletal diseases and served on committees which developed the guidelines on low back pain
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--> and whiplash injuries. Dr. Liang is a graduate of Johns Hopkins University, Harvard Medical School, and Harvard School of Public Health. He has authored over 200 publications. Larry M. Manheim, Ph.D., is Acting Director of the Program in Health Care Financing at the Institute for Health Services Research and Policy Studies, Northwestern University, and Research Scientist at the Veterans Administrations Midwest Center for Health Services and Policy Research. After earning his doctorate in economics at the University of California, Berkeley, Dr. Manheim held positions with Mathematics Policy Research, Inc. with the Civil Aeronautics Board, and with the Interstate Commerce Commission before coming to Northwestern. He has been principal investigator on numerous grants from private and public sources, including a feasibility grant to survey rheumatologists on imports of HMOs on rheumatology practice. His publications include a wide variety of topics related to hospital costs and the organization and delivery of health care. Michael R. McGarvey, M.D., is Senior Vice President of Health Industry Services for Blue Cross and Blue Shield of New Jersey, Inc., the state's largest health insurer providing coverage for more than 2 million people. As Senior Vice President, Dr. McGarvey is responsible for all aspects of BCBSNJ's managed care operations in New Jersey, as well as market research, product development, provider relations and health care management. Dr. McGarvey has more than 25 years of experience in health care delivery and administration. Before joining BCBSNJ he was Managing Director of Health strategies for Alexander & Alexander Consulting Group, a leading international human resources and benefits consulting organization. Previously, he was an executive with Empire Blue Cross and Blue Shield, New York, first as Vice President of Health Services Management, then as Corporate Vice President of Health Affairs. He is a former Chief Medical Officer and Deputy Director for the New York State Department of Health's Office of Health Systems Management, and a former Vice President for Health Affairs and Professor of Health Sciences at Hunter College of the City University of New York. Dr. McGarvey is a Trustee of the New York Academy of Medicine, and a Director of the New York County Society of Internal Medicine and the American Medical Review Research Center. Dr. McGarvey received his medical degree from the University of Southern California School of Medicine. He is licensed to practice medicine in New York and California. Robert E. Mechanic, M.B.A., is a Senior Manager at Lewin-VHI where he specializes in health care financing and reimbursement. Mr. Mechanic manages the firm's analytic modeling of hospital capacity, reimbursement and financial performance and has conducted a series of studies on the impact of
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--> health care reform and managed care on academic medical centers. He has conducted a wide range of strategic planning studies for health care providers, insurers, government agencies, foundations, and associations. In work with the American College of Rheumatology, Mr. Mechanic prepared a managed care monograph for rheumatologists and a computer model to project future work force supply and demand. He has assisted government agencies and special commissions in the design and analysis of health care reform proposals at the national level and in a variety of states including Utah, North Carolina, Maryland, Delaware and West Virginia. Mr. Mechanic has worked with over a dozen states on Medicaid financing and reimbursement policy and has conducted numerous studies of federal health care programs including the Federal Employees Health Benefits Program (FEHBP) and Medicare's hospital prospective payment system (PPS). Prior to joining Lewin-VHI, Mr. Mechanic was an analyst at the Congressional Budget Office. He holds an M.B.A. in finance from the Wharton School at the University of Pennsylvania and a B.S. in Economics with distinction from the University of Wisconsin. Robert F. Meenan, M.D., M.P.H., M.B.A., is the Director of the Boston University School of Public Health. He also serves as Chairman of the Department of Socio-Medical Sciences and Community Medicine, Associate Dean for Public Health, and Professor of Medicine and Public Health at Boston University School of Medicine. Dr. Meenan is a graduate of Harvard College, Boston University School of Medicine, the School of Public Health at the University of California, Berkeley (M.P.H. in Health Planning and Administration), and the Graduate School of Management at Boston University (M.B.A. in Health Care Management). He trained in Internal Medicine at Boston City Hospital and in Rheumatology at the University of California, San Francisco. He is a member of the American Society for Clinical Investigation, a past president of the American College of Rheumatology, and a member of the Board of Trustees of the Arthritis Foundation at both the national and state levels. Dr. Meenan's research interests focus on outcome measurement and health economics as they relate to rheumatic diseases. Robert J. Newcomer, Ph.D., is Professor and Chair of the Medical Sociology program at the School of Nursing, University of California, San Francisco and a faculty member in the Institute for Health & Aging. He earned a masters in city planning from the University of Southern California in 1971 and completed a Ph.D. there in 1975. He joined the research faculty at the University of California, San Francisco in the fall of 1976 where he later directed an extensive study of state, area, and community agency programs on aging. Dr. Newcomer then directed the National Policy Center on Health, a center grant providing technical assistance to the Administration on Aging and the network of state and area agencies. During the past 10 years he has been
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--> involved in studies and consultation with managed care systems, both as an evaluator of program performance (including patient surveys, administrative data systems, Medicare claims systems), and in the formulation of delivery models for the high risk plan members. His current work includes the development of a framework for chronic care monitoring and high risk patient identification in managed health plans. As part of this work, he was the principal investigator of the Social Health Maintenance Organization (S/HMO) Demonstration evaluation, a five year evaluation funded by the Health Care Financing Administration that involved a 36-month longitudinal analysis of Medicare Part A and B claims data, collection of primary data on health status, service use, health plan choice, and health care satisfaction, and case study analyses of four project sites. Dr. Newcomer and his team are now collaborating with the University of Minnesota in the design and implementation of the second generation of the S/HMO. Dr. Newcomer has concurrently (1989–1996) directed a five year evaluation and technical assistance project involving Medicare reimbursement for case management and home care benefits to persons with dementia, and he has recently completed a three year project for the Robert Wood Johnson Foundation examining potential indicators and data sources for tracking the service needs, use, and processes of care for those with chronic health conditions. Dr. Newcomer has published more than 60 articles and book chapters and seven books, including Indicators of Chronic Health Conditions: Monitoring Community-Level Delivery Systems (with A.E. Benjamin), which will be published by the Johns Hopkins University Press in 1997, and Managed Care and Quality Assurance: Integrating Acute and Chronic Care (with Anne Wilkinson), published in 1996 by Springer Publications. Mark Robbins, M.D., M.P.H., has been practicing rheumatology within the staff model of Harvard Community Health Plan, now the mixed IPA, group, and staff model Harvard Pilgrim Health Care with 1.2 million members. Elected by his 600 physician peers, he serves on the Physician's Council of the HPHC Health Centers Division. During this time he has also been involved in health services research and consulting for a Boston-based public health consulting firm called John Snow, Inc. He has worked for state primary care associations around issues of community and migrant health centers market position and ability to deliver managed care. He is currently working on two Robert Wood Johnson studies of managed care. This first study benchmarks the most innovative practices of large employers and business coalitions in evaluating and purchasing health care services in four distinct health care markets (Boston, San Francisco, Orlando, Minneapolis) and their impact on managed care organizations. The second study for the State of Florida, Agency for Health Care Administration, is an organizational assessment of
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--> evolving managed care and alternative integrated delivery systems (PHOs) across the state. He has recently participated in the American College of Rheumatology's ad hoc committee on clinical guidelines for rheumatoid arthritis and the consensus panel on Manpower Planning for Rheumatology through 2010. Naomi Rothfield, M.D., has been Chief of the Division of Rheumatic Diseases at the University of Connecticut School of Medicine since 1972. She directs a faculty of 12 physicians and basic scientists who carry out basic and clinical research and a busy rheumatology clinical practice with daily outpatient sessions. The Division also is responsible for the teaching of nearly 50 medical and orthopedic residents in addition to providing teaching for medical students. She has been the Director of the NIAMS funded University of Connecticut Arthritis and Musculoskeletal Diseases Center since 1979. Dr. Rothfield graduated from New York University School of Medicine and did her rheumatology fellowship at New York University School of Medicine/Bellevue Hospital under the supervision of Drs. Currier McEwen and Edward S. Franklin and remained there on the faculty until moving to University of Connecticut in 1968. She has published extensively on systemic and cutaneous lupus, and on autoantibodies in various rheumatic diseases. She has served on the Editorial Boards of a number of journals. She has authored more than 200 publications and has served on Study Sections for the NIH, the Arthritis Foundation, and the Veterans Administration. She was selected as a Master by the American College of Rheumatology, and received an Achievement Award from the Afro-American College of Rheumatology . In 1995 she was the recipient of the Solomon A. Berson Alumni Achievement Award in Clinical Science from New York University School of Medicine. She is a member of a number of academic societies including the American Society for Clinical Investigation and the Association of American Physicians. Dr. Rothfield is married to Lawrence Rothfield, M.D., Professor of Microbiology, University of Connecticut School of Medicine. They are the parents of 4 children and have 5 grandchildren. John W. Rowe, M.D., is President of the Mount Sinai School of Medicine and The Mount Sinai Hospital in New York City, where he also serves as a Professor of Medicine and of Geriatrics. Mount Sinai one of the nation's largest academic health science centers, has the only formal medical school department of geriatrics in the United States. The Mount Sinai Health System, one of the nation's largest regional systems, extends throughout the greater metropolitan area and provides an accessible, high-quality integrated network of care. Before joining Mount Sinai in 1988, Dr. Rowe was a Professor of Medicine and the founding Director of the Division on Aging at Harvard Medical School and Chief of Gerontology at Boston's Beth Israel Hospital.
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--> He has authored over 200 scientific publications, mostly in the physiology of the aging process, and a leading textbook of geriatric medicine. Dr. Rowe has received many honors and awards for his research and health policy efforts regarding care of the elderly including the Allied Signal Award in 1995. Dr. Rowe is Director of the MacArthur Foundation Research Network on Successful Aging. He served on the Board of Governors of the American Board of Internal Medicine and is a member of the Institute of Medicine of the National Academy of Sciences. Alvin R. Tarlov, M.D., served for 13 years as Chairman of the Department of Medicine at the University of Chicago, later for seven years as President of the Henry J. Kaiser Family Foundation, and from 1990 through December, 1994 he was the Director of the Division of Health Improvement, The Health Institute, New England Medical Center. He holds professorships at two universities, Tufts and Harvard. Dr. Tarlov's research interests have been in health manpower (Chairman and author of the Graduate Medical Education National Advisory Committee Report), and in measuring the effects of medical services. He was the founder in 1983 of The Medical Outcomes Study and continues actively in analysis and interpretation of the results. He is President of the Medical Outcomes Trust, a non-profit public service organization that is a depository and distributor of high quality standardized questionnaires that measure health-related quality of life. In 1994 Dr. Tarlov became Chairman of the Board and President of the Massachusetts Health Data Consortium. In January, 1995 Dr. Tarlov was named Executive Director of The Health Institute at New England Medical Center. Edward Yelin, Ph.D., is Director of the Education, Epidemiology, and Health Services Research Component of the Multipurpose Arthritis Center at the University of California-San Francisco. He is also a member of the Division of Occupational and Environmental Medicine at UCSF; a member of the faculty of the Institute for Health Policy Studies and the Aging Health Policy Center at UCSF. He received his A.B. in public affairs from the University of Chicago, and his M.C.P. and Ph.D. in City and Regional Planning from the University of California-Berkeley. He is an active member of the Arthritis Foundation, and the American College of Rheumatology.
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Representative terms from entire chapter: