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Suggested Citation:"Appendix B: Committee Biosketches." National Academies of Sciences, Engineering, and Medicine. 2016. Accounting for Social Risk Factors in Medicare Payment: Criteria, Factors, and Methods. Washington, DC: The National Academies Press. doi: 10.17226/23513.
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Appendix B

Committee Biosketches

Donald M. Steinwachs, Ph.D. (Chair), is a professor in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. He is active in the Center for Health Services and Outcomes Research, previously named the Health Services Research and Development Center, where he served as director for many years. His research spans the design and application of health information systems for evaluation and management, development of classification systems and modeling tools, and research on the impact of organization, financing, and quality of care on outcomes for persons with chronic diseases. Dr. Steinwachs was a co-developer of the widely used ACG (Adjusted Clinical Groups) case-mix adjustment and co-developer of the Johns Hopkins HaH (Hospital at Home). He developed methods for measuring provider continuity, needs and unmet needs for care, and measures of the timeliness of care. He was president of the Association for Health Services Research (now AcademyHealth) and received the 2013 Distinguished Research Award from AcademyHealth. He currently serves on the National Research Advisory Council of the Department of Veterans Affairs. He served on numerous committees of the National Academies of Sciences, Engineering, and Medicine, including the Board on Health Care Services and the Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care. He holds a Ph.D. from Johns Hopkins University and is an elected member of the National Academy of Medicine.

John Z. Ayanian, M.D., M.P.P., is director of the Institute for Healthcare Policy and Innovation, the Alice Hamilton Professor of Medicine at the School of Medicine, professor of health management and policy at the School of Public Health, and professor of public policy at the Ford School of Public Policy, all at the University of Michigan. He also serves as associate editor of the New England Journal of Medicine. Dr. Ayanian has focused his career on health policy and health services research related to access to care, quality of care, and health care disparities, and has served in key health policy advisory roles to state and federal government. Prior to joining the University of Michigan, Dr. Ayanian was a professor at the Harvard Medical School and at the Harvard School of Public Health, and a practicing primary care physician at Brigham and Women’s Hospital in Boston. At Harvard, Dr. Ayanian also directed the Health Disparities Research Program of Harvard Catalyst, Harvard’s Clinical and Translational Sciences Center; the Outcomes Research Program of the Dana-Farber/Harvard Cancer Center; and the Harvard Medical School Fellowship in General Medicine and Primary Care. In addition to his medical degree from Harvard Medical School, he holds an M.P.P. from Harvard’s John F.

Suggested Citation:"Appendix B: Committee Biosketches." National Academies of Sciences, Engineering, and Medicine. 2016. Accounting for Social Risk Factors in Medicare Payment: Criteria, Factors, and Methods. Washington, DC: The National Academies Press. doi: 10.17226/23513.
×

Kennedy School of Government. He is an elected member of the National Academy of Medicine.

Charles Baumgart, M.D., is senior medical director at xG Health Solutions, an organization that was spun out of Geisinger Health System, designed to partner with health care organizations nationally to bring Geisinger population health management expertise to local health care improvement efforts. He has worked with numerous health care systems, both academic and community based, as well as with managed care organizations. He has most recently been the xG Health clinical/physician lead for support of a New York Delivery System Reform Incentive Payment program site, the Suffolk County Care Collaborative (Stony Brook University Hospital). Before joining xG Health Solutions, Dr. Baumgart was the Geisinger Health Plan senior medical director for government programs. His responsibilities included the development of the clinical management program for a new Managed Medicaid program in northeast Pennsylvania, leveraging Geisinger’s existing Advanced Medical Home model. In his role, he worked with all aspects of population and quality management, including support of medical home development, analytics, and provider pay-for-performance programs. Dr. Baumgart previously served as a senior medical director and then the vice president and chief medical officer for Presbyterian Health Plan in Albuquerque, New Mexico. Dr. Baumgart graduated with an M.D. from the University of Iowa. Dr. Baumgart is board certified in internal medicine and quality assurance and utilization review. He has participated in the advanced training program in health care delivery improvement with Intermountain Healthcare, is a certified managed care executive through America’s Health Insurance Plans, and served as a senior examiner with the Malcolm Baldrige National Quality Award Program.

Melinda Buntin, Ph.D., is professor and the chair of the Department of Health Policy at Vanderbilt University’s School of Medicine. She previously served as deputy assistant director for health at the Congressional Budget Office (CBO), where she was responsible for managing and directing studies of health care and health care financing issues in the Health, Retirement, and Long-term Analysis Division. Prior to joining CBO, Dr. Buntin worked at the Office of the National Coordinator for Health Information Technology, where she established and directed the economic analysis, evaluation, and modeling group, while on leave from RAND Corporation. At RAND, Dr. Buntin served as deputy director of RAND Health’s Economics, Financing, and Organization Program, director of Public Sector Initiatives for RAND Health, and co-director of the Bing Center for Health Economics. Her research at RAND focused on insurance benefit design, health insurance markets, provider payment, and the care use and needs of the elderly. She has a Ph.D. in health policy with a concentration in economics from Harvard University. Dr. Buntin is a member of the National Academies of Sciences, Engineering, and Medicine’s Board on Health Care Services.

Ana V. Diez Roux, M.D., Ph.D., M.P.H., is Distinguished University Professor of Epidemiology and dean of the Drexel University Dornsife School of Public Health. Before joining Drexel University, she served on the faculties of Columbia University and the University of Michigan, where she was chair of the Department of Epidemiology and director of the Center for Social Epidemiology and Population Health at the University of Michigan School of Public Health. Dr. Diez Roux is internationally known for her research on the social determinants of population health and the study of how neighborhoods affect health. She has been a member of the MacArthur Network on Socioeconomic Factors and Health and was co-director of the Network on Inequality, Complexity and Health. Dr. Diez Roux received an M.D. from the

Suggested Citation:"Appendix B: Committee Biosketches." National Academies of Sciences, Engineering, and Medicine. 2016. Accounting for Social Risk Factors in Medicare Payment: Criteria, Factors, and Methods. Washington, DC: The National Academies Press. doi: 10.17226/23513.
×

University of Buenos Aires and a master’s degree in public health and doctorate in health policy and management from the Johns Hopkins Bloomberg School of Public Health. She is an elected member of the National Academy of Medicine and has served on numerous committees of the National Research Council and the Institute of Medicine, most recently on the Committee on Recommended Social and Behavioral Domains and Measures for Electronic Health Records.

Marc N. Elliott, Ph.D., is a senior principal researcher and holds the Distinguished Chair in Statistics at the RAND Corporation. His areas of interest include health disparities, Medicare, vulnerable populations, experiences with health care, profiling of health care institutions, survey sampling, experimental design, causal inference, and case-mix adjustment. He has developed Bayesian methods of estimating race/ethnicity and associated disparities using surname and address information. Dr. Elliott led an Office of Minority Health project, developing novel, cost-effective sampling and analytic methods to improve national health estimates for small racial/ethnic subgroups. Since 2006, he has led the Centers for Medicare & Medicaid Services Medicare CAHPS (Consumer Assessment of Health Providers and Systems) Analysis project. Since 1996, he has been RAND’s lead statistician on the Agency for Healthcare Research and Quality (AHRQ) CAHPS I-III projects and currently co-leads the AHRQ CAHPS IV project. Dr. Elliott was recognized by Thomas Reuters as being one of the Top 1 percent of Cited Scientists 2002-2012. Dr. Elliott is a fellow of the American Statistical Association. He earned his Ph.D. in statistics from Rice University.

José J. Escarce, M.D., Ph.D., is a professor of medicine in the David Geffen School of Medicine at the University of California, Los Angeles (UCLA), and a professor of health policy and management in the UCLA Fielding School of Public Health. His research interests and expertise include health economics, managed care, physician behavior, racial/ethnic and socioeconomic disparities in health care, technological change in medicine, and access, costs, and quality of care. Dr. Escarce is currently working on projects that address sociodemographic barriers to access, vertical integration between acute and postacute care, bundled payments, and the effects of financial and nonfinancial incentives on costs and quality in provider groups and health systems. He holds an M.D. from the University of Pennsylvania School of Medicine and a Ph.D. from the Wharton School. Dr. Escarce is an elected member of the National Academy of Medicine and was a member of the Institute of Medicine Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care and of the National Academies of Sciences, Engineering, and Medicine’s Board on Population Health and Public Health Practice.

Robert Ferrer, M.D., M.P.H., is John M. Smith, Jr. Professor and vice chair for research in the Department of Family and Community Medicine at the University of Texas Health Science Center at San Antonio (UTHSCSA). Dr. Ferrer is a practicing family physician with research interests at the interface of primary care and public health, including primary care transformation and quality improvement, social determinants of health, and applications of complexity science to health and health care. Currently, he also serves as director of community engagement for UTHSCSA’s Clinical Translational Science Award. Dr. Ferrer is active in community health initiatives, having served as chair of the leadership team for San Antonio’s Communities Putting Prevention to Work grant from the Centers for Disease Control and Prevention and is now vice-chair of the Bexar County Health Collaborative. He has also been a member of the Expert Panel for the Agency for Healthcare Research and Quality Innovations Exchange. Dr. Ferrer holds an M.D. from Hahnemann University School of Medicine and an M.P.H. from the University of Washington.

Suggested Citation:"Appendix B: Committee Biosketches." National Academies of Sciences, Engineering, and Medicine. 2016. Accounting for Social Risk Factors in Medicare Payment: Criteria, Factors, and Methods. Washington, DC: The National Academies Press. doi: 10.17226/23513.
×

Darrell J. Gaskin, Ph.D., is William C. and Nancy F. Richardson Professor of Health Policy and director of the Johns Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health. His research aims to improve access to care for poor, minority, and other vulnuerable populations and to eliminate racial/ethnic and socioeconomic disparities in health care. His current research explores the relationship between “place” and health care disparities and examines racial/ethnic and socioeconomic disparities in hospital care. He is vice chair of the Board of Directors of AcademyHealth and a member of the Center for Health Policy Development Board and the board of directors for the National Academy of State Health Policy. He has served as a member of the Congressional Black Caucus Commission on the Budget Deficit, Economic Crisis, and Wealth Creation and of the Board of Directors of the Maryland Health Insurance Plan, the state’s high-risk pool, and was vice chair of the Board of Directors of the Maryland Health Benefits Exchange Commission. He has also served as a member of several Institute of Medicine committees, including the Committee on Valuing Community-Based, Non-Clinical Prevention Policies and Wellness Strategies and the Committee on the Future of Emergency Care in the United States Health System. He received an M.S. from the Massachusetts Institute of Technology and a Ph.D. from the Johns Hopkins Bloomberg School of Public Health.

Mark D. Hayward, Ph.D., is Centennial Commission Professor in the Liberal Arts and professor of sociology at the University of Texas at Austin. From 2005 to 2015, he was director of the university’s Population Research Center. His primary research addresses how life course exposures and events influence the morbidity and mortality experiences of the adult population. Recent studies have clarified how early life conditions and especially educational experience influence socioeconomic, race, and gender disparities in adult morbidity and mortality; the demography of race/ethnic and gender disparities in healthy life expectancy; social inequality in the biomarkers of aging; and the health consequences of marriage, divorce, and widowhood. He recently served as the president of the Southern Demographic Association and chair of the Aging and Life Course section of the American Sociological Association. He has served on the boards of the Population Association of America and the Society of Biodemography and Social Biology, and he was a member and then chair of the Inter-University Consortium for Political and Social Research Council. Currently, he is a member of the National Advisory Committee for the Robert Wood Johnson Foundation’s Health and Society Scholars Program. He served on the National Research Council (NRC) Committee on Population and the NRC Panel on New Directions in Social Demography, Social Epidemiology, and the Sociology of Aging. Dr. Hayward received his Ph.D. in sociology from Indiana University.

James S. Jackson, Ph.D., is the past director of the Institute for Social Research and the Daniel Katz Distinguished University Professor of Psychology at the University of Michigan. He has previously held positions as chair of the Social Psychology Training Program and director of the Research Center for Group Dynamics, the Program for Research on Black Americans, and the Center for Afroamerican and African Studies, all at the University of Michigan. His research focuses on issues of racial and ethnic influences on life course development, attitude change, reciprocity, social support, and coping and health among African Americans. His research efforts include carrying out a number of national and international surveys of black populations. Dr. Jackson is a fellow of the American Academy of Arts and Sciences and the American Academy of Political and Social Science, and was appointed to the National Science Board of the United States by President Obama in 2014. He has served on several committees of the National Academies of Sciences, Engineering, and Medicine, including currently on the Board on the

Suggested Citation:"Appendix B: Committee Biosketches." National Academies of Sciences, Engineering, and Medicine. 2016. Accounting for Social Risk Factors in Medicare Payment: Criteria, Factors, and Methods. Washington, DC: The National Academies Press. doi: 10.17226/23513.
×

Health of Select Populations; on the Board on Behavioral, Cognitive, and Sensory Sciences; Standing Committee on Integrating New Behavioral Health Measures into the Substance Abuse and Mental Health Services Administration’s Data Collection Programs (as chair); and Roundtable on the Application of Social and Behavioral Science Research. Dr. Jackson holds a Ph.D. in social psychology from Wayne State University and is an elected member of the National Academy of Medicine.

Daniel Polsky, Ph.D., is the executive director of the Leonard Davis Institute of Health Economics, Professor of Medicine in the Perelman School of Medicine, and the Robert D. Eilers Professor of Health Care Management in the Wharton School at the University of Pennsylvania. His research areas include access to health care, provider payment, disparities, and economic evaluation of medical and behavioral health interventions. He serves on the Congressional Budget Office’s Panel of Health Advisers and the National Academies of Sciences, Engineering, and Medicine’s Board on Population Health and Public Health Practice. He was the senior economist on health issues at the President’s Council of Economic Advisers in 2007-2008. He received a Ph.D. in Economics from the University of Pennsylvania and a master of public policy from the University of Michigan.

Meredith Rosenthal, Ph.D., is professor of health economics and policy and the associate dean of diversity at the Harvard T.H. Chan School of Public Health. She is a member of the Massachusetts Public Health Council and an elected board chair of the Massachusetts Health Quality Partners. Dr. Rosenthal’s research focuses primarily on policies that will help slow the growth in health care spending. These efforts include changes in payment incentives, benefit design, and the provision of information and behavioral “nudges” to both patients and providers. Her research has influenced the design of provider payment systems in both the public and private sectors. She has advised federal and state policy makers in health care payment policy and implementation, and has also testified in congressional hearings on pay-for-performance and in legislative hearings in California and Massachusetts concerning health care provider payment and benefit design policies. Dr. Rosenthal earned her Ph.D. in health policy (economics track) at Harvard. She is an elected member of the National Academy of Medicine.

Anthony Shih, M.D., M.P.H., is executive vice president of The New York Academy of Medicine (NYAM). Established in 1847, NYAM advances solutions that promote the health and well-being of people in cities worldwide. Dr. Shih’s expertise is in health care policy, urban health, health system performance measurement, health care quality improvement, and health care philanthropy. Prior to joining NYAM, Dr. Shih served as The Commonwealth Fund’s executive vice president for programs, overseeing all of the fund’s program and research activities, which were focused on improving the U.S. health care system. Previously, Dr. Shih held several senior management roles, including chief quality officer and vice president of strategy at IPRO, a leading independent, not-for-profit health care quality improvement organization. At IPRO, he developed and managed large-scale quality assessment and improvement projects for Medicare and Medicaid populations, as well as led IPRO’s Health Care Transparency Group. Earlier in his career, Dr. Shih was assistant medical director for a community-based mental health organization serving immigrant and refugee populations in Oakland, California. Board-certified in preventive medicine, Dr. Shih received his M.D. from the New York University School of Medicine and his M.P.H. from the Columbia University Mailman School of Public Health.

Suggested Citation:"Appendix B: Committee Biosketches." National Academies of Sciences, Engineering, and Medicine. 2016. Accounting for Social Risk Factors in Medicare Payment: Criteria, Factors, and Methods. Washington, DC: The National Academies Press. doi: 10.17226/23513.
×
Page 110
Suggested Citation:"Appendix B: Committee Biosketches." National Academies of Sciences, Engineering, and Medicine. 2016. Accounting for Social Risk Factors in Medicare Payment: Criteria, Factors, and Methods. Washington, DC: The National Academies Press. doi: 10.17226/23513.
×
Page 111
Suggested Citation:"Appendix B: Committee Biosketches." National Academies of Sciences, Engineering, and Medicine. 2016. Accounting for Social Risk Factors in Medicare Payment: Criteria, Factors, and Methods. Washington, DC: The National Academies Press. doi: 10.17226/23513.
×
Page 112
Suggested Citation:"Appendix B: Committee Biosketches." National Academies of Sciences, Engineering, and Medicine. 2016. Accounting for Social Risk Factors in Medicare Payment: Criteria, Factors, and Methods. Washington, DC: The National Academies Press. doi: 10.17226/23513.
×
Page 113
Suggested Citation:"Appendix B: Committee Biosketches." National Academies of Sciences, Engineering, and Medicine. 2016. Accounting for Social Risk Factors in Medicare Payment: Criteria, Factors, and Methods. Washington, DC: The National Academies Press. doi: 10.17226/23513.
×
Page 114
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Recent health care payment reforms aim to improve the alignment of Medicare payment strategies with goals to improve the quality of care provided, patient experiences with health care, and health outcomes, while also controlling costs. These efforts move Medicare away from the volume-based payment of traditional fee-for-service models and toward value-based purchasing, in which cost control is an explicit goal in addition to clinical and quality goals. Specific payment strategies include pay-for-performance and other quality incentive programs that tie financial rewards and sanctions to the quality and efficiency of care provided and accountable care organizations in which health care providers are held accountable for both the quality and cost of the care they deliver.

Accounting For Social Risk Factors in Medicare Payment: Criteria, Factors, and Methods is the third in a series of five brief reports that aim to inform ASPE analyses that account for social risk factors in Medicare payment programs mandated through the IMPACT Act. This report builds on the conceptual relationships and empirical associations between social risk factors and performance indicators used in value-based payment identified in the first report to provide guidance on which factors could be considered for Medicare accounting purposes, criteria to identify these factors, and methods to do so in ways that can improve care and promote greater health equity for socially at-risk patients.

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