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Pay-for-Performance: Practical Guidance for Decision-Making May 16, 2006 Hosted by: AcademyHealth PANELIST BIOGRAPHIES R. Adams Dudley, M.D., M.B.A. Dr. Dudley is Associate Professor of Medicine and Health Policy at the University of California , San Francisco. His major research interests include developing measures of quality of care, assessing the impact of quality-based or value-based purchasing, and financial risk adjustment (adjusting premiums and capitation rates to reflect the severity of illness of enrollees). He has served as a consultant on health policy issues to the Institute of Medicine's National Roundtable on Quality of Care, Committee on Quality of Health Care in America, and National Cancer Policy Board, to the The Joint Commission, to the World Health Organization, to the Pacific Business Group on Health, General Motors, the Leapfrog Group and other large employers, and to the American Thoracic Society and other medical societies. He has three primary research projects currently. The California Intensive Care Outcomes (CALICO) project involves developing public reports of hospital-specific ICU quality of care for all hospitals with ICUs in California. The California Hospital Assessment and Reporting Task Force (CHART), which he leads, has convened representatives of consumers, purchasers, health plans, and hospitals in California to establish a consensus, universal, robust hospital performance reporting system. Dr. Dudley also is working with public and private purchasers to summarize the research on quality-based purchasing strategies and identify optimal approaches to health care purchasing. Meredith Rosenthal, Ph.D. Dr. Rosenthal is an associate professor of health economics and policy at Harvard School of Public Health. Dr. Rosenthal received her Ph.D. in health economics at Harvard University in 1998. Her principal research interests revolve around economic incentives that influence provider and consumer health care decisions. She is currently work ing on a series of related projects that examine evolving trends in the health insurance market, including financial incentives for improving health care quality and patient safety and consumer-directed health benefits. Dr. Rosenthal, along with colleagues at Harvard, has undertaken several efforts related to the practice of pay-for-performance and its theoretical and empirical underpinnings. Dr. Rosenthal is currently principal investigator on an evaluation of PacifiCare's Quality Incentive Program, one of the largest commercial health plan efforts to reward health care quality. In the area of hospital quality, Dr. Rosenthal and colleagues at the Harvard Medical School are using all-payer discharge data from HealthShare Technology, Inc., to model alternative approaches to scoring hospitals on both cost and quality measures for pay-for-performance and tiered network efforts. Gary J. Young J.D., Ph.D. Dr. Young is professor and chair of the Department of Health Services at the Boston University School of Public Health. He is also associate director of the Boston University-affiliated Center for Organization, Leadership and Management Research, which is funded by the Department of Veterans Affairs. Dr. Young's research focuses on organizational, managerial, and legal issues associated with the delivery of healthcare services. He has directed research projects for a number of private and public organizations including the National Science Foundation, the Robert Wood Johnson Foundation, and the Agency for Healthcare Research and Quality. He currently oversees a large-scale study of pay-for-quality programs, which is funded by both the Agency for Healthcare Research and Quality and the Robert Wood Johnson Foundation. His published work has appeared in such journals as the Journal of the American Medical Association, Health Affairs, Medical Care, Journal of Health Politics, Policy and Law, and Academy of Management Journal. In 1998 he received from the Association of University Programs in Health Administration (AUPHA) the John D. Thompson Prize in Health Services Research. He has also received several other awards for his research from the American College of Health Care Executives and the Academy of Management. He frequently presents his research at professional and industry associations in the health care industry and has also served as a faculty member for executive education programs and workshops sponsored by such organizations as General Motors, America 's Health Insurance Plans (AHIP) and the American College of Obstetricians and Gynecologists. Before joining Boston University, Dr. Young worked as a senior associate for a national healthcare management and policy consulting firm and as an analyst for the Agency for Health Care Policy and Research (AHCPR), U.S. Department of Health and Human Services. Dr. Young has a Ph.D. in management and a law degree, both from the State University of New York. David K. Kelley, M.D., M.P.A. Dr. Kelley is the Chief Medical Officer for Pennsylvania Department of Public Welfare's Office of Medical Assistance Programs. He oversees the clinical and quality aspects of the Medical Assistance Program that provides health benefits to over 1.7 million recipients. The Office includes oversight of eight managed care organizations, a FFS program, and Long Term Care Programs. Prior to joining the Department, Dr. Kelley worked for Aetna Health Inc. as the Medical Director responsible for utilization and quality management in central and northeastern Pennsylvania. He chaired Aetna 's Mid-Atlantic Regional Quality Advisory Committee. Prior to Aetna, he served as Assistant Professor and Director of Clinical Quality Improvement at Penn State University 's College of Medicine. As the Director for Clinical Quality Improvement, he oversaw the quality and utilization management at Penn State 's Hershey Medical Center. He also spent 4 years in private practice. He is Board Certified in Internal Medicine and Certification eligible in Geriatrics. Douglas W. Libby, RPh Doug Libby is the Executive Director of the Maine Health Management Coalition. Under Mr. Libby's leadership the MHMC has grown to include 36 Maine employers who collectively purchase $600 million of health care services for over 175,000 employees in Maine. MHMC's mission is to bring health care purchasers and providers together to measure and report on the value of health care services to inform employer and employee decisions. Mr. Libby has led the development of MHMC's Pathways to Excellence initiative designed to measure, report and reward provider performance. MHMC has brought together all stakeholders to select measures, collect information and develop consumer friendly information on healthcare quality and cost. MHMC has recently embarked on an initiative to help its members communicate information on quality to their employees. Prior to joining MHMC Mr. Libby was President of RxCELLENCE Consulting Inc. specializing in assisting health care organizations improve the quality and efficiency of their medication use systems. Mr. Libby's consulting work has included accreditation preparations, drug security evaluations, hospital pharmacy operational reviews and medication systems evaluation and improvement. Prior to founding RxCELLENCE Consulting and joining MHMC, Doug held positions as Director of Pharmacy and Director of Performance & Service Quality Improvement at Brighton Medical Center in Portland. Mr. Libby holds a BS in Pharmacy from the University of Connecticut. |
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