Guest Commentary: It’s Always Sunny in Philadelphia

Alexis Skoufalos, EdD
Associate Dean for Continuing Professional Education
Jefferson School of Population Health

Thursday, July 21st was sunny and stiflingly hot – one of the most brutal summer days we’ve experienced in Philadelphia in many years. And yet, over 150 of JSPH’s colleagues came together on the Jefferson campus to share with us their thoughts about important issues in population health.

In an odd way, it was a birthday party of sorts. July marks JSPH’s birthday month – it was only 3 years ago that we toasted the beginning of our journey to create a new school dedicated to educating leaders that would help us improve the quality of health and health care in America.

In that time, we’ve developed new academic programs, published two books, convened multiple conferences, conducted cutting-edge research, added stellar new leaders, faculty and staff to our team, and encouraged some of our most valued colleagues as they moved on to new endeavors.

In 3 short years, we have assembled a diverse and talented team with a passion for making meaningful change. The challenges we face have only become more complex in the last few years, and the stakes have never been higher.

While we have much to celebrate, there is so much more to do. And we can’t do it alone; we need to hear from you about the type information you need, the challenges you face that we can help address, and the programs we should focus on in the future.

We are committed to making a world of difference in health care. Let us know how we can help you by contacting any one of the leaders listed below.

JSPH Program Contacts:

Caroline Golab, PhD
Associate Dean, Academic and Student Affairs
(215) 503-8468
caroline.golab@jefferson.edu

Joseph D. Jackson, PhD
Program Director, Applied Health Economics and Outcomes Research
(215) 955-4755
joseph.jackson@jefferson.edu

Kathryn M. Kash, PhD
Program Director, Chronic Care Management
(215) 955-9549
kathryn.kash@jefferson.edu

Mark Legnini, DrPH
Director, Center for Value in Healthcare
(215) 955-0427
mark.legnini@jefferson.edu

David B. Nash, MD, MBA
Dean, Jefferson School of Population Health
(215) 955-6969
david.nash@jefferson.edu

James Pelegano, MD, MS
Program Director, Healthcare Quality and Safety
(215) 955-3888
james.pelagano@jefferson.edu

Rob Simmons, DrPH, MPH, MCHES, CPH
Program Director, Public Health
(215) 955-7312
rob.simmons@jefferson.edu

Alexis Skoufalos, EdD
Associate Dean for Continuing Professional Education
(215) 955-2822
alexis.skoufalos@jefferson.edu

More on Accountable Care Organizations

The Jefferson School of Population Health just finished hosting a special two day invitation only advisory board on the current status of Health Reform. We had one dozen experts from all around the nation convene on our campus for a two day discussion of the details and an update on implementation challenges. It was sobering indeed!! At this juncture, I believe that most organizations are NOT culturally ready for the hard work of true accountability.The heart of a real ACO, whether with Medicare or commercial patients, is the realization that clinicians will have to self evaluate, measure what they do everyday, and be willing to engage in the gut bustingly difficult work of improvement. The "shared savings" may in fact be minimal, especially in the early stages. It will take a commitment to practicing based on the evidence and a willingness to benchmark performance against regional and national leaders. A tall order for any organization and in my view, most are not at all ready for this cultural paradigm shift. Who will make it---organizations with a hierarchical doctor culure, accustomed to profiling and willing to police members within their own ranks. The Ochsners, Geisingers and Mayos of the world will be able to make it work, very few others have the skill sets necessary at this juncture. Stay tuned for more posts from our amazing advisory board and for publications that will come from our deliberations together. DAVID NASH

Guest Commentary: JSPH Fellowship Program Celebrates 17 Years

Joe Couto, PharmD, MBA
Assistant Professor, Jefferson School of Population Health
Director, Fellowship Program

On Monday, June 27th JSPH hosted our annual Fellow’s Day, where we celebrated 17 years of training Fellows in health economics and outcomes research. The half-day program began with a keynote from one of our own, Joe Doyle, who completed the fellowship in 1998. Joe gave a detailed account of work he recently had published in Health Affairs along with another Jefferson fellowship graduate Feride Frech-Tamas and several other colleagues at Novartis and Thomson Reuters. Their article was entitled “A Value-Based Insurance Design Program At A Large Company Boosted Medication Adherence For Employees With Chronic Illnesses,” and examined the impact of value based insurance on asthma, cardiovascular, and diabetes medication use over a 3 year period.

We then heard from current Fellows Kellie Dudash and Sangtaeck Lim, who each presented an outcomes research project they completed during the first year of their fellowship. Next Joe Jackson, the program director for our Applied Health Economics and Outcomes Research master's degree, outlined plans for the new program that will be launching in September of this year. This new degree program has especially exciting implications for our fellowship program, as it will offer future Fellows the opportunity to earn a formal degree in the field in which they are training. We ended the morning on a bittersweet note as we graduated an exceptional class of second year Fellows: Eddie Lee, Lane Slabaugh, and Anita Mohandas. My fellowship overlapped with Eddie, Lane, and Anita and it was my distinct pleasure having worked with all three of them.

Fellows Day is first and foremost a celebration of the accomplishments of our current Fellows. However the entire morning served as yet another reminder to the faculty and staff of JSPH, our fellowship sponsors, invited guests, and former fellows in attendance of the rich history of our fellowship and its role in shaping the science of health economics and outcomes research.

Health Reform and Comparative Effectiveness Research

The Patient Centered Outcomes Research Institute is up and running!! So, what does PCORI mean for those of us interested in the science of Comparative Effectiveness Research and the intersection with Health Economics and Outcomes Research? First, lots of jargon here and some of it pretty turgid. CER has been discussed in our blog several times but in a nutshell---trying to figure out what really works in clinical medicine so we can improve care, lower costs, and reduce errors. PCORI will be handing out some new money to support CER. We hope the Jefferson School of Population Health will be the beneficiary of some of this new funding soon. We are also launching our unique, on line Masters Degree in Applied Health Economics and Outcomes Research in September 2011. In my many speaking engagements, esepcially those with the pharmaceutical and biotech industries, I have been emphasizing the following---do not shy away from CER, rather, embrace it!! The Accountable Care Organizations of the future will want products that work, and that are cost effective. ACOs, especially those that have risk, will want to make sure that they are practicing evidence based medicine and using products that are supported by that evidence. I know that these terms are confusing, but stay tuned in this space for more on PCORI, HEOR, CER, ACOs and all the rest. We will continue to try to clear the fog of jargon and help to make sense out of some very important new policies. DAVID NASH

Guest Commentary: A Lesson in Communications from Richard Foster

Rob Lieberthal, PhD
Faculty, Jefferson School of Population Health

I went to the Society of Actuaries Spring Health meeting in Boston to improve the quality of my research. I wanted to learn the actuarial perspective on comparative effectiveness research, learn about new SOA initiatives that I can get involved in, and find new sources of data. My plan was to improve my technical skills. The main lesson I got was an amazing perspective on the importance of communication.

Richard Foster, the Chief Actuary at the Center for Medicare and Medicaid Services, was the keynote speaker of the conference. The main theme of his speech was communicating technical results to difficult audiences. Mr. Foster’s most powerful example of a difficult audience was the Medicare administrator who tried to suppress his estimates of the Medicare Modernization Act (see his take here). He cautioned that a more common problem is that politicians can’t, or don’t want to, understand the opinions he gives as CMS’s chief actuary. His feeling is that the miscommunication is getting worse with rising partisanship. Mr. Foster works hard to make sure his estimates are not misquoted or misconstrued. He went as far as to publicly contradict then health reform director and current White House deputy chief of staff Nancy-Ann DeParle.

I have been thinking about how that standard of behavior applies to the problem of communicating the results of comparative effectiveness studies today. Many of the technical issues that held back research in the past, like computer resources or lack of data, have become less important. The communication problems have become more difficult, largely because the work we do is being taken more seriously. Richard Foster has issued a challenge not only to health actuaries but to all of us who work in quantitative roles in health care. Can we communicate our work to non-experts? And can we do it in such a way as to minimize the chance that it will be misused? I feel that answering this challenge is the key to research that is not only technically correct, but also has an impact on population health.

Guest Commentary: JSPH Graduation 2011

Patrick Monaghan
Director of Communications
Jefferson School of Population Health

The Jefferson School of Population Health graduated its second-ever class last Thursday morning, during commencement ceremonies held at the Kimmel Center for the Performing Arts. Ten JSPH students walked during the ceremony, which featured keynote remarks from Donna E. Shalala, PhD, President of the University of Miami and the former Secretary of Health and Human Services.

The location – one of the foremost concert halls in the nation – was not lost on Dr. Shalala, who referenced famed Philadelphia Orchestra Music Director Eugene Ormandy in her comments, comparing the newly minted healthcare professionals to the skilled musicians who usually “work the room.”

TJU President Robert L. Barchi, MD, PhD, lauded the graduates for their academic accomplishments, underscoring how desperately our nation’s ailing healthcare system is in need of an infusion of new leaders. JSPH Dean David B. Nash, MD, MBA, reminded the graduates that they stand at an important crossroad in population health, one framed in part by the Affordable Care Act, the landmark healthcare legislation enacted a little over one year ago.

For the graduates, the real work is just beginning. They’re now part of a new generation of healthcare leaders – those who will work to reduce the unexplained variation in health care services, abolish disparities in how care is delivered, improve the coordination of care and improve the quality and safety of the care they deliver.

Congratulations and continued success to the Class of 2011!

ISPOR and the JSPH

For more than a decade and a half, our team from the Jefferson School of Population Health (and its predecessor department and office) has been very well represented at the annual meeting of the International Association of Pharmacoeconomics and Outcomes Research or ISPOR!!! ISPOR is the global leader in research on what works and what doesn't and all of the economic implications for pharmaceutical agents world wide. The annual meeting now draws more than 2,300 persons from all over the globe and it spans nearly a week, counting the pre-courses and related activities. Today, I think ISPOR is more important than ever as health reform and Comparative Effectiveness Research have pushed this agenda to the front page. The cost of pharma agents continues to rise, particularly in the oncology arena. We cannot continue to spend money on products without better proof of their comparative effectiveness and possible role in evidence based care moving forward. ISPOR uniquely fills this research void. This year, one of our fellows, Dr. Kellie Dudash, won acclaim for her podium presentation and came away with the prize for best new investigator---a real coup for her, and for our entire research team too. I am particularly proud of Kellie, Dr. Joe Couto and of course, Neil Goldfarb, our long time Associate Dean for Research. This is further confirmation for me that the JSPH is a national leader in interpreting the outcomes of the ACA and leads the way from an academic perspective in doing research in this arena. Our research supports the notion, covered in this blog many times, that the future means -- NO OUTCOME, NO INCOME!! DAVID NASH