USCSchaeffer Annual Report_2020 Leonard D. Schaeffer Center for Health Policy&Economics Message from the Directors

Relevance and Reach

Like so many other institutions, the Schaeffer Center had to dramatically pivot in 2020 to maintain our relevance and reach. Fortunately, we had a decade of evidence-based research on health and innovation upon which to build— and a set of research partners who understood the acute policy needs. Neeraj Sood, writing in e Wall Street Journal, was among the first to call for population screening to understand the dynamics of COVID-19. We launched a new COVID Initiative under his leadership, and—with support from the USC Offices of the President and the Provost, the Rockefeller Foundation and others—have partnered with the mayor of Los Angeles and the L.A. County The mission of the Leonard D. 01 Message from the Directors 30 Meeting the Challenges Ahead Department of Public Health to conduct population surveillance. Schaeffer Center for Health Policy 04 Driving the Future of Healthcare 32 Data Report e USC-Brookings Schaeffer Initiative, led by Paul Ginsburg, continued & Economics is to measurably 34 Financial Report improve value in health through its legacy of improving regulation and functioning of healthcare markets. In Research Programs 35 Supporters evidence-based policy solutions, 06 Value of Life Sciences Innovation 36 Research Training Programs 2020, the initiative’s efforts culminated in the No Surprises Act as part of the year- research excellence, and private and public sector engagement. 10 Behavioral Sciences 38 Events and Seminars end omnibus spending bill. e legislation alleviates the patient from bearing 12 COVID Initiative 44 Select Publications the financial brunt of surprise medical bills—a clear market failure—and 18 Aging and Cognition 49 National Academy Participation sets up an arbitration process for providers and insurers. 20 Population Health 50 Fellows and Staff 24 Affordability and Value 54 Advisory Board e Value of Life Sciences Innovation program, led by Karen Van Nuys, 26 USC-Brookings Schaeffer Initiative 55 About the Schools continued to shine a spotlight on distortions in the prescription drug marketplace. for Health Policy 56 About the Schaeffer Center e team demonstrated some alarming associations between list prices and drug rebates—highlighting the opacity of prices in the marketplace and the financial consequences for patients. is research informed an executive order, Lowering Prices for Patients by Eliminating Kickbacks to Middlemen. Message from the Directors

Our External Affairs team continued to convene healthcare experts, “The Schaeffer Center’s mission to improve policymakers and stakeholders representing diverse views for a series of conferences and webinars. Although we moved events to a virtual platform health and the healthcare system was truly tested for safety reasons, this proved to expand their reach, as geography no this year. The Center responded rapidly to address longer limited people’s ability to attend and participate. a pandemic that caused public health, economic We also continued a long history of collaboration with outside partners. Working with the Aspen Institute, we assembled a distinguished advisory and humanitarian crises. Staff organized virtual panel to recommend ways to modernize health technology assessment in forums for private- and public-sector engagement the United States. It is clear the U.S. must do a better job of linking the price of innovations to the benefits they provide for individuals and society, and and faculty provided much-needed analysis and Dana Goldman we are developing solutions for this pressing issue. evidence-based solutions for policymakers and public In addition, we collaborated with Gates Ventures to explore innovative health officials. As our nation and the world clinical advances and diagnostics—from cancer to Alzheimer’s disease—and the policy challenges associated with access to and adoption of these advances. begin to heal, the Schaeffer Center will continue None of these accomplishments would be possible without the support of to be at the forefront of policy research that seeks Leonard Schaeffer and his wife, Pamela, our Advisory Board and the outstanding faculty in our two partner schools at USC: the Sol Price School of Public not a return to normal but to a better healthcare Erin Trish Policy and the School of Pharmacy. We are grateful for everyone’s support system than before.” during this tumultuous time. – Leonard D. Schaeffer, USC Schaeffer Center Advisory Board Chair

Dana Goldman Leonard D. Schaeffer Director’s Chair, USC Schaeffer Center

Erin Trish Associate Director, USC Schaeffer Center

2 USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu USC Schaeffer Center for Every aspect of the Schaeffer Center’s federal regulations and state laws to save work drives innovation. Our scholars patients from spiraling out-of-pocket costs and Health Policy & Economics: ceaselessly explore cutting-edge ways to improve access to breakthrough therapies. Driving the Future of maximize the value of healthcare while also The following pages highlight just a few Healthcare enhancing affordability to expand its reach. studies that have made an impact over the The spread of COVID-19 over this past past year. Our work informs policymakers and year served as a reminder of how vital this private-sector leaders and has been cited research truly is, as we developed viable by the White House and Congress as well as strategies for testing as well as distribution by state and international authorities. for that moment when vaccines were ready. We continue to push new frontiers in Indeed, amid unprecedented challenges, health policy advancements by consistently the record-breaking development of vaccines introducing innovative concepts and methods was a bright spot reflecting the true value to the health policy conversation. From and wonders of innovation. promoting better treatments and preventive For more than 10 years, Schaeffer Center measures for Alzheimer’s to increasing the experts have worked to advance innovative convenience of kidney care, our efforts strive prescription drug payment models that lead to help people lead healthier lives as well to better health and long-term returns. We as longer ones. Our research makes a real have shed light on the broken—and at times impact on improving the health of individuals distorted—pharmaceutical distribution and society as a whole. system and provided policy solutions that benefit patients. Our analyses helped spur XY_Value of Life Sciences Innovation

The life sciences are at the front lines of transforming healthcare through innovations that benefit countless people. The Value of Life Sciences Innovation (VLSI) program exemplifies the Schaeffer Center’s focus on evidence-based analyses that encourage biomedical advances while developing pricing and reimbursement strategies to help ensure that patients receive the therapies they need.

Drug price controls would hamper innovation and could reduce life expectancy over the long term by 3%.

25+ studies and articles were authored under the VLSI program over 5 years. 70% of global pharmaceutical The Schaeffer Center’s VLSI program Still, prices remain controversial—especially based pricing schemes as an alternative to profits, which drive advances strategies for spurring in the United States, where they are generally price controls. Such strategies link a drug’s future innovation, stem innovation while ensuring access. higher than in nations that impose price expense to its benefits as shown in clinical from the U.S. controls. However, Schaeffer Center research trials and other data-driven methods. The many successful COVID-19 vaccines and shows that instituting price controls here One perceived roadblock to implementing therapies developed at unprecedented speed would harm health in the long run. For exam- value-based prices was Medicaid’s best-price during the pandemic provide a stunning illus- ple, as Congress considered H.R. 3, the Lower rule. However, Schaeffer Center Director of tration of the benefits of a robust scientific Drug Costs Now Act, Schaeffer Center model- Research Darius Lakdawalla and colleagues discovery system supported by investment, ing showed that while lower U.S. prices might have found that, while the rule does present incentives and policy. Yet such benefits are not improve health by increasing access in the challenges, it need not impede progress. unique to the COVID experience. From cancer short run, they would also hamper innovation Spurred by such analysis, the Centers treatments and HIV/AIDS therapies to hepatitis and ultimately reduce life expectancy by about for Medicare & Medicaid Services finalized C cures and interventional cardiology, innova- 3%. Other countries would also feel this loss, regulatory changes allowing states, private tions in the life sciences over the past half as they benefit from having Americans shoulder payers and manufacturers more flexibility century have lengthened life spans by curing much of the expense of innovation. in value-based pricing arrangements for many deadly diseases and transforming others VLSI Executive Director Karen Van Nuys, prescription drugs. into manageable chronic conditions. Schaeffer Center Director Dana Goldman and others at the Center have proposed value-

USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu 7 01_Value of Life Sciences Innovation

Two years after launch, Almost half of Part D beneficiaries biosimilar drugs approved for who do not receive a low-income subsidy conditions like Crohn’s disease would save money if cost-sharing were 10% 17% and rheumatoid arthritis cap- based on net prices; 20% would save tured only 10% of the market more than $100 per year. and lowered reimbursement by just 17%. ^X% ][.]% ]X% \^.]%

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6 recommendations for how health [X% Z].Y% ZX.X% technology assessment can improve decision- ZX% YX% ].^% making in the medical marketplace came X.a% X% from Schaeffer Center experts. 5 ?>5 ?>95 ?>655 ?>955 ?>6555

VLSI scholars investigate what Van Nuys says. “We’re not ready to give up a $1 increase in rebates is associated with a The Schaeffer Center explores [b Ensure that HTA reports present clinical and drives adoption patterns for on competition just yet—we need to under- $1.17 increase in list price. In addition, Schaeffer the unique role and requirements economic findings in a disaggregated format biosimilar drugs. stand the barriers that may be slowing Center Associate Director Erin Trish and for health technology assessment \b Evaluate existing and new healthcare services biosimilar uptake, and whether alleviating Director of Health Policy Geoffrey Joyce found in U.S. healthcare markets. and technologies, including drugs, devices, A $1 rebate increase is associated Offering the same effectiveness as biologic them could lower costs.” that if Medicare cost-sharing were based on diagnostics, procedures and public health with a $1.17 increase in list price. medications, biosimilar drugs can save money post-rebate prices, out-of-pocket spending In collaboration with the Aspen Institute, the interventions for patients and payers, but the biosimilar Studies reveal the relationship would be reduced for nearly half of Part D Schaeffer Center formed an expert advisory ]b Engage healthcare providers, consumer market has been slower to bloom in the U.S. between higher rebates and higher beneficiaries who do not receive low-income panel to examine the U.S. healthcare system’s groups, public and private payers, employers than in Europe. Van Nuys and Schaeffer Center prices—suggesting that eliminating subsidies. Some 20% of them would save more unique requirements and how health technol- and the life sciences industry in the activities Senior Fellow Alice Chen have investigated the Medicare’s safe harbor could save than $100 per year and about 1% would save ogy assessment (HTA) could be designed and of any public HTA entity dynamics underlying this slow uptake. Their money for patients. more than $1,000 annually. applied here to better link the cost of innova- ^b Create a policy path for the HTA coordinating research suggests that the market is function- To allay concerns that eliminating the safe tions to their value for patients. As opposed to entity’s findings to influence decisions ing but that increasing physician awareness Although drug rebates are meant to save harbor for rebates would raise Part D premiums, other developed nations, the U.S. relies almost and removing reimbursement-related barriers money, Schaeffer Center research suggests the Goldman and Trish showed that any premium exclusively on privately funded HTAs, but the “The U.S. market fails to produce enough to biosimilar adoption can strengthen it. opposite may be true. Since a rebate is really increases would be modest, and most benefici- panel sees room for public-sector funding to high-quality evidence,” says Lakdawalla, who “There has been some concern that U.S. a kickback allowed by federal safe-harbor aries would be protected. improve our country’s disjointed approach. co-chaired the panel. “Robust, unbiased as- biologic markets are developing too slowly, regulations, the current system of negotiation This evidence motivated an executive The panel proposes six recommendations sessments of the evidence can help accelerate with some even arguing it’s time to give up on between pharmacy-benefits managers and order to eliminate hidden rebates in Medicare that, taken together, would enhance the HTA the long overdue transition to value-based biosimilars and instead have the government manufacturers may increase prices. Part D. landscape and improve decision making: pricing in healthcare.” regulate biologic drug prices outright,” Van Nuys and Schaeffer Center Senior Yb Encourage private HTA efforts Fellow Neeraj Sood showed that, on average, Zb Establish a publicly funded HTA coordinating entity to augment private efforts and evaluate their overall quality

8 USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu 9 XZ_Behavioral Sciences

Behavioral science combines insights from psychology, economics and other social sciences to understand how people make decisions relevant to their wellbeing. The Schaeffer Center applies the field’s knowledge to find ways to enhance that wellbeing. This research took on increased urgency as COVID-19 began proliferating throughout the world. 20% 4% of adults in their 20s of adults 70 and older 5 thousand+ people responded to questions about the COVID-19 Twenty percent of adults in their 20s had warning signs of depression and anxiety in a poll conducted in March 2020. pandemic for the Understanding America Study. This compares to only 4% of adults age 70 and older.

During a tumultuous year, Schaeffer protective behaviors. These findings could help The USC Behavioral Science and Twenty years from now, adults age BMJ published a study co-authored by Center investigators applied methods leaders improve communication and imple- Well-Being Policy Collaboration unites 65+ will make up more than 20% of Doctor and Schaeffer Center Fellow Daniella from behavioral science to better mentation of mitigation strategies as we experts from across disciplines to the U.S. population—and physicians Meeker that builds on their groundbreaking understand individual responses to continue to battle COVID-19—and better promote policies with positive and health systems will need work in low-cost nudges that improve prescrib- % safety measures and election polling. prepare for future pandemics. social impact. guidance to provide these older pa- ing practices. To help ensure the success of 23 Meanwhile, Bruine de Bruin used politics as tients with the best care. such interventions, the authors suggest that: As COVID-19 rapidly unfolded in spring 2020, a lens to analyze the flaws in standard polling. Because behavioral science is by nature • Nudges should be carefully designed and health leaders urged behavioral changes— For example, traditional polls ask people whom multidisciplinary, its leading minds are spread The new USC Roybal Center for Behavioral implemented for awareness and ease of including social distancing—to contain its they would vote for if an election were held across a range of departments at a variety Interventions in Aging was created to strengthen use by clinicians. of Americans will be over spread. Although many followed these guide- today or their likelihood of voting for specific of institutions. This new collaboration, led by the ability of clinicians to recommend safe • Details such as orienting clinicians to age 65 by 2040. lines, others flouted them. candidates. But Bruine de Bruin found that Bruine de Bruin and Jason Doctor—director of and effective treatments for elderly patients goals and publicizing their commitment To understand how and why Americans asking people about the political preferences health informatics at the Schaeffer Center and through evidence-based behavioral economic are important to success. responded in those crucial early days, Wändi of those in their social circles and in their states co-director of the Behavioral Sciences pro- interventions. • Strategies should be adjusted to address Bruine de Bruin—co-director of the Behavioral could paint a more complete picture of the gram—is building a network of communica- With funding from the National Institutes of the needs of different groups and clinical Sciences program—and colleagues polled American electorate. tion and research partnerships among these Health, the Roybal Center’s co-principal inves- contexts. 5,414 nationally representative adults through “People often get information about political experts through conferences, seminars, a web- tigators—Doctor and Schaeffer Center Director • Trust between clinicians and administrators the online Understanding America Study. The issues from friends and family—and those con- site and co-authored studies. Dana Goldman—lead research that advances is critical. study showed that those perceiving greater versations may influence their voting choices,” The collaboration’s activities will strengthen healthy aging for older adults, with a focus on danger—partly based on case numbers locally Bruine de Bruin and her co-authors note. research in subjects from personal finance those who are economically insecure, culturally The nudges devised by Doctor and colleagues and nationally as well as age and economic and poverty to climate change, environmental diverse and underserved by human services are being increasingly adopted across the factors—were more likely to implement risks and security—all of which affect human organizations. The Roybal Center’s studies nation as well as in the United Kingdom. health. include stemming the opioid crisis by influencing physicians to avoid unnecessary prescriptions.

10 USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu 11 X[_COVID Initiative

COVID-19 has cost millions of lives worldwide, overwhelmed healthcare systems, devastated economies and changed society for years to come. To ease the pandemic’s impact, the Schaeffer Center immediately launched research to improve public safety while getting people back to work without fear of infection.

I106 billion in potential gains delivered by COVID-19 treatments by the end of 2021

2,200 quotes and interviews of Schaeffer Center experts about the coronavirus in mainstream media 63% of Americans said The Schaeffer Center is partnering in different communities. The pilot study may accuracy of repeat rapid antigen testing they would take the with the city of Los Angeles to examine help determine the best ways of leveraging for screening school-aged children. The COVID-19 vaccine the advantages of rapid antigen testing these inexpensive tests to facilitate safe researchers hope to establish the best way to in December 2020, to track COVID-19 and reopen schools reopening efforts. Los Angeles is one of the deploy rapid testing, how often each student down from 83% in and businesses safely. nation’s first metropolitan areas to launch should be tested and the most efficient March 2020. a large-scale study of rapid tests in both symp- large-scale testing methods. Schaeffer Center Senior Fellow and Director of tomatic and asymptomatic participants. the COVID Initiative Neeraj Sood is collaborating Mayor Eric Garcetti held a press conference Rapid and effective vaccine with the Los Angeles County Department of in October 2020 with Sood to discuss the distribution requires a well-designed Public Health and the Los Angeles Mayor’s project. “Rapid tests are cheaper, faster and plan. Schaeffer Center fellows Office to examine the advantages of rapid more accessible—and they are a potential explored ways to build the antigen testing among first responders and game-changer in our ability to respond to infrastructure to facilitate quick school-aged children. Rapid tests have the COVID-19, reopen our schools and get our and effective vaccination. potential to quickly alert people who are economy back on track,” Garcetti told journal- contagious and need to isolate, thereby ists. “Los Angeles never shies away from a Even the most potent vaccine only works if stopping the chain of transmission. challenge, and we are tapping into our trade- it reaches communities quickly. The Schaeffer The study examines antigens—which mark creativity, our innovative spirit, and our Center leveraged scientific and strategic trigger our immune systems to produce virus- strong partners with USC and the county to expertise to help local, state and federal fighting antibodies—in the bloodstream of advance groundbreaking research, prevent governments make the difficult decisions both symptomatic and asymptomatic partici- the spread of this virus and save lives.” crucial to efficient distribution. pants to understand how COVID-19 spreads The second phase of the project seeks to assess the feasibility, acceptability and

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“We want to understand whether rapid antigen tests identify infectious and asymptomatic individuals, whether they can be Neeraj Sood participated in a press briefing with Los Angeles self-administered, and how they can be used for screening at Mayor Eric Garcetti and the schools and workplaces. We are especially excited to be piloting Los Angeles County Department a new rapid antigen test and mobile app that uses computer of Public Health about the project to examine use of rapid antigen vision technology to automatically interpret results.” tests among first responders and – Neeraj Sood, Schaeffer Center COVID Initiative Director school-aged children.

Those who perceived a higher risk of dying or getting seriously sick from COVID-19 were more likely to engage in protective behaviors.

Schaeffer Center Senior Fellow Jeffrey is likely to have a substantial impact on the Analysis promotes widescale clear policies for educating frontline staff “Unless addressed by effective health Schaeffer experts offer pooled McCombs and colleagues emphasized the supply of many drugs.” random testing and greater care on steps to maintain personal hygiene and communication that reaches individuals across testing as a cost-effective measure importance of community pharmacists to any In addition, vaccine hesitancy is a major with personal protective equipment. protect the health of vulnerable, noninfected all social strata, variations in perceptions about to help safely reopen businesses immunization effort. “Roughly 9 out of 10 concern. According to a survey of Americans patients in addition to those presenting the COVID-19 epidemic raise concerns about and schools. Americans live within five miles of a pharmacy conducted in December 2020, only 63% said In March 2020, Sood penned an opinion with COVID-19,” he and colleagues wrote in the ability of the U.S. to implement and sustain with the capacity to provide vaccinations they would take the COVID-19 vaccine, down piece in The Wall Street Journal calling for a position paper for the National Pressure the widespread and restrictive policies that are As the pandemic spread and testing supplies during extended hours and without an appoint- from 83% in March 2020. “These results sug- random testing rather than only testing the Injury Advisory Panel. required to curtail the pandemic,” Bruine de became more limited, screening as many people ment,” they wrote. However, to be truly effective, gest that we need to have good strategies in symptomatic to better understand community Bruin and her fellow researchers wrote. as possible as quickly as possible became urgent. “state practice laws concerning vaccine place very soon to ensure the greatest possible spread. Schaeffer Center Fellow William Padula As COVID-19 began spreading, so In a co-authored op-ed for the Los Angeles In July 2020, Schaeffer Center Director of prescribing authority should be uniform across uptake of vaccines,” said Wändi Bruine de expanded on this idea. Writing in Applied did disagreements about its hazards Times in April 2020, Goldman proposed Research Darius Lakdawalla, Associate Director states and written to automatically include Bruin, co-director of the Schaeffer Center’s Health Economics and Health Policy, Padula and how to respond. Schaeffer Center modifying California’s smog alert system to Erin Trish and Goldman proposed pooled new vaccines once they are approved by the Behavioral Sciences program, during an expert noted “there is substantial evidence to support research emphasized the importance warn people of COVID-19 spikes. Such “virus testing as a way to safely reopen businesses Food and Drug Administration.” panel on vaccine adoption hosted virtually the belief that many of the infected population of clear messaging and public alerts alerts” would be triggered by high levels of and schools. In February 2020, Schaeffer Center Director by the Schaeffer Center. are asymptomatic.” Therefore, “the U.S. to protect people from COVID-19. infection or mortality rates. Instead of laboratories running tests on of Health Policy Geoffrey Joyce brought attention Schaeffer Center Director Dana Goldman, should consider randomizing testing in the “People could return to work while observing each individual in a company or school, pooled to the dangers of shortages posed by supply Senior Fellow John Romley and Visiting Scholar general population.” Bruine de Bruin conducted a national study reasonable safety rules, such as wearing masks testing processes samples in batches. If a result chains. In an interview with the Los Angeles Matthew A. Crane examined the public health Padula also found that long hours of that highlighted the importance of clearly com- in public places and practicing social distancing shows one or more infections, individual testing Times, he said, “the vast majority of raw materi- challenge of vaccine hesitancy and urged trans- wearing the same mask may result in facial municating the disease’s risks. She found that in restaurants and workplaces,” Goldman and is used to find the source. However, if the pool als that go into a prescription drug are produced parency from public health agencies at all levels injuries, rendering caregivers vulnerable to the people who understood the potential dangers his co-author wrote. To that end, they also comes back negative, all members are cleared overseas, mostly in China and India.” As a result, to address safety concerns. Communication very virus from which the gear aims to protect were more likely to take protective measures. encouraged public service campaigns remind- for in-person work or school. he noted, “[t]he coronavirus shutting down with minorities, especially the Black community, them. “Healthcare facilities should establish ing the public to follow these commonsense China or India for an extended period of time is especially vital as they may be distrustful of safety measures. vaccines due to historical wrongs.

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“Testing as a surveillance strategy is critical for a successful reopening of the country, especially given the concerns about people being infectious and asymptomatic. But testing millions of people individually is cost-prohibitive. Our study shows pooled testing is an effective tool for identifying people who have the virus at a reasonable cost.” – Darius Lakdawalla, Schaeffer Center Director of Research

12 webinars hosted by the Schaeffer Center brought together leaders to discuss the pandemic and its impact.

Pooled testing could Pooled testing works by batching samples from several people. If the pooled sample result is positive, it indicates at least % reduce testing costs for one person in that pool is infected. Individuals in the infected pool are retested to reveal the source. By contrast, if the pooled 50 schools and businesses sample comes back negative, it clears all members of the pool until the next testing cycle. by at least half.

The team found that pools of four are to 4.5 million deaths among older Americans. and entire industries shut down, compared They estimated that an outpatient treatment “We will need to manage COVID-19, The USC-Brookings Schaeffer Initiative optimal—and would cut costs of periodic test- Fortunately, policymakers heeded enough to virus death totals that may reach only the reducing hospitalization risk by 50% would and possibly other novel viruses, for years to for Health Policy helped protect families by ing by more than half while providing accurate advice from experts, including Schaeffer numbers from a bad flu season (55,000).” result in 285,000 fewer hospitalizations, up to come,” the team added. “A vital tool will be disseminating information on the pitfalls to avoid results. In response to this research, the Food Center fellows, to avoid that outcome, but However, Joyce noted, the emerging data 71,000 fewer deaths and almost $88 billion in effective treatments. We must prioritize their and the types of comprehensive coverage to and Drug Administration began issuing emer- the toll has still been tragically high. showed that governments had no choice but value by the end of 2021. Meanwhile, a hospital- development now. If we do, we will be rewarded look for. The initiative also explained how and gency-use authorizations for pooled-testing To avoid the worst, Mireille Jacobson, co- to impose restrictions. “Assuming that mortality based treatment that reduces mortality and with resilient health systems, a stronger where to sign up. The authors noted, however, techniques and school administrators reached director of the Schaeffer Center’s Aging and rates would rise from 0.5% to 1.5% as hospitals length of stay by 30% would save between economy and longer lives.” that people had to act fast. In many cases, the out to Schaeffer Center experts for advice. Cognition program, wrote in STAT in March 2020: become increasingly overrun, the estimated 51,000 and 85,000 lives, generating up to deadline for getting coverage is 60 days after The findings also garnered nationwide media “We should all be prepared to make significant cost of COVID-19 increases to $5.6 trillion,” $106 billion in value during that same period. The USC-Brookings Schaeffer the previous plan ends—and healthcare costs coverage. economic sacrifices now to minimize the harm he calculated. “With the U.S. not pursuing a strategy Initiative helps consumers navigate often remain uncovered until enrollees sign up. of this evolving crisis. Furthermore, we should of ‘crushing the virus’ like Europe and Asia, the insurance market to get better In a story for Marketplace in May 2020, Schaeffer Center research examined provide assistance to help those who are A Schaeffer Center model showed treatment to manage the virus’s impact healthcare value—with the USC-Brookings Schaeffer Initiative Fellow the balance between public health disproportionally affected by such measures the potential value of new COVID-19 becomes even more valuable,” they wrote. pandemic adding new urgency. Christen Linke Young explained that the plans concerns and the economic conse- weather the current storm and get back on therapies—in vivid terms of lives This was especially true before vaccines “are likely more affordable than people may be quences of COVID-19. their feet once the epidemic has passed.” saved and dollars conserved. became available. Yet innovative treatments As COVID-19 cases mounted, the Affordable expecting," adding that the plans are subsidized Joyce examined the economics of COVID-19 will remain vital to COVID-19 management, Care Act (ACA) enabled many families to obtain and based on estimated total yearly income. Nobel Laureate and Schaffer Center Distin- for MarketWatch in April 2020. “Some econo- Schaeffer Center Fellows Karen Mulligan and as vaccines are not perfect and some subsidized coverage during special enrollment “On average, for people who bought a plan on guished Fellow Daniel McFadden analyzed mists and business leaders believe the costs Karen Van Nuys, along with Joyce, used a data people will refuse inoculation. periods or if they had lost coverage along with a healthcare.gov last year, the financial assis- a worst-case scenario of the pandemic in of constraining the virus have exceeded the model to consider the financial and health- job loss. However, those who are excluded may tance covered 87% of the premium.” spring 2020, finding that it could cause up benefits,” he wrote. “They point to unemploy- related benefits of two hypothetical treatments. turn to insurance that does not comply with ment totals not seen since the Depression ACA standards.

16 USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu 17 X\_Aging and Cognition

Alzheimer’s disease is the most common form of dementia and a leading cause of death for older Americans. It currently afflicts more than 5 million people across the country—a figure that threatens to triple in the next 40 years. But new therapies are on the way, and the Schaeffer Center is exploring options to facilitate their use, improve clinical trials, and ease the burden of the disease for patients and families.

75% of survey respondents reported never receiving a structured cognitive assessment at an annual wellness 14 million visit, even though an assessment Americans will be stricken with Alzheimer’s disease is required under the ACA. by 2060 without significant new interventions.

Schaeffer Center researchers With breakthroughs on the horizon, Schaeffer Center Director Dana Goldman However, more people need regular The Schaeffer Center is exploring By 2050, the total cost of Alzheimer’s uncover why Alzheimer’s clinical Alzheimer’s disease may finally meet moderated the panel, which included Sharon assessments so interventions can be employed. new ways to ease the toll of disease will be $1.5 trillion. But a delay trials are slower to enroll participants, its match, but health systems must Cohen, medical director of the Toronto Memory A Schaeffer Center study led by Aging and Alzheimer’s disease on individuals, of even one year would reduce costs take longer to complete and are be prepared. Program at the University of Toronto, and Heather Cognition program Co-Director Mireille Jacobson families and caregivers, along with and prevalence. more expensive than those for Snyder, vice president of Medical and Scientific showed that only one-fourth of Medicare strategies to reduce the burden other conditions. New Alzheimer’s disease treatments and Relations at the Alzheimer’s Association. patients report receiving structured cognitive on health systems. cY.]T prevention strategies are drawing near, with A second panel discussed possible models assessments during annual wellness visits, even cY.[T In a survey of nearly 900 Alzheimer’s stake- a reported 132 drugs in the pipeline. Many to pay for novel treatments. Schaeffer Center though they are a required component. With a $4.1 million grant from the National cY.YT holders, researchers found that 99% of eligible of these could slow or reverse development Director of Research Darius Lakdawalla Institute on Aging, the Schaeffer Center cX.aT patients are never referred to or consider of Alzheimer’s telltale brain plaques, called suggested that USC’s Future Elderly Model A healthy lifestyle and management launched the multisite Center for Advancing participating in an Alzheimer’s clinical trial. amyloids. microsimulation could help estimate long-term of risk factors such as high blood Sociodemographic and Economic Study of Schaeffer Center experts say that patient “We are close to major breakthroughs,” health consequences of functional and cogni- pressure and high cholesterol could Alzheimer’s Disease (CeASES-ADRD). Led by organizations, healthcare providers, researchers, said Paul Aisen, founding director of the USC tive decline and associated costs, and inform reduce dementia rates. Julie Zissimopoulos, co-director of the Aging government and industry must work together Alzheimer’s Therapeutic Research Institute, a pricing strategy that would reflect the and Cognition program, CeASES-ADRD confronts in a holistic approach to reform clinical trials during a webinar held by the USC-Brookings lifetime health burden of Alzheimer’s. Certain combinations of cardiovascular drugs the enormous health, economic and social Status 6-Year 8-Year 9-Year for Alzheimer’s, improving awareness of the Schaeffer Initiative for Health Policy. Leonard Early interventions are key. Citing Schaeffer may reduce the risk of Alzheimer’s disease, costs of Alzheimer’s disease by increasing Quo Delay Delay Delay disease and facilitating participation in trials Schaeffer introduced Aisen, who noted that Center research, panelist Sarah Lenz Lock, according to a Schaeffer Center study of nearly knowledge and technological capacity and among diverse patients. advances in brain imaging and blood-based senior vice president for Policy and Brain Health 700,000 Medicare beneficiaries. Since 1 in 4 building a global network of researchers. biomarkers may help with Alzheimer’s at AARP, noted that if innovative drugs reduce adults over age 65 uses both antihypertensives Partners include Stanford University and prevention. the risk of getting Alzheimer’s by 20% to 40%, and statins, treatments already in use could the University of Texas at Austin. or can delay onset by five years, the overall reduce the number of people with Alzheimer’s cost burden could be cut in half. and related dementias.

18 USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu 19 X]_Population Health

Health inequity is one of today’s most urgent challenges. The Schaeffer Center develops high-value strategies to improve the wellbeing of vulnerable and underserved populations. Our research explores issues confronting patients of all ages and backgrounds—as well as systemic issues within the healthcare system.

158 thousand+ Americans died from drug overdoses, suicide or alcoholism in 2017 alone.

Each generation of less-educated In conducting the study, Nobel Laureate and example of how the U.S. medical system has Americans reports more pain through- Schaeffer Center Distinguished Fellow Sir Angus failed to uphold its mandate of improving out their lives than their elders, and Deaton, Princeton Professor Anne Case and people’s health. education may hold the key. Schaeffer Center Fellow Arthur Stone drew from surveys of more than 2.5 million adults in the The Schaeffer Center promotes Schaeffer Center research reveals that middle- United States and Europe. The research builds policies to ensure high-quality care 100M aged Americans now report more pain than on previous work by Deaton and Case that for kidney patients. Americans experience the elderly, and reports of pain are rising more coined the term “deaths of despair.” pain, costing the U.S. quickly in younger people. The trend seems to Deaton and Case’s bestselling book, Schaeffer Center Fellow Eugene Lin and Director as much as $635 billion be driven by the two-thirds of U.S. adults with- Deaths of Despair and the Future of American of the USC-Brookings Schaeffer Initiative Paul each year. out a four-year college degree. This troubling Capitalism, documents the devastating deaths Ginsburg co-authored an influential report finding seems to be unique to our nation— that preceded COVID-19. In 2017 alone, 158,000 on the dominance of in-center dialysis care, and is rising with each generation. Americans died from drug overdoses, suicide which has persisted despite home-based alter- The intergenerational increase could be or alcoholism. The toll contributed to the first natives offering similar outcomes and often driven by numerous factors to which the less three-year drop in U.S. life expectancy since being preferred by patients. In 2019, a presi- educated are vulnerable—including stagnant the flu pandemic of 1918. dential executive order, Advancing American wages, unemployment, broken homes and Although policymakers have tried to Kidney Health, was signed to enable more social isolation. If the trend continues address opioid addiction as a main cause, patients to receive dialysis treatments at unchecked, tomorrow’s elderly will be sicker Deaton and Case argue that these addictions home—increasing patient satisfaction while than older people today, presenting even merely accelerated an already existing epidemic. reducing Medicare costs. greater challenges for the healthcare system Opioid overprescribing also provides a glaring that tends to their needs.

USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu 21 05_Population Health

“Current research is limited by a lack of complete and representative data sets. Our goal is to change this and ultimately better understand how different populations have different health behaviors and experience different social determinants of health. With that information, we hope to create precision public health interventions that meet individual needs.” – Ritika Chaturvedi, Schaeffer Center Research Scientist and Principal Investigator, American Life in Real-Time

of L.A. County residents— Adults with congenital many of whom live in the urban heart defects have a life 37 million % 20 core—have only intermittent expectancy 4.6 years lower Americans use cannabis each year. access to comprehensive than healthy adults. stroke centers. 145 opioid policy studies revealed a need for more rigor in research design and statistical methods.

A new digital initiative collects Schaeffer Center research examines healthcare system. However, the process has A Schaeffer Center expert evaluates “The unregulated vaping market today is a data from across sociodemographic how states are tackling the opioid been slow and mostly unknown to the public. markets for recreational drugs to Wild West of hucksters, unsubstantiated claims groups to improve population health crisis to promote best practices for Further, more needs to be done to modernize examine their health ramifications. and unknown ingredients. The health of our % and reduce disparities. stemming addiction. information systems so those helping people nation, particularly our young people, is riding 1 overcome addiction can better communicate As more states and nations legalize marijuana on getting it under control,” said Pacula, for The American Life in Real-Time project is Ten Western states reported an increase of with insurers. for recreational use, policymakers rely on an article that appeared in The Hill. building the first large-scale digital health nearly 100% in deaths caused by synthetic Pacula’s expertise for evidence-driven analysis dataset that will represent everyone in the opioids in 2020. To promote effective tactics Researchers calculate the lifetime of the long-term effects of decriminalization. Who receives advanced stroke care of Medicare patients live nation—including previously underrepresented for stopping the tidal wave of opioid addiction, costs of adult congenital heart disease. In her role as president of the International may depend on traffic. with kidney failure but represent ethnic and economic groups. The Schaeffer Schaeffer Center Senior Fellow Rosalie Liccardo Society for the Study of Drug Policy, Pacula has 7% of Medicare spending. Center launched the initiative with the RAND Pacula collaborated on an examination of Schaeffer Center Fellow Cynthia Gong, Health testified before the United Nations and World Schaeffer Center Fellow Sarah Axeen and Corporation and Evidation Health to correct three approaches taken by states: Policy Microsimulation Director Bryan Tysinger Health Organization and has briefed state colleagues at the Keck School of Medicine at the bias in most data sets that investigators rely • Increasing healthcare insurance coverage and Schaeffer Center Director Dana Goldman legislatures and the Centers for Disease USC analyzed how long it took emergency med- on. For example, as information collected by and payment rates modeled the lifetime health, education, labor Control and Prevention. ical services to transport patients to hospitals internet-enabled devices is increasingly used • Expanding treatment capacity and social outcomes of people with congenital Vaping represents a particular health with comprehensive stroke centers in L.A. to study public health, people who cannot afford • Developing more comprehensive and heart disease. They found that adults with the concern, especially since young e-cigarette County. The study revealed that shifting traffic or choose not to purchase such technology connected treatment networks condition face a lifetime burden of $500,000 users have been shown to be five times more conditions—not distance—result in nearly are being left out of data pools. compared to those who are healthy. The study likely to be diagnosed with COVID-19 than 20% of the population having only intermittent The study notes that, thanks to federal used the Future Adult Model, an economic- nonusers. However, Pacula suggests that access to care. The researchers hope these efforts and certain state initiatives, substance- demographic microsimulation that covers the making e-cigarettes illegal would simply drive findings will influence how planners and public use treatment organizations are gradually entire U.S. population, to study the lifetime the market underground—making it harder health professionals allocate resources and becoming better integrated into the overall impacts of chronic diseases. to track health effects. think about access.

22 USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu 23 X^_Affordability and Value

U.S. medical costs are the highest in the world—but vast spending does not automatically result in healthier outcomes. By measuring and analyzing value in healthcare and proposing insightful and affordable ways to enhance resources, Schaeffer Center experts are helping improve healthcare for all.

30% I of health spending in 10 thousand the U.S. is wasteful or per person annual spending on healthcare in the U.S. medically inappropriate.

Higher spending does not necessarily delivery and revised payment models indicated Markets Initiative examines numerous areas While the U.S. has achieved cancer mortality drop by 9% compared to lead to better cancer outcomes— that lower spending is achievable without for potential improvements, such as encourag- significant reductions in cancer their slightly younger peers. especially at the end of life. adversely affecting outcomes, with the best ing innovation to treat chronic disease, making mortality, it’s been an expensive The authors’ conclusion: Universal coverage results coming from efforts to limit expensive health insurance markets work more efficiently, endeavor—with oncology spending improves detection and outcomes, especially Schaeffer Center Director of Research Darius hospital use. improving regulation to support medical rising from $27 billion in 1990 to for underserved populations that may delay Lakdawalla and Schaeffer Center Director Dana innovation and designing pay-for-performance $137 billion in 2017. healthcare if they have inconsistent insurance Goldman reviewed studies that examined the The Schaeffer Center’s new frameworks. coverage. 10% increase in cancer relationship between spending and outcomes Healthcare Markets Initiative In a study published in the Journal of Policy detection with access to in cancer in the U.S. and internationally. They explores novel ways to deliver A Schaeffer Center study examined Analysis and Management, Schaeffer Center Medicare at age 65 found that higher cancer spending, in interna- value and improve efficiency. life-expectancy gains in recent experts explored whether cancer detection Five-year survival for older tional comparisons, was almost always corre- decades for healthy Americans and and mortality rates shifted at age 65, when individuals with major chronic lated with better outcomes and lower mortality. U.S. healthcare markets suffer from both those with chronic conditions such Americans become eligible for Medicare. conditions is improving and racial However, spending in the United States— overuse and underuse. The challenge is how to as diabetes, hypertension and Focusing on breast, colorectal and lung disparities are narrowing. especially when focused at the end of life— create market incentives to eliminate the ineffi- coronary artery disease. cancer—since guidelines recommend screen- did not always produce better outcomes and ciencies that make some services too expensive ings for those conditions before and after age a]% aY% aY% was frequently associated with higher mortality. and many public-sector reimbursements too Published in Health Economics, the research 65—they found that access to Medicare aX% `_% `_% Writing in the Journal of Clinical Oncology, low. Led by Lakdawalla and Nonresident Senior found that in people with or without chronic coverage increased cancer detection by 10% `^% `_% the team noted that although the average Fellow Joe Grogan, the Healthcare Markets conditions, survival gains were significant only at age 65 compared to people just one to `]% `[% `X% patient in the United States has faster access Initiative brings together experts and innovators among those over age 65—notably, the sole two years younger. In terms of survival, the `X% to a greater number of innovative treatments to seek ways of redesigning healthcare markets group in the U.S. with universal access to public analysis revealed a 4.5% decrease in cancer and services, overall costs are driven up through to improve their function. insurance. Racial disparities in life expectancy mortality for women age 65 when contrasted _]% wasteful spending. Studies of alternative care Taking a broad view of medical services, also narrowed with access to Medicare. with women ages 63–64—and results were _X% drugs, devices and insurance, the Healthcare even better for Black women, who saw ZXX\ ZXY\ ZXX\ ZXY\ ZXX\ ZXY\ ZXX\ ZXY\ Black Males White Males Black Females White Females

24 USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu 25 X__USC-Brookings Schaeffer Initiative for Health Policy

The USC-Brookings Schaeffer Initiative for Health Policy combines the data and analytic strengths of the Schaeffer Center with the policy expertise of Economic Studies at Brookings. In the five years since its founding, the initiative has become an influential powerhouse that informs the national healthcare debate with rigorous, evidence-based analysis and practical recommendations.

of insurer spending on % medical care goes to providers 12 in categories that commonly issue surprise bills. 50% of uninsured Americans are eligible for subsidized Surprise medical billing has become In one study, Erin L. Duffy, a Schaeffer “The law really captures every single form health insurance one of the most pressing topics in Center postdoctoral research fellow, and her of surprise billing that we think of in this context, coverage. healthcare, and USC-Brookings co-authors found that 12% of insurer spending except ground ambulances,” Adler told The Schaeffer Initiative experts have been on medical care goes to providers who com- New York Times. prolific contributors to analysis of monly issue surprise bills. With renewed support from Arnold Ventures the issue and policy solutions. Loren Adler, associate director of the through 2023, USC-Brookings Schaeffer experts Schaeffer Initiative, provided technical assis- will continue the team’s solution-focused work Too often after a hospital procedure or visit tance to state leaders in Indiana, Maine and on surprise billing. to an emergency room, patients get hit with Virginia in crafting surprise billing legislation unexpected bills from out-of-network providers in 2020—with Indiana passing the first state Services for which surprise billing —such as anesthesiologists, emergency room law to protect patients enrolled in self- is common make up 12% of health doctors and radiologists—that they had no insured employer health plans. plan spending. role in choosing. Ginsburg, Adler and other initiative leaders Under the leadership of Director Paul have also provided guidance to Congress Emergency outpatient [.Y% Ginsburg, the USC-Brookings Schaeffer Initiative on this issue. As a result, in December 2020, Anesthesia Z.\% for Health Policy produced seven publications Congress passed legislation that eliminates Pathology Z.\% on surprise billing over the past year, including surprise bills for patients who receive emer- Radiology Z.[% investigations of different states’ laws, the most gency care, are transported by air ambulance Emergency Y.]% common sources of surprise bills and how or receive nonemergency care at an in-network Ground ambulances X.[% policies to address surprise billing could lower hospital. Adler was subsequently quoted in Total GH.F% premiums for all. numerous media outlets.

26 USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu 07_USC-Brookings Schaeffer Initiative for Health Policy

“Policymakers are well aware that we spend a lot on healthcare. What they need now is better information on why, and what we can do about it.” Even before the pandemic forced millions of people out of jobs, a – Erin Trish, Schaeffer Center Associate Director substantial number of individuals were losing their employer-covered health insurance after layoffs.

I 67% 56% 3.6 million uninsured for at least uninsured for at least in support from Arnold Ventures will focus on rising healthcare spending. one month three months 30 studies authored by Schaeffer Initiative experts on surprise billing have been published since 2016.

Regulatory gaps lead some Americans Despite reports of cost reform by as downside risk,” they wrote. “Sound evidence but getting insurance through these sources Schaeffer Initiative researchers to choose health insurance that falls CMS, analysis reveals that savings and theory should inform vision and set a requires information and action on the part launch a new portfolio of projects below the standards set by the ACA. were overstated. course. Resolve will be a must and patience of the individual. In an analysis published by to improve understanding of rising a virtue. Guided by these principles, designing Health Affairs, Linke Young and colleagues healthcare spending. Building on decades of prior law, the Affordable The Centers for Medicare & Medicaid Services a payment system that improves the efficiency found two obstacles to enrollment that could Care Act (ACA) took important steps toward (CMS) estimated that the Medicare Shared of care delivery, meets fiscal goals and makes be addressed through federal and state policies: With $3.6 million in support from Arnold a comprehensive regulatory structure that sets Savings Program led to $2.6 billion in gross patients better off should be doable.” perceived affordability of coverage and com- Ventures, the team will take a data-driven minimum standards for healthcare coverage. savings in 2019 and $1.2 billion in net savings plexity of the enrollment landscape. They look at provider prices, market consolidation, Yet some plans—referred to as “junk insurance” when accounting for shared-savings payments Employer-sponsored insurance offered three ways to improve health insurance private equity, consumer costs, and a patch- —still fail to meet those standards, leaving to participating Accountable Care Organizations is the primary source of coverage for enrollment: simplified income rules, consumer work of related state and federal laws consumers burdened by high costs. (ACOs). Alice Chen, a Schaeffer senior fellow, U.S. workers and their dependents— assistance and automatic enrollment. Such to produce evidence-based insights for In addition to conducting an expansive and J. Michael McWilliams, a Schaeffer Center so when unemployment rises so does approaches could increase health insurance consumers, insurers and policymakers. analysis of junk insurance, Schaeffer Initiative visiting scholar, crafted a two-part response the uninsured rate. Auto enrollment coverage even during an economic downturn. The researchers hope to fill knowledge Fellow Christen Linke Young has met with staff published in Health Affairs. They outlined the into subsidized coverage could be Linke Young continued her work on auto gaps that have prevented action or led from numerous congressional committees and ways that the CMS assessment is misleading a solution. enrollment through additional publications, state and federal policymakers to pursue state insurance departments to offer pathways and recommended reforms to help ACOs a webinar co-hosted by the Schaeffer Initiative ineffective solutions. to improved regulation and oversight. After achieve their potential and help CMS reach Millions of Americans who lose their employer- and the American Enterprise Institute, conver- a yearlong investigation into the issue, the its efficiency goals. based insurance fall through the cracks. They sations with members of Congress and a House Committee on Energy and Commerce “At this stage of Medicare payment reform, might qualify for Medicaid or insurance through state auto-enrollment proposal with Covered released a report on short-term plans to curb progress is not served by applauding illusory subsidized marketplaces created by the ACA California. junk insurance, citing work by Linke Young savings or overselling simple solutions such and Kathleen Hannick, a Schaeffer Initiative senior research assistant.

28 USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu 29 USC Schaeffer Center 2020 _ meeting the challenges ahead

COVID-19 has brought many lessons Looking ahead, we will continue to arm about infectious disease, public health, policymakers—from the new presidential pharmaceutical distribution, health outcomes administration to local communities—with and the need for clear, reliable and honest evidence-based analysis to inform their communication. As soon as the crisis unfolded, decision-making and improve health policy. the Schaeffer Center quickly pivoted, develop- We will continue to develop partnerships ing much-needed insights to help alleviate across the country and around the globe the impact on public health and the economy. to ensure the underserved and vulnerable Meanwhile, we furthered the Center’s impor- have access to affordable care. And we will tant work in a host of other ongoing health continue conducting research with impact policy concerns. Our experts found new and making significant contributions to strategies for easing the damage wrought policy and health improvement. by Alzheimer’s disease, reducing substance Though the future will inevitably bring addiction, saving consumers from surprise new healthcare crises, we are prepared to medical bills and enhancing the value meet these challenges and rise to the occasion. of treatments for conditions ranging from The Schaeffer Center will always remain cancer to diabetes. resolute in developing innovative, cost- effective methods for improving individual and population health. Data Report _

The Schaeffer Center’s microsimulation team the Social Security and Medicare programs. Schaeffer Center researchers leveraged and data core leverage the information and Schaeffer Center researchers have used the the FEM to evaluate the economic and health tools necessary to help answer big questions FEM to explore an increasingly wide variety of impacts of the CIRM investment in California. in health policy with evidence-based solutions. policy questions, ranging from the fiscal future They estimate that a new therapy that halves Including programmers, microsimulation model- of the U.S. to the role biomedical innovation the rate of diabetes among adults over age 51 ers, statisticians, analysts and a data resource can play in future health outcomes. They are would translate to a $332 billion gain between administrator, the team brings expertise in also using the model to drill down into the 2018 and 2050 in social value. the methods and programming necessary to financial impact of a range of disease states. Ultimately, the goal is to offer a tool to rigorously analyze big data. Schaeffer Center The Future Adult Model (FAM) extends help policymakers weigh the pros and cons of fellows and students rely on this team for the FEM to the adult population age 25 and potential policies using actual evidence about support on a range of projects. older in the United States, allowing the team to impact when deciding where to put resources. model much more of the life span. For example, Findings using the FEM and FAM models have Health Policy Microsimulation the researchers analyzed lifetime health, edu- been published in top journals and cited— For more than a decade, the Schaeffer Center cation, labor and social outcomes for people or commissioned—by government agencies, has been at the forefront of developing pioneer- born with congenital heart defects—many the White House, the National Academy of ing economic demographic microsimulation more of whom are living into adulthood due to Sciences and private organizations interested tools to effectively model future trends in advances in technology. The team found that in aging policy. health and longevity and answer salient ques- living with congenital heart defects is associated tions in health policy. The centerpiece effort is with significant challenges, negatively impact- Data Partnerships and Collaborations the Future Elderly Model (FEM), which projects ing quality of life, disability and life expectancy In addition to being a resource for Schaeffer a rich set of health and economic outcomes as well as medical spending, chronic disease Center researchers, the data core and micro- for the U.S. population age 50 and older. The and employment outcomes. simulation team partners with local, state, fed- In just one project, data from the Greater chronic mental and physical health problems, FEM was originally set up to answer questions The microsimulation team is building a eral and international collaborators to develop Los Angeles Homeless Count is analyzed by the HIV status, veteran status and the length of about the long-term economic viability of global network of collaborators who are devel- data projects and models. Key collaborations Schaeffer Center’s data core team members, time persons have experienced homelessness. oping country-level FEM-based models in 18 include the National Academies of Sciences, who clean, categorize and divide the data to The Schaeffer Center has served as the nations. This effort will allow researchers to Engineering, and Medicine; Los Angeles County understand key components of the homeless project’s data partner since 2017. compare demographic, health and economic Department of Public Health; and Los Angeles population, including age, race, ethnicity, trends on a global scale. Homeless Services Authority. Data Library and Data Security Models have also gone local, with simulations The data library maintained at the Schaeffer conducted for California and Los Angeles County Center includes survey data, public and private 170million to help policymakers at the state and county Gains in social value by 2050 if disease claims, contextual data and electronic health levels understand trends and the impact of incidence in California were reduced network data feeds. The Schaeffer Center data lives represented in Schaeffer Center data policy decisions. core is a pioneering information resource and For example, in 2004, the California Institute Value of Health (in billions) computing environment that meets exacting

for Regenerative Medicine (CIRM) was launched c[]X c[[Z standards of excellence in data security. The A team of 16 data scientists maintains with $3 billion in funding approved by the state’s data core manages a mix of security measures, over 70 databases and provides support for voters. CIRM delves deep into the possibilities c[XX from an air-gapped workstation to state-of-the- of stem cell research, which holds promise art, Health Insurance Portability and Accounta- cZZa each of the Center’s research projects. for generating breakthroughs for conditions cZ]X bility Act (HIPAA)-compliant systems that include

including Alzheimer’s, cancer, diabetes, heart cZXX 24/7 monitoring to ensure private health data disease, vision loss—and even COVID-19. Yet cY]Y resources are protected. this leading-edge science requires significant cY]X investment. cYXX c_Z c^X c]^ c][ c\_ c]X c[X cYX cY] cY[ cX Breast Cancer Colon Cancer Lung Cancer Prostate Diabetes Stroke Cancer

]X% Incidence Reduction YX% Incidence Reduction

32 USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu 33 Financial Report _ Supporters _

For fiscal year 2020 (July 1, 2019–June 30, In fiscal year 2020, the Center funded A wide range of public and private Josephine Herbert Gleis Foundation Pamela and Leonard D. Schaeffer 2020), total expenditures on the operating the $12.9 million in operating expenses with funders provide grants, gifts and Dana P. Goldman Arnold Schwarzenegger budget were $12.9 million. The operating budget $18.9 million current revenue. University support sponsorships that help advance our Toni and Chase Haddix The Eunice Kennedy Shriver includes compensation for faculty, scholars does not include faculty salaries covered by work. The Schaeffer Center gratefully Ann and Kent Harada National Institute of Child Health and staff, programmatic expenses and general the schools. Since its inception, the Schaeffer acknowledges the following fiscal Brian Harper and Human Development operating costs. Faculty salaries that are covered Center has raised more than $130 million, the year 2020 supporters: Helmsley Charitable Trust Jacque J. Sokolov by the schools are not included in these totals. majority of which has come from federal grants. Jaeb Center for Health Research Neeraj Sood Expenses by function are outlined in the graph 5AM Ventures Gauri Jauhar Walter Jay Unger below left. Conflict of Interest Policy Agency for Healthcare Research Quality Jedel Family Foundation University of Southern California The USC Leonard D. Schaeffer Center for Catherine Ahmed Johnson & Johnson USC Lusk Center for Real Estate Health Policy & Economics conducts innovative, Allergan Alliance Advocacy Henry J. Kaiser Family Foundation USC Schwarzenegger Institute for independent research that makes significant Amgen Carole King State and Global Policy 70 federally funded projects spanning contributions to policy and health improvement. Laura and John Arnold Foundation Komoto Family Foundation Utrecht University Center experts pursue a range of priority research Brent Bayless Philip Lebherz Walgreens Boots Alliance topics such as Alzheimer’s disease, Medicare areas focused on addressing problems within Blue Cross Blue Shield of Arizona Los Angeles Homeless Timothy Wright Part D, aging and health disparities the health sphere. Donors may request that Blue Cross Blue Shield of Illinois Services Authority Meng Yin their funds be used to address a general Blue Cross Blue Shield of Massachusetts Massachusetts Institute of Technology USC Provost Charles F. Zukoski research priority area, including: Brewster Foundation Richard N. Merkin, MD • Improve the performance of healthcare Bristol-Myers Squibb Gordon and Betty Moore Foundation Thank you markets Cathy and Drew Burch National Cancer Institute Your generosity contributes to a% _% • Foster better pharmaceutical policy California Hospital Association National Institute of Diabetes and the work of the Schaeffer Center— \% Y_% and regulation Cambia Health Solutions Digestive and Kidney Diseases from groundbreaking, multidisciplinary a% • Increase value in healthcare delivery Cedars-Sinai National Institute of Nursing Research research to national conferences Operating Revenues ]Y% • Improve health and reduce disparities Centers for Disease Control and Prevention National Institute on Aging to fellowships—all of which helps Expenses Y]% throughout the life span Centers for Medicare & Medicaid Services National Institute on Alcohol Abuse us pursue innovative solutions ^[% Children’s Hospital Los Angeles and Alcoholism to improve healthcare delivery, Z]% Schaeffer Center funding comes from a range City of San Jose National Institute on Drug Abuse policies and outcomes. of sources, including government entities, CommonSpirit Health National Library of Medicine foundations, corporations, individuals and Stephanie and John Connaughton National Science Foundation For more information about how endowment. At all times, the independence Susan and John Diekman Regina Nordahl to make a gift, please contact: >67.=M >685M and integrity of the research is paramount and Jason Doctor Novartis Pharmaceuticals Corporation Ann S. M. Harada for fiscal year ZXZX (inception through X^d[XdZX) the Center retains the right to publish all Donaghue Foundation Sam Nussbaum Managing Director • Research: ><.6M • Government, >::.6M findings from its research activities. Funding Edwards Lifesciences Patricia and James P. OConor (213) 821-1764 Salaries, research expenses, National Institutes of Health, Centers sources are always disclosed. The Center Edwards Lifesciences Foundation Patient-Centered Outcomes initiatives and special projects for Medicare & Medicaid Services, does not conduct proprietary research. USC President Carol L. Folt Research Institute and other government sources • Data Core and Health As is the case at many elite academic Steven Fradkin Melinda and Norm Payson Informatics, >6.=M • Corporations, >87.7M institutions, faculty associated with the USC Bill & Melinda Gates Foundation Pfizer Salaries, data and data infrastructure Industry Schaeffer Center are sought for their expertise Gates Ventures LLC Pharmaceutical Research and • External Affairs, >6.7M • Individuals and Foundations, by corporations, government entities and Genentech Manufacturers of America Salaries, development, >77.;M others. These external activities (e.g., consulting) Gilead Sciences Tom Pike communications and event expenses Foundations, family foundations are governed by the USC Faculty Handbook Providence St. Joseph Health and individuals • Research Training Programs, >5.9M and the university’s Conflict of Interest in Riksbankens Jubileumsfond Salaries and training expenses • USC and Others, >=.5M Professional and Business Practices and Conflict Judith A. Salerno University support and of Interest in Research policies. All outside • Administration, >6.7M miscellaneous income Salaries and general operating activities must be disclosed via the university’s expenses online disclosure system, diSClose, and faculty must adhere to all measures put in place to manage any appearance of conflict.

34 USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu 35 Research Training Programs _

In partnership with the USC School of 27 early-career scholars since its launch Pharmacy and USC Price School of Public in 2012. Collaborating centers include the Policy, the USC Schaeffer Center prepares the USC Roybal Center for Behavioral Interventions next generation of health policy researchers in Aging, USC Edward R. Roybal Institute on to bring innovation and expertise to higher Aging, USC Roybal Center for Financial Decision education, government, healthcare and research Making and Financial Independence in Old institutions. Our programs: Age, USC Alzheimer Disease Research Center, • Offer one-on-one mentorship and and USC/UCLA Center on Biodemography opportunities to collaborate with distin- and Population Health. guished investigators in the field • Provide dedicated, full-time administrative USC Center for Advancing and data support at the Schaeffer Center, Predoctoral Fellowships Sociodemographic and Economic and access to university-wide educational Predoctoral students in related programs in Study of Alzheimer’s Disease and and career-development resources the School of Pharmacy, Price School of Public Related Dementias • Equip trainees with sophisticated data- Policy, and USC Dornsife College of Letters, Arts Funded through the National Institutes of analysis tools and resources and Sciences can conduct research under the Health, the USC Center for Advancing Sociode- • Ensure numerous professional development guidance of a Schaeffer Center fellow, gaining mographic and Economic Study of Alzheimer’s opportunities, including support for grant knowledge and experience relevant to their Disease and Related Dementias (CeASES-ADRD) writing, publication in peer-reviewed doctoral program. is an interdisciplinary research center launched journals, and travel for attending and in 2020 by the Schaeffer Center, University presenting at major conferences Postdoctoral Fellowships of Texas at Austin Population Research Center • Assist trainees in securing influential Scholars chosen for our prestigious postdoc- and Stanford Health Policy. Its mission is to by senior and junior researchers from academic USC Schaeffer Center Summer positions in prestigious academic, public toral fellowships focus completely on research, advance innovative social science research in and research institutions focused on the Internships and private settings with no teaching requirement. They receive Alzheimer’s disease and related dementias, consequences of current patterns of practice Each summer, the USC Schaeffer Center one-on-one mentoring to support development increase and diversify the number of researchers and development of interventions that will welcomes outstanding graduate, undergraduate Clinical Fellowships of their individual research agendas and collab- working in the field, and disseminate findings improve care delivery, quality of care and and high school students to gain hands-on The clinical fellows program fosters orate with other Schaeffer Center researchers. for impact. Goals are accomplished through value to aging adults. experience and mentorship in health policy collaboration between Schaeffer Center fellows network meetings, workshops, pilot project research and data analysis as well as an and exceptional early-career scholars, clinical Pilot Funding support and the new annual USC Science of Additional Opportunities introduction to the broader field of health researchers and thought leaders. The program Alzheimer's Disease and Related Dementias economics through a three-week intensive provides training and support for grants, USC Alzheimer’s Disease Resource for Social Scientists Program. USC Science of Alzheimer’s internship program. Interns are paired papers and ongoing research projects. Center for Minority Aging and Health Disease and Related Dementias for with a Schaeffer Center mentor and given Economics Research USC Roybal Center for Behavioral Social Scientists Program resources to conduct a tailored research % The USC Alzheimer’s Disease Resource Center Interventions in Aging The inaugural Science of Alzheimer’s project. 100 for Minority Aging and Health Economics The USC Roybal Center for Behavioral Disease and Related Dementias for Social Research (USC AD-RCMAR) aims to increase Interventions in Aging conducts research that Scientists Program, set to take place in 2021, Research Assistantships of Schaeffer Center trainees the number, diversity and academic success of advances healthy aging for older adults who are will consist of informative and interactive Students from relevant disciplines—such go on to careers in healthcare or junior faculty who are focusing their research economically insecure, culturally diverse and lectures presented by national biomedical as economics, public policy, health policy, on the health and economic wellbeing of underserved by human services organizations. experts. Social scientists—from junior to statistics, medicine and psychology—work health policy in academic, private minority elderly populations, with an emphasis By developing and testing interventions based advanced—who are interested in research directly with Schaeffer Center fellows on on reducing the burden of Alzheimer’s disease on insights from behavioral science to promote into the biomedical foundations of Alzheimer’s specific research projects, attaining valuable and public-sector organizations. and dementia. Funded through a grant from the healthy aging, the Roybal Center aims to and related dementias can apply to participate. experience and skills to further their National Institute on Aging and support from strengthen the ability of clinicians to recommend The program is funded by the National research proficiency. the USC Office of the Provost, Price School the safest, most effective treatments for patients. Institute on Aging. of Public Policy and School of Pharmacy, USC The Roybal Center funds pilot projects proposed AD-RCMAR has cultivated the research of

36 USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu 37 Events and Seminars _

Schaeffer Center Celebrates A Short- and Long-Term Public-Private Efforts to Test Panelists included: Faculty Honors Approach to COVID-19 and Mitigate COVID-19 James Capretta, MA, resident fellow and Milton University of Southern California April 17, 2020 April 29, 2020 Friedman Chair, American Enterprise Institute Los Angeles William A. Haseltine, PhD, chair and president Schaeffer Center Director Dana Goldman, PhD, Lanhee J. Chen, PhD, David and Diane Steffy Fellow February 13, 2020 of ACCESS Health International and a Brookings led a discussion with panelists including Amgen in American Public Policy Studies, Hoover Institution; director of domestic policy studies, Public Policy The Schaeffer Center hosted a celebration Institution trustee, joined USC-Brookings Senior Vice President and former Acting U.S. Program, Stanford University of its senior fellows who have been appointed Schaeffer Initiative Director Paul B. Ginsburg, Surgeon General Steven Galson, MD, MPH, Bob Stan Dorn, JD, senior fellow and director, National to named professorships at USC. Senior Fellow PhD, for a discussion on tackling COVID-19. Kocher, MD, former member of the California Center for Coverage Innovation, Families USA Wändi Bruine de Bruin, MSc, PhD, was named Haseltine, who is known for his groundbreaking Coronavirus Testing Task Force, and Darius David Kendall, JD, senior fellow for health and Provost Professor of Public Policy, Psychology work on HIV/AIDS and pioneering applications Lakdawalla, PhD, Schaeffer Center director of fiscal policy, Third Way and Behavioral Science at the USC Price School of genomics to drug discovery, noted that the research. They discussed public-private efforts Christen Linke Young, JD, fellow, USC-Brookings of Public Policy and the USC Dornsife College 24th Annual Wall Street Comes to steps recommended by public health officials to effectively and economically test for COVID- Schaeffer Initiative of Letters, Arts and Sciences. Senior Fellow Washington Healthcare Roundtable such as quarantining and contact tracing are 19 during the first months of the pandemic, how Jason Doctor, PhD, was appointed as the March 31, 2020 “straight out of any epidemiology textbook” and public health officials ramped up the most Telehealth in the Era of COVID-19 Norman Topping National Medical Enterprise Designed to bridge the worlds of Wall Street must be applied rigorously and consistently, in ambitious contact-tracing effort ever undertaken May 19, 2020 Chair in Medicine and Public Policy at the Price and Washington, D.C., the roundtable featured every community, in order to reduce infections. in the country, and ways to continue to get Bob Kocher, MD, Schaeffer Center nonresident School. Senior Fellow Rosalie Liccardo Pacula, an expert panel of equity analysts who discussed He also sees hope for overcoming the disease people back to work and restart the economy. senior fellow, partner at Venrock and former PhD, now holds the Elizabeth Garrett Chair market trends shaping the healthcare system in the deep reservoir of knowledge in the member of the California Public-Private in Health Policy, Economics and Law at the and the impact of federal policies on healthcare scientific community, which has successfully Coronavirus Testing Task Force, led a discussion Price School. companies. Topics discussed included merger combatted other coronavirus-driven diseases about the outlook for telehealth during and and acquisition trends, provider payment like MERS and SARS. after the pandemic. The panel noted advantages reform, insurance premium trends, hospital and downsides of virtual care and monitoring and provider consolidation and other issues. Health Economic Considerations devices, barriers for certain populations and The panel was moderated by Paul B. Ginsburg, of the COVID-19 Pandemic the likelihood that the pandemic will propel + PhD, director of the USC-Brookings Schaeffer April 21, 2020 long-term use of telehealth. 26 Initiative for Health Policy and professor at the William Padula, PhD, a fellow at the Schaeffer USC Price School. Center and assistant professor of pharmaceutical Panelists included: conferences, seminars, policy forums and and health economics at the USC School of Andrew Dreyfus, president and CEO, Blue Cross webinars in 2020 Panelists included: Pharmacy, shared initial research findings and Blue Shield Massachusetts Matthew Borsch, MBA, MPH, managing director, potential policy solutions for grappling with Health Insurance Auto Enrollment Hill Ferguson, MBA, CEO, Doctor on Demand BMO Capital Markets COVID-19—and future pandemics. Within days May 18, 2020 Leslie Saxon, MD, professor of medicine and clinical + Ricky Goldwasser, MBA, managing director, of COVID-19 being reported in the U.S., Padula The USC-Brookings Schaeffer Initiative for scholar, Keck School of Medicine of USC; executive 65 thought leaders participated in Morgan Stanley director, USC Center for Body Computing and colleagues began investigating the value of Health Policy, in partnership with the American Schaeffer Center events in 2020. George Hill, managing director and equity hypothetical treatments and vaccines, applying Enterprise Institute, hosted a webinar about research analyst, Deutsche Bank data from the World Health Organization and how auto enrollment could help expand health the Johns Hopkins Coronavirus Resource Center. insurance coverage. Auto enrollment automati- 23,000total views across Zoom, The team’s modeling methods are identifying cally places individuals into the health insurance Facebook and YouTube platforms in 2020 optimal price points and gauging the long-term coverage they are qualified for and has received effects that new treatments could have on support across the political spectrum. During the population. the discussion moderated by Paul B. Ginsburg, PhD, panelists discussed how to practically and effectively grow auto enrollment in health insurance. This conversation was even more critical given the significant increases in individuals who have lost employment due to the pandemic.

38 USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu 39 USC Schaeffer Center Events and Seminars

Daria Pelech, PhD, principal analyst, Health, Deaths of Despair and the Are U.S. Healthcare Prices Too High, Retirement, and Long-Term Analysis Division, American Healthcare System Too Low or Some Mix of the Two? Congressional Budget Office July 7, 2020 September 9, 2020 Louise Sheiner, PhD, Robert S. Kerr Senior Fellow in Deaths of despair primarily strike those without Part 1 of a series on healthcare price regulation Economic Studies and policy director, Hutchins Center a college degree whose loss of a way of life can honoring the late healthcare economist Uwe on Fiscal and Monetary Policy, Brookings Institution lead them to suicide, alcoholism, drug overdose E. Reinhardt: Some policymakers and analysts and premature death. Angus Deaton, PhD, have called for governments to play a larger role Pitfalls and Potholes: Data Issues Schaeffer Center Distinguished Fellow and in determining the prices of healthcare services, to Consider When Conducting Analyses Presidential Professor of Economics at the USC such as by regulating prices or introducing a of State Opioid Policies Dornsife College of Letters, Arts and Sciences, public option. A panel of experts led by Paul B. September 14, 2020 and Anne Case, PhD, Alexander Stewart 1886 Ginsburg, PhD, reviewed evidence commonly What is meant by a “state opioid policy,” How Will COVID-19 Change Professor of Economics and Public Affairs Innovation in Alzheimer’s Disease: used to assess prices paid by privately insured and what gets ignored when such policies are American Healthcare? Emeritus at Princeton University, discussed Policies to Support Access to Treatments, Americans, comparisons of prices paid by designed? Rosalie Liccardo Pacula, PhD, led a June 9, 2020 ways that the COVID-19 pandemic—which has Diagnostics and Prevention public and private payers, and how policymakers discussion of current sources for state opioid Dana Goldman, PhD, and Jay Crosson, MD, disproportionately impacted African Americans September 1, 2020 might respond accordingly. policy data, opioid policy strengths and limita- past chair of the Congressional Medicare and Hispanics—has further exacerbated Progress against Alzheimer’s disease and tions, making the most of geographic diversity Payment Advisory Commission (MedPAC) and deaths of despair and noted some policy related disorders remains frustratingly elusive, in opioid policies and measuring change an infectious disease physician, discussed the approaches that could help those most at risk. but diagnostics and early treatments may be over time. epidemiology of COVID-19 and what it means Dana Goldman, PhD, served as moderator. on the horizon. Dana Goldman, PhD, led a for America, cost consequences of the discussion of policies that will need to be in Panelists included: pandemic, and the impact of COVID-19 on The Intersection of Two Pandemics: place to support access, ways to support novel Tisamarie Sherry, MD, PhD, associate physician the pharmaceutical industry. COVID-19 and Addiction payment approaches and how the healthcare policy researcher, RAND Corporation July 23, 2020 system can be ready to meet demand. Rosanna Smart, PhD, economist, RAND Corporation Prioritizing Infectious Disease Research Individuals who suffer from addiction may be Bradley Stein, MD, PhD, senior physician policy in Treatment and Vaccine Development especially vulnerable to serious complications Panelists included: researcher, RAND Corporation; adjunct associate professor of psychiatry, University of Pittsburgh June 16, 2020 if they contract COVID-19. Furthermore, the Paul Aisen, MD, founding director, USC Alzheimer’s COVID-19 has propelled infectious disease pandemic has caused unprecedented levels of Therapeutic Research Institute; professor of neurology, Keck School of Medicine of USC Panelists included: research, treatments and vaccines to the top stress and other life disruptions, which may ex- The Future of Value-Based Payment Sharon Cohen, MD, medical director, Toronto Memory Richard E. Besser, MD, president and CEO, of the public health agenda. Dana Goldman, acerbate substance use disorders and interfere September 16, 2020 Program; assistant professor, Division of Neurology, Robert Wood Johnson Foundation PhD, George Scangos, PhD, president and with recovery. Rosalie Liccardo Pacula, PhD, The last decade has brought an increased focus University of Toronto Melinda Buntin, PhD, Mike Curb Professor and Chair, CEO of Vir Biotechnology—which is developing Admiral Brett Giroir, MD, 16th assistant secre- Darius Lakdawalla, PhD, director of research, Department of Health Policy, Vanderbilt University on improving payment models to reward value a therapeutic for COVID-19—and Vassilios tary for health in the U.S. Department of Health Schaeffer Center; Quintiles Chair in Pharmaceutical Medical Center over volume of care delivered. While many Papadopoulos, DPharm, PhD, DSc (hon), dean and Human Services, and Adam Leventhal, Development and Regulatory Innovation Amitabh Chandra, PhD, Ethel Zimmerman Wiener consider this a step in the right direction, chal- of the USC School of Pharmacy, discussed the PhD, professor at the Keck School of Medicine Sarah Lenz Lock, JD, senior vice president for Professor of Public Policy and director of health policy lenges still need to be addressed to facilitate policies needed to prioritize infectious disease of USC, discussed how public health officials policy and brain health in the policy, research and research, Harvard Kennedy School; the Henry and the transition. Paul Ginsburg, PhD, Schaeffer international affairs division, AARP Allison McCance Professor of Business Administration, mitigation and treatments to protect against can mitigate the devastating effects of two Center Associate Director Erin Trish, PhD, and Harvard Business School future outbreaks of COVID-19 and other intertwined pandemics: COVID-19 and addiction. Steve Miller, MD, chief clinical officer, Elizabeth Fowler, JD, PhD, executive vice presi- Cigna Corporation Tsung-Mei Cheng, LLB, MA, health policy research diseases. dent for programs at The Commonwealth Fund, Leonard D. Schaeffer, Judge Robert Maclay analyst, Princeton School of Public International The Future of American Healthcare Widney Chair and Professor, USC Affairs, Princeton University discussed the future of value-based payment July 28, 2020 in the U.S., including how COVID-19 has affected Heather Snyder, PhD, vice president of medical Michael Chernew, PhD, Leonard D. Schaeffer Dana Goldman, PhD, and Harvey V. Fineberg, and scientific relations, Alzheimer’s Association Professor of Health Care Policy; director, Healthcare the move toward value-based payment. MD, PhD, president of the Gordon and Betty Markets and Regulation Lab, Department of Health Care Policy, Harvard Medical School Moore Foundation, held an engaging and wide- ranging conversation about the future of American healthcare and, as Goldman said, “the future of American health.”

40 USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu 41 USC Schaeffer Center Events and Seminars

The Future of Higher Education Richard N. Merkin, MD, Seminar Series September 24, 2020 Distinguished Speaker Series The Seminar Series features prominent COVID-19 forced schools to a virtual teaching Public Policy and COVID-19: academics, researchers, policymakers and format, and college administrators found their The Path Forward industry leaders discussing timely themes in costs soaring and revenues falling. Amid all this The Richard N. Merkin, MD, Distinguished health policy and economics. The seminars uncertainty, technology has emerged as a Speaker Series brings together prominent prioritize informal discussions with the audience. primary ingredient of higher education. Through policymakers, experts and industry leaders The 2020 seminars, all held early in the year this lens, Dana Goldman, PhD, and Raynard to inform pressing debates in health policy. before COVID-19 restrictions were in place, Kington, PhD, MBA, MD, head of school for Merkin’s philanthropic leadership and included the following featured speakers: Phillips Academy and an expert in education commitment to improving healthcare and health policy, had a wide-ranging discus- made this speaker series possible. David Bates, MD, MSc, professor of medicine, Healthcare Price Regulation and sion about the future of higher education. November 17, 2020 Making Progress in Cancer Diagnostics: Harvard Medical School; professor of health policy and management, Harvard T.H. Chan School of Public Public Options: Assessing Approaches When it comes to COVID-19 strategies, some Clinical Practice and Policy Health; director, Center for Patient Safety Research to Increasing the Public Role argue for loosening restrictions and allowing December 10, 2020 and Practice, Brigham and Women’s Hospital: “The September 23, 2020 younger, low-risk individuals to return to pre- Cancer deaths are down nearly 30% over Case for Making Healthcare Data Broadly Available” Part 2 of a panel series on healthcare price pandemic activities, while others argue that the last three decades, yet cancer remains Han Bleichrodt, PhD, professor of behavioral regulation honoring the late healthcare econo- this will undermine vital public health efforts. the nation’s second-deadliest disease. Black economics, Erasmus School of Economics; professor of behavioral economics, Research School of Economics, mist Uwe E. Reinhardt: USC-Brookings Schaeffer Darius Lakdawalla, PhD, led a conversation on Americans and rural residents are more likely Australian National University: “Incentives in Surveys” Initiative fellows Matthew Fiedler, PhD, and the path forward with Jay Bhattacharya, MD, to be diagnosed with cancer at advanced Thomas Buchmueller, PhD, Schaeffer Center visiting Christen Linke Young, JD, joined a panel to PhD, Schaeffer Center nonresident senior fellow, stages and die from the disease. Could innova- scholar; Waldo O. Hildebrand Professor of Risk Man- discuss approaches to expanding the govern- professor of medicine at Stanford University tion in cancer screening narrow these persistent agement and Insurance and professor of business ment’s role in determining healthcare prices Center for Primary Care Outcomes Research gaps? Dana Goldman, PhD, and Ruth Katz, JD, economics and public policy, Stephen M. Ross School in private insurance markets—limiting out-of- and director at the Stanford Center on MPH, vice president and executive director of Business, University of Michigan; research associate, National Bureau of Economic Research: “How Well Do network prices, comprehensive price regulation the Demography and Economics of Health of the Health, Medicine and Society Program Doctors Know Their Patients? Evidence from a Manda- and creating a public option—and how the Lessons from International Experience Aging, and Sten H. Vermund, MD, PhD, dean, at the Aspen Institute, led an expert panel in tory Access Prescription Drug Monitoring Program” effects of these policy approaches might in Determining Healthcare Prices and Anna M. R. Lauder Professor of Public discussion of these issues. Michael D. Frakes, PhD, A. Kenneth Pye Professor of compare to an approach focusing solely on October 7, 2020 Health and professor of pediatrics at Yale Law and Professor of Economics, Duke Law; research improving competition in provider markets. Part 3 of a series on healthcare price regulation School of Medicine. Panelists included: associate, National Bureau of Economic Research: honoring the late healthcare economist Uwe Otis W. Brawley, MD, Bloomberg Distinguished “The Effects of Patent Examination on Drug Pricing” Panelists included: E. Reinhardt: Paul B. Ginsburg, PhD, led this Richard N. Merkin, MD, Professor of Oncology and Epidemiology, Johns Hopkins University Benedic Ippolito, PhD, research fellow, American panel that examined systems used to deter- Distinguished Speaker Series Howard A.“Skip” Burris III, MD, president, chief Enterprise Institute mine the prices of healthcare services in other Research, Advocacy and medical officer and executive director, drug Robert Murray, MA, MBA, president, Global Health developed countries, and a few specific systems the Fight Against Alzheimer’s development, Sarah Cannon Research Institute; Payment; former executive director, Maryland Health in greater detail, to determine lessons these December 1, 2020 associate, Tennessee Oncology PLLC Services Cost Review Commission other systems may have for policymakers in The United States has more than 5 million Stacey Fedewa, PhD, MPH, senior principal scientist, Cori Uccello, MA, actuary and senior health fellow, Screening and Risk Factors Surveillance Team, American Academy of Actuaries the United States. patients with Alzheimer’s disease, and this number is expected to increase significantly in Data Sciences Department, American Cancer Society Panelists included: the coming decades. In addition to diminished Darius Lakdawalla, PhD, senior fellow and director of research, USC Schaeffer Center; Quintiles Chair Adam Elshaug, PhD, MPH, former visiting fellow, quality of life for patients and families, this in Pharmaceutical Development and Regulatory USC-Brookings Schaeffer Initiative for Health Policy; also translates into unprecedented costs. professor and chair, health policy, and co-director, Innovation, USC School of Pharmacy; professor, Menzies Centre for Health Policy, University of Sydney Dana Goldman, PhD, Paul Aisen, MD, and USC Price School of Public Policy Lauren Miller Rogen, a screenwriter, director, Miriam Laugesen, PhD, associate professor, Mailman Lincoln Nadauld, MD, PhD, founder, Intermountain School of Public Health, Columbia University producer and patient advocate whose life Precision Genomics Chris Pope, PhD, senior fellow, Manhattan Institute has been touched by the disease, discussed Lee N. Newcomer, MD, former chief medical officer, UnitedHealth Group Reginald Williams II, vice president, international the latest research developments and ways health policy and practice innovations, to increase awareness of Alzheimer’s and Joshua Ofman, MD, MSHS, chief medical officer, GRAIL The Commonwealth Fund its effects on patients, families and the Azra Raza, MD, Chan Soon-Shiong Professor of healthcare system. Medicine and director, MDS Center, Columbia University

42 USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu 43 Select Publications _

White Papers Trish, E., K. Kaiser and G. Joyce. (2020). Bruine de Bruin, W. (2020). Age Ciancio, A., F. Kämpfen, I. V. Kohler, D. El Genedy, M., E. Hahnel, T. Tomova- Hlávka, J. P., S. Mattke and A. Wilks. How would sharing rebates at the point- differences in COVID-19 risk perceptions Bennett, W. Bruine de Bruin, J. Darling Simitchieva, W. V. Padula et al. (2020). (2020). The potential benefits of deferred Aisen, P., J. Hlávka, D. Goldman et al. of-sale affect beneficiary cost-sharing and mental health: Evidence from a et al. (2020). Know your epidemic, Cost-effectiveness of multi-layered payment for a hypothetical gene therapy (2020). Prospects for future advances in Medicare Part D? national US survey conducted in March know your response: Early perceptions silicone foam dressings for prevention for congestive heart failure: A cost- in Alzheimer’s disease. 2020. Journals of Gerontology: of COVID-19 and self-reported social of sacral and heel pressure ulcers in consequence analysis. Applied Health Fiedler, M. (2020). Capping prices or Journal Articles Series B, gbaa074. distancing in the United States. high-risk intensive care unit patients: Economics and Health Policy, 18 (5): PLOS One, 15 (9): e0238341. An economic analysis of a randomised 669-77. creating a public option: How would they , , and D. Benne Alpert, A., S. Dykstra and M. Jacobson. Bruine de Bruin W. tt. controlled trial. International Wound change what we pay for healthcare? Cohen, B. G., , , Jackson, D., R. Anders, , (2020). How do prescription drug (2020). Relationships between initial D. P. Goldman J. Y. Ho Journal, 17 (5): 1291-99. W. V. Padula Fiedler, M., and Z. Song. (2020). monitoring programs reduce opioid COVID-19 risk perceptions and protective D. L. McFadden, M. S. Ryan and J. Daly and P. M. Davidson. (2020). Estimating potential spending on prescribing? The role of hassle costs health behaviors: A national survey. B. Tysinger. (2020). Improved survival Erickson, K. F., E. Lin and W. C. Winkel- Vulnerability of nurse and physicians with COVID-19 care. versus information. National Bureau of American Journal of Preventive Medicine, for individuals with common chronic mayer. (2020). The dialysis care-policy COVID-19: Monitoring and surveillance Economic Research, w27584. 59 (2): 157-67. conditions in the Medicare population. issue: Guest editors’ introductory remarks. needed. Journal of Clinical Nursing, Fiedler, M., and C. Linke Young. (2020). Health Economics (Sep). Seminars in Dialysis, 33 (1): 4. 29 (19-20): 3584-87. Federal policy options to realize the Annika, K., and E. Lin. (2020). What the Casanova, M., and E. Aguila. (2020). potential of all payer claims databases. comprehensive ESRD care program tells Gender differences in cognitive function Davidson, P. M., W. V. Padula, J. Daly Fox, C. R., J. N. Doctor, N. J. Goldstein, Jacobson, M., J. Thunell and us about the Advancing American Kidney among older Mexican immigrants. Journal and D. Jackson. (2020). Moral outrage D. Meeker et al. (2020). Details matter: J. Zissimopoulos. (2020). Cognitive Goldman, D., K. Malzbender, L. Lavin- Health initiative. American Journal of of the Economics of Ageing, 16: 100226. in COVID19-Understandable but not Predicting when nudging clinicians will assessment at Medicare’s annual wellness Mena et al. (2020). Key barriers for Kidney Diseases, 76 (6): 893-95. a strategy. Journal of Clinical Nursing, succeed or fail. BMJ, 370. visit in fee-for-service and Medicare Case, A., and . (2020). Deaths clinical trials for Alzheimer’s disease. A. Deaton 29: 3600-2. Advantage plans. Health Affairs, 39 (11): of Despair and the Future of Capitalism. Frakes, M. D., M. B. Frank and . Arms trong, D. G., M. A. Swerdlow, S. A. Seabury 1935-42. + Goldman, D., A. Rose, M. Ryan, B. A. A. Armstrong, M. S. Conte, W. V. Princeton: Princeton University Press. Del Missier, F., G. Galfano, E. Venerus, (2020). The effect of malpractice law on , Tysinger et al. (2020). The economic Padula and S. A. Bus. (2020). Five-year D. Ferrara, W. Bruine de Bruin and physician supply: Evidence from negligence- Johnson, E., C. Lam, S. Axeen, 1300 studies published in Case, A., A. Deaton and A. A. Stone. case for public investment in stem mortality and direct costs of care for B. Penolazzi. (2020). Decision-making standard reforms. Journal of Health R. Trotsky-Sirr and T. Schneberk. (2020). (2020). Decoding the mystery of American cell research. people with diabetic foot complications competence in schizophrenia. Economics, 70: 102272. The opioid epidemic meets the coronavirus leading journals by Schaeffer Center pain reveals a warning for the future. are comparable to cancer. Journal of Schizophrenia Research, 215: 457-59. pandemic: Rates of emergency department Lakdawalla, D., E. Keeler, D. Goldman Proceedings of the National Academy Fuse Brown, E. C., E. Trish, B. Ly, M. Hall Foot and Ankle Research, 13 (1): 1-4. visits for opiate use disorder during fellows since 2009 and E. Trish. (2020). Getting Americans of Sciences, 117 (40): 24785-89. Del Missier, F., P. Hansson, A. M. Parker, and . (2020). Out-of-network air L. Adler COVID-19. Annals of Emergency Medicine, back to work (and school) with pooled Bae-Shaaw, Y. H., H. Eom, R. F. Chun W. Bruine de Bruin and T. Mäntylä. ambulance bills: Prevalence, magnitude, Chen, A. J., L. Gascue, R. Ribero 76 (4): S33. testing. and D. S. Fox. (2020). Real-world (2020). Decision-making competence and policy solutions. Milbank Quarterly, + and K. Van Nuys. (2020). Uptake of evidence on impact of a pharmacist-led in older adults: A rosy view from a 98 (3): 747-74. Kabiri, M., A. Sexton Ward, A. Ramasamy 250 citations of research by Linke Young, C. (2020). Taking a broader infliximab biosimilars among the Medicare transitional care program on 30- and longitudinal investigation. Psychology et al. (2020). The societal value of broader view of “junk insurance.” population. JAMA Internal Medicine, Glickman, A., and J. S. Berns. and Aging, 35 (4): 553-64. E. Lin access to antiobesity medications. Schaeffer Center fellows in government 90-day readmissions after acute care 180 (9): 1255-56. (2020). Conflicts of interest in dialysis: Linke Young, C., and S. Lee. (2020). episodes. American Journal of Health- Obesity, 28 (2): 429-36. Doctor, J. N., J. Vaidya, X. Jiang … and A barrier to policy reforms. Seminars How well could tax-based auto- System Pharmacy, 77 (7): 535-45. Chen, A. J., R. Ribero and K. Van Nuys. reports and documents since 2009 D. Meeker. (2020). Efficient determination in Dialysis, 33 (1): 83-89. Kapteyn, A., M. Angrisani, D. Bennett, D., enrollment work? (2018). Provider differences in biosimilar , , Z. A. Marcum, S. L. Gray of equivalence for encrypted data. W. Bruine de Bruin et al. (2020). Tracking Barthold D. uptake in the filgrastim market. American Gong, C. L., H. Zhao, Y. Wei, B. Tysinger, Linke Young, C., and S. Lee. (2020). and J. Zissimopoulos. (2020). Computers & Security, 97: 101939. the effect of the COVID-19 pandemic on Journal of Managed Care, 26 (5): 208-13. D. P. Goldman and R. G. Williams. (2020). Making ACA enrollment more automatic Alzheimer’s disease and related dementias the lives of American households. Survey Dworkis, D. A., S. Axeen and S. Arora. Lifetime burden of adult congenital heart for the newly unemployed. risk: Comparing users of non-selective , , M. Richards, C. M. Whaley Research Methods, 14 (2): 179-86. Chen A. (2020). Rubber meeting the road: Access disease in the USA using a microsimulation and M3-selective bladder antimuscarinic and X. Zhao. (2020). The extent of exter- Linke Young, C., and J. Levitis. (2020). to comprehensive stroke care in the face model. Pediatric Cardiology, 41 (7): 1515-25. Karmarkar, T., W. V. Padula, D. J. Gaskin, drugs. Pharmacoepidemiology and nalities from Medicare payment policy. Georgia’s latest 1332 proposal continues of traffic. Academic Emergency Medicine, E. Watson and C. V. Rodriguez. (2020). Drug Safety, 29 (12): 1650-58. RAND Corporation, WR-A621-3. Griffin, B. A., M. S. Schuler, E. A. Stuart … to violate the ACA. 27 (6): 457-60. Characteristics associated with time-to- and R. L. Pacula. (2020). Variation in Bian, S. X., and E. Lin. (2020). Chen, C., J. Thunell and J. Zissimopoulos. treatment initiation for chronic hepatitis C Linke Young, C., and J. Levitis. (2020). Duffy, E. L., L. Adler, P. B. Ginsburg performance of commonly used statistical Competing with a pandemic: Trends in (2020). Changes in physical and mental with new direct acting antivirals. Pharma- Georgia’s 1332 waiver violates the ACA and E. Trish. (2020). Prevalence and methods for estimating effectiveness health of Black, Hispanic, and White care- coepidemiology and Drug Safety (Oct). and cannot lawfully be approved. research design in a time of Covid-19. characteristics of surprise out-of-network of state-level opioid policies on opioid- PLOS One, 15 (9): e0238831. givers and non-caregivers associated with bills from professionals in ambulatory related mortality. National Bureau of Kause, A., W. Bruine de Bruin, S. Domingos McCombs, J., R. Dang, Y. Seo et al. (2020). onset of spousal dementia. Alzheimer’s Brown, L. L., L. R. Abrams, surgery centers: An analysis of surprise Economic Research, w27029. et al. (2020). Communications about Is the U.S. ready to quickly vaccinate its U. A. Mitchell & Dementia: Translational Research & and J. A. Ailshire. (2020). Measuring medical bills generated by ambulatory uncertainty in scientific climate-related population against COVID-19? Clinical Interventions, 6 (1): e12082. Harcourt, R., W. Bruine de Bruin, more than exposure: Does stress appraisal surgery centers. Health Affairs, 39 findings: A qualitative systematic review. S. Dessai and A. Taylor. (2020). What Mulligan, K., D. Lakdawalla, matter for black-white differences in Cheng, J., J. Kim, S. D. Bieber and (5): 783-90. Environmental Research Letters (Aug). adaptation stories are UK newspapers D. Goldman, J. Hlávka, D. Peneva et al. anxiety and depressive symptoms among E. Lin. (2020). Four years into MACRA: Duffy, E. L., B. Ly, L. Adler and E. Trish. telling? A narrative analysis. Environmental Kause, A., W. Bruine de Bruin, F. Fung, (2020). Health technology assessment older adults? Innovation in Aging, 4 (5): What has changed? Seminars in Dialysis, (2020). Policies to address surprise billing Communication, 14 (8): 1061-78. A. Taylor and J. Lowe. (2020). Visualizations for the U.S. healthcare system. igaa040. 33 (1): 26-34. can affect health insurance premiums. of projected rainfall change in the United Hlávka, J. P. (2020). Security, privacy, Mulligan, K., K. Van Nuys, D. Peneva, , , J. Y. Lee, S. Persell, , Cho, J., L. I. Kelley-Quon, J. L. Barrington- American Journal of Managed Care 26 Kingdom: An interview study about user Brown T. D. Meeker and information-sharing aspects of M. Ryan and G. Joyce. (2020). , Trimis, A. Kechter, and A. M. (9): 401-4. perceptions. Sustainability, 12 (7): 2955. T. Knight J. N. Doctor and J. A. Linder. S. Axeen healthcare artificial intelligence. In The value of treatment for COVID-19. (2020). A qualitative analysis of primary Leventhal. (2020). Behavioral health risk Duffy, E. L., C. Whaley and C. White. Artificial Intelligence in Healthcare, ed. Kim, J., L. Neumann, P. Paul, M. Aratow, care clinicians’ justifications for ordering factors for nonmedical use of prescription Sood, N., R. Ribero, M. Ryan and (2020). The price and spending impacts A. Bohr and K. Memarzadeh, 235-70. D. S. Bell, J. N. Doctor and D. Meeker. opioids. Journal of General Internal opioids in adolescence. SSRN, 3529461. K. Van Nuys. (2020). The association of limits on payments to hospitals for Amsterdam: Elsevier. (2020). Privacy-protecting, reliable Medicine, 35 (suppl. 1): S18-19. between drug rebates and list prices. out-of-network care. response data discovery using COVID-19 patient observations. Medrxiv (Sep).

44 USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu 45 USC Schaeffer Select Publications

Lakdawalla, D. N., and C. E. Phelps. Mattke, S., S. Schneider, P. Orr, Padula, W. V. (2020). Multiple orphan Romley, J. A., A. Dunn, D. Goldman Tankumpuan, T., S. Sindhu, N. Perrin, Perspectives, Op-Eds Fiedler, M. (2020). The ACA’s individual (2019). Evaluation of medical technologies D. Lakdawalla and D. Goldman. (2020). drugs have extended exclusivity periods and N. Sood. (2020). Quantifying Y. Commodore-Mensah, C. Budhatthoki, and Blog Posts mandate in retrospect: What did it do, with uncertain benefits. National Bureau Temporal trends in mortality after tran- in the US. PharmacoEconomics & productivity growth in the delivery of W. Padula et al. (2020). Profile of patients and where do we go from here? of Economic Research, w26058. scatheter aortic valve replacement: A Outcomes News, 856: 20-27. important episodes of care within the with heart failure: A multi-site Thailand Adler, L. (2020). How the CARES Act Health Affairs, Mar. 2. systematic review and meta-regression Medicare program using insurance claims heart failure snapshot study. Research affects COVID-19 test pricing. , , , , , J. M. Black, P. M. Davidson , (2020). Competing visions Leaf D. E. B. Tysinger D. P. Goldman analysis. Structural Heart, 4 (1): 16-23. Padula W. V. and administrative data. In Big Data for Square (Oct). Health Affairs, Apr. 9. Fiedler M. and . (2020). Predicting et al. (2020). Adverse effects of the for the future of health policy. New England D. N. Lakdawalla 21st Century Economic Statistics, ed. quantity and quality of life Moran, D., A. W. Wu, C. Connors, M. R. Medicare PSI-90 hospital penalty system , , , , Beier, D., B. Kocher and A. Roy. (2020). Journal of Medicine, 383: 1197-99. with the Future K. G. Abraham, R. S. Jarmin, B. Moyer Terp S. S. A. Seabury S. Axeen Elderly Model. Health Economics (Oct). Chappidi, S. K. Sreedhara, J. H. Selter on revenue-neutral hospital-acquired J. M. Pines, C. N. Lam, V. Arientyl and Ten actions for better post-pandemic and M. D. Shapiro. Chicago: University Fiedler, M. (2020). States are being and W. V. Padula. (2020). Cost-benefit conditions. Journal of Patient Safety, M. Menchine. (2020). The association healthcare in the United States. Lee, H., D. Myers, G. Painter, of Chicago Press. crushed by the coronavirus. Only this can J. Thunell analysis of a support program for nursing 16 (2): e97-e102. between hospital characteristics and Health Affairs, Jul. 23. and J. Zissimopoulos. (2020). The role help. New York Times, Apr. 22. staff. Journal of Patient Safety, 16 (4): Romley, J. A., Z. Xie, T. Chiou, emergency medical treatment and labor of parental financial assistance in the Padula, W. V., H. H. Chen and C. E. Bruine de Bruin, W., and D. Bennett. e250-e54. D. Goldman and A. L. Peters. (2020). act citation events. Medical Care, , , and transition to homeownership by young Phelps. (2020). Is the choice of cost- (2020). USC study finds increasing actions Fiedler M. L. Adler C. Linke Young Extended-release formulation and 58 (9): 793-99. (2020). Health care in President Trump’s adults. Journal of Housing Economics, Mulligan, K., S. Choksy, C. Ishitani and effectiveness threshold in cost-utility and risk perceptions for coronavirus. medication adherence. Journal of fiscal year 2021 budget. JAMA Health 47: 101597. J. A. Romley. (2020). New evidence analysis endogenous to the resulting Thunell, J., Y. Chen, G. Joyce, The Evidence Base, Mar. 18. General Internal Medicine, 35 (1): 354-56. Forum, Feb. 13. on the compensation of chief executive value of technology? A systematic D. Barthold, P. G. Shekelle, R. D. Brinton Lin, E., G. M. Chertow, J. Bhattacharya Bruine de Bruin, W., J. Milward-Hopkins officers at nonprofit US hospitals. review. Applied Health Economics and Rowe, T. A., T. Brown, J. Y. Lee, J. A. and J. Zissimopoulos. (2020). Drug Fiedler, M., and W. Powell. (2020). and D. Lakdawalla. (2020). Early delays and A. Kause. (2020). Even concerned Medical Care Research and Review, Health Policy (Aug). Linder, M. W. Friedberg, J. N. Doctor et al. therapies for chronic conditions and States will need more fiscal relief. in insurance coverage and long-term consumers don’t know which food choices 77 (5): 498-506. (2020). Clinician-level variation in three risk of Alzheimer’s disease and related policymakers should make that happen use of home-based peritoneal dialysis. Padula, W. V., S. Parasrampuria, have the lowest climate impact. The measures representing overuse based on dementias: A scoping review. automatically. USC-Brookings Schaeffer Medical Care, 58 (7): 632-42. Mulligan, K., S. A. Seabury, P. U. Dugel, M. P. Socal et al. (2020). Market exclusivity Conversation, Mar. 10. the American Geriatrics Society Choosing Alzheimer’s & Dementia (Oct). on Health Policy, Apr. 2. J. F. Blim, D. P. Goldman and M. S. for drugs with multiple orphan approvals Lin, E., and K. F. Erickson. (2020). Payer Wisely statement. Journal of General Bruine de Bruin, W., A. Samek and Humayun. (2020). Economic value of (1983–2017) and associated budget Truong, T., M. Dittmar, A. Ghaffari and , (2020). Approving the Pfizer mix among patients receiving dialysis. Internal Medicine, 35 (6): 1797-1802. D. Bennett. (2020). Americans disagree Fox S. anti–vascular endothelial growth factor impact in the US. PharmacoEconomics, E. Lin. (2020). Policy and pandemic: The vaccine would, finally, mark the end of the JAMA, 324 (9): 900-1. on how risky the coronavirus is, but most treatment for patients with wet age- 38: 1115–21. Schuler, M. S., S. E. Heins, R. Smart … changing practice of nephrology during are changing their behavior anyway. beginning. The Evidence Base, Nov. 10. Lin, E., P. B. Ginsburg, G. M. Chertow related macular degeneration in the R. L. Pacula et al. (2020). The state of the COVID-19 outbreak. Advances in The Conversation, Mar. 26. Padula, W. V., and N. M. Reid. (2020). Fund, J., and . (2020). Has and J. S. Berns. (2020). The “Advancing United States. JAMA Ophthalmology, the science in opioid policy research. Chronic Kidney Disease, 27 (5): 390-96. J. Hay Wound, ostomy, and continence nurses Sweden found the right solution to the American Kidney Health” executive order: 138 (1): 40-47. Drug and Alcohol Dependence, 214: 108137. Case, A., and A. Deaton. (2020). could be an answer to the economic Van Deen, W. K., A. Obremskey, G. Moore, coronavirus? National Review, Apr. 6. Challenges and opportunities for the America can afford a world-class health Myerson, R. M., R. D. Tucker-Seeley, impact of coronavirus. Journal of Wound Shih, T. M., K. R. Sail, Y. J. Jalundhwala … M. E. van den Akker-van, J. N. Doctor large dialysis organizations. American system. Why don’t we have one? D. P. Goldman and D. N. Lakdawalla. Ostomy & Continence Nursing, 47 (5): and D. N. Lakdawalla. (2020). The effect and C. Hwang. (2020). An assessment of Galesic, M., and W. Bruine de Bruin. Journal of Kidney Dialysis, 76 (5): P731-34. New York Times, Apr. 14. (2020). Does Medicare coverage improve 523-24. of functional status impairment on nursing symptom burden in inflammatory bowel (2020). Election polls are more accurate if they ask participants how others will vote. Li, M., D. N. Lakdawalla and cancer detection and mortality outcomes?. home admission risk among patients with diseases to develop a patient preference- Case, A., and A. Deaton. (2020). Padula, W. V., and M. J. Sculpher. The Conversation, Nov. 18. . (2020). Association Journal of Policy Analysis and Management, advanced Parkinson’s disease. Journal of weighted symptom score. Quality of Life American capitalism is failing Trump’s D. P. Goldman (2020). Ideas about resourcing health between spending and outcomes for 39: 577-604. Medical Economics, 23 (3): 297-307. Research, 29 (12): 3387-96. base as white working-class “deaths of care in the United States: Can economic Ginsburg, P. (2020). Commentary on patients with cancer. Journal of Clinical despair” rise. NBC News, Apr. 14. Natsui, S., J. N. Doctor, L. S. May, D. R. evaluation achieve meaningful use? Silverstein, A. R., R. Kee, C. D. Gleeson, Whaley, C. M., M. F. Pera, J. Cantor … “health spending under single-payer Oncology, 38 (4): 323-31. Vinson, S. Arora, K. Yadav and D. Meeker. Annals of Internal Medicine (Sep). J. Sussell, A. K. O’Sullivan, D. P. Goldman N. Sood and D. M. Bravata. (2020). Chen, S. (2020). US pharmacists can approaches.” Journal of Ambulatory Care Management, 43 (3): 199-204. MacDonell-Yilmaz, R., K. Anderson, B. (2020). Trends in measurement and and D. Hasin. (2020). Risk factors and Changes in health services use among now test for coronavirus. They could do Padula, W. V., and I. Steinberg. (2020). DeNardo, P. Sprinz and . improvement of emergency physician costs associated with 30-day readmissions commercially insured US populations more if government allowed it. The W. V. Padula What current and missing data can Goldman, D. (2020). Early detection: (2020). Cost-effectiveness analysis of performance: An environmental scan. following alcohol-related hospitalizations during the COVID-19 pandemic. JAMA Conversation, Apr. 13. teach us about medication errors. A new front in the war on cancer. Scientific screening extremely low birthweight eMedical Res, 2: 100006. in the United States from 2010 to 2015. Network Open, 3 (11): e2024984. BMJ Quality & Safety (Sep). Crane, M., D. Goldman and J. Romley. American, May 6. children for hepatoblastoma using serum Alcohol, 89: 19-25. Nielson, J. L., S. R. Cooper, S. A. Seabury Williams, A. R., F. Levin, K. Hill, R. Pacula (2020). Free COVID-19 vaccines: Not alpha-fetoprotein. Journal of Pediatrics, Powell, D., and D. Goldman. (2020). Goldman, D. (2020). Obesity, second … and TRACK-TBI Investigators. (2020). Sood, N., P. Simon, P. Ebner … and et al. (2020). Cannabis policy and out- enough to guarantee acceptance, 225: P80-89. Disentangling moral hazard and adverse to smoking as the most preventable cause Statistical guidelines for handling missing J. Bhattacharya. (2020). Seroprevalence comes for the addiction psychiatrist: especially among Black Americans. selection in private health insurance. of US deaths, needs new approaches. Mattke, S., S. K. Cho, T. Bittner, data in traumatic brain injury clinical of SARS-CoV-2–specific antibodies among Making progress toward model state laws The Evidence Base, Oct. 9. J. Hlávka Journal of Econometrics (Aug). The Conversation, Jan. 27. and M. Hanson. (2020). Blood-based research. Journal of Neurotrauma (Mar). adults in Los Angeles County, California, to reduce harm. American Journal on Doctor, J., and L. Laine. (2020). biomarkers for Alzheimer’s pathology Powell, D., and . (2020). on April 10-11, 2020. JAMA, 323 (23): Addictions, 29 (3): 187-88. Goldman, D., D. Conti and M. Kahn. Okan, Y., E. R. Stone, J. Parillo, R. L. Pacula Without oversight, electronic prescribing and the diagnostic process for a disease- The evolving consequences of oxycontin 2425–27. (2020). The COVID-19 vaccine model W. Bruine de Bruin and A. M. Parker. Zetts, R. M., A. M. Garcia, J. N. Doctor can harm patients. STAT, Feb. 18. modifying treatment: Projecting the reformulation on drug overdoses. National needs to prioritize “superspreaders.” (2020). Probability size matters: The effect Strough, J., and W. Bruine de Bruin. et al. (2020). Primary care physicians’ impact on the cost and wait times. Bureau of Economic Research, w26988. Duffy, E., E. Trish and L. Adler. (2020). Here is why. The Conversation, Sep. 3. of foreground-only versus foreground+ (2020). Decision making across adulthood. attitudes and perceptions towards antibi- Alzheimer’s & Dementia: Diagnosis, Surprise medical bills increase costs for background graphs on risk aversion Powell, D., and E. Taylor. Annual Review of Developmental otic resistance and antibiotic stewardship: Goldman, D., and S. Hedt. (2020). Assessment & Disease Monitoring, R. L. Pacula everyone, not just for the people who get diminishes with larger probabilities. (2020). How increasing medical access Psychology, 2: 345-63. A national survey. Open Forum Infectious A compelling story: Some coronavirus 12 (1): e12081 them. The Conversation, Oct. 1. Risk Analysis, 40 (4): 771-88. to opioids contributes to the opioid Diseases, 7 (7): ofaa244. curves are starting to flatten. The Strough, J., J. Wilson and W. Bruine de Mattke, S., S. K. Cho, T. Bittner, J. Hlávka epidemic: Evidence from Medicare Part D. Edlin, A., and D. Goldman. (2020). Evidence Base, Apr. 3. Pacula, R. L. (2020). The need to Bruin. (2020). Aging and financial decision Zhu, Y., Y. Chen, E. M. Crimmins and and M. Hanson. (2020). Impact of blood Journal of Health Economics, 71: 102286. How California’s smog alert system could more effectively regulate END markets: making. In Psychological Perspectives J. M. Zissimopoulos. (2020). Sex, race, Goldman, D., D. Lakdawalla and E. Trish. biomarkers on cost and wait time in be adapted to fight the coronavirus. A primary public health lesson of the US Ridgely, M. S., J. Timbie, , L. Wolf on Financial Decision Making, ed. and age differences in prevalence of (2020). Hospitals closed to prepare for diagnosing treatment-eligible patients for E. Duffy Los Angeles Times, Apr. 19. vaping associated lung injury outbreak. and C. Buttorff. (2020). Consolidation T. Zaleskiewicz and J. Traczyk, 167-86. dementia in Medicare claims and survey COVID-19. It is time to reopen most of Alzheimer’s disease: A simulation study. Addiction (Aug). by any other name? The emergence of Cham, Switzerland: Springer Nature. data. Journals of Gerontology: Series B Edlin, A., and B. Nesbitt. (2020). The them. The Evidence Base, Apr. 10. Alzheimer’s & Dementia, 16: e037200. clinically integrated networks. Health (Jun). “certified recovered” from COVID-19 could Services Research, 55: 114. lead the economic recovery. STAT, Apr. 6.

46 USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu 47 National Academies of Sciences, Engineering, and Medicine Participation _

Ho, J. (2020). Measures and models Linke Young, C. (2020). Remanding O’Brien, J. (2020). In the era of COVID-19, National Academy Neeraj Sood for longevity and aging: The burden of Texas v. U.S. to the lower court prolongs states need practical solutions to address of Medicine Committee on the Prevention mortality from Covid-19. Items: Insights harms to consumers and the health care health care costs. The Hill, Jun. 6. and Control of Sexually Transmitted from Social Sciences, Jun. 25. industry. USC-Brookings Schaeffer on Eileen Crimmins , , K. Cleary and J. Brooks. Infections in the United States, Health Policy, Jan. 3. O’Brien J. Elected 2012 Jacobson, M., and T. Chang. (2020). (2020). Will the rebate rule need extra National Academies of Sciences, The economic rationale for strong action Linke Young, C., and L. Adler (2020). innings? The Evidence Base, Nov. 23. Dana Goldman Engineering, and Medicine now against COVID-19. STAT, Mar. 18. Responding to COVID-19: Using the CARES , (2020). Declaring the Elected 2009 Act’s hospital fund to help the uninsured, Pacula R. Arthur Stone Joyce, G. (2020). Are we overreacting vape industry illegal will only drive it achieve other goals. Health Affairs, Apr. 11. Leonard Schaeffer High-Level Expert Group on to the coronavirus? Let’s do the math. underground. The Hill, Sep. 19. the Measurement of Economic MarketWatch, Apr. 25. Linke Young, C., J. Capretta, S. Dorn et al. Elected 1997 , (2020). States need to wake Performance and Social Progress, (2020). How to boost health insurance Pacula R. , (2020). 5 COVID-19 myths. up to public health risks from cannabis. Joyce G. enrollment: Three practical steps that merit National Academy Organisation for Economic The Conversation, Jul. 8. STAT, Jan. 21. bipartisan support. Health Affairs, Aug. 17. of Sciences Co-operation and Development Kocher, B. (2020). COVID-19 is normalizing Padula, W. (2020). Why only test Linke Young, C., and K. Hannick. (2020). Eileen Crimmins Sir Angus Deaton telehealth, and that’s a good thing. Fast symptomatic patients? Consider random Left to right: Misleading marketing of short-term health High-Level Expert Group on Company, Apr. 16. screening for COVID-19. Applied Health Darius Lakdawalla, Elected 2016 plans amid COVID-19. USC-Brookings the Measurement of Economic Economics and Health Policy, Apr. 8. Rosalie Liccardo Pacula, Kocher, B., and D. Goldman. (2020). Schaeffer on Health Policy, Mar. 24. Daniel McFadden Performance and Social Progress, The COVID-19 vaccines are coming. Here’s Padula, W., and M. Mishra. (2020). Reginald Tucker-Seeley Elected 1981 Linke Young, C., and J. Levitis. (2020). Organisation for Economic how they should be rolled out. Los Angeles A health care draft could help unemploy- Comments submitted on HHS notice of Co-operation and Development Times, Oct. 25. ment and front line burden in response benefit and payment parameters for 2021. to COVID-19. The Hill, Apr. 8. Matthew Fiedler Kocher, B., and S. Shah. (2020). How USC-Brookings Schaeffer on Health Policy, Technical Review Panel for the to ensure COVID-19 doesn’t delay value- Mar. 3. Padula, W., and I. Steinberg. (2020). based care. Health Affairs, Aug. 11. What current and missing data can teach CBO Health Insurance Simulation Manski, C. (2020). COVID-19 policy must us about medication errors. BMJ Quality Model, Congressional Budget Office , , and S. Shah. (2020). take all impacts into account. Scientific Kocher B. & Safety, Sep. 25. What if we gave hospitals real incentives American, Mar. 28. Paul Ginsburg to prepare for the next pandemic? Padula, W., and E. Trish. (2020). Committee on Emerging Science, McFadden, D. (2020). COVID-19—How Health Affairs, Apr. 24. Global budgets offer financial cushion bad can it get? The Evidence Base, Mar. 17. Technology, and Innovation in Steven Teutsch amid the coronavirus pandemic. Lakdawalla, D., and D. Goldman. Health and Medicine, National Committee on Evidence-Based McWilliams, J., and A. Chen. (2020). Modern Healthcare, May 18. (2020). To get Congress and the economy Academy of Medicine, Medicare Understanding the latest ACO “savings”: Practices for Public Health Emergency back to work, jump in the testing pool. , (2020). It’s dangerous to test Payment Advisory Commission, Curb your enthusiasm and sharpen your Sood N. Preparedness and Response, The Hill, May 13. only the sick. Wall Street Journal, Mar. 15. vice chair pencils—Part 2. Health Affairs, Nov. 12. National Academies of Sciences, Lakdawalla, D., and E. Trish. (2020). Sood, N., and Z. Wagner. (2020). India’s Engineering, and Medicine McWilliams, J., and A. Chen. (2020). Select Committee Dana Goldman Group testing for coronavirus—called historic effort to expand health insurance Understanding the latest ACO “savings”: Participation (including Improving the Representation Reginald Tucker-Seeley pooled testing—could be the fastest and to individuals living below the poverty line. Curb your enthusiasm and sharpen your non-Academy committees) of Women and Underrepresented cheapest way to increase screening JAMA Health Forum, 1 (3): e200229. Roundtable on the Promotion of pencils—Part 2. Health Affairs, Nov. 13. Minorities in Clinical Trials and nationwide. The Conversation, Jul. 2. Wändi Bruine de Bruin Health Equity, National Academies of Tinglong, D., M. Zaman, W. Padula and Research, National Academies of Melnick, G. (2020). California must Sciences, Engineering, and Medicine Lieberman, S., and . P. Davidson. (2020). Supply chain failures Respiratory Protection for the P. Ginsburg E. Trish quickly implement policies for tracking Sciences, Engineering, and Medicine (2020). Sharing drug rebates with amid Covid-19 signal a new pillar for global Public and Workers Without and controlling health care costs and Julie Zissimopoulos Medicare Part D patients: Why and how. health preparedness. Journal of Clinical Respiratory Protection Programs Darius Lakdawalla price increases. CalMatters, Jul. 24. Committee on Developing a Health Affairs, Sep. 14. Nursing, Jul. 3. at Their Workplaces, National Addressing Sickle Cell Disease: Behavioral and Social Science Melnick, G., and K. Fonkych. (2020). Academies of Sciences, A Strategic Plan and Blueprint Lin, E. (2020). For the sake of kidney Worsham, C., A. Jena and D. Goldman. Research Agenda on Alzheimer’s Regulating out-of-network hospital for Action, National Academies patients, vote no on Proposition 23. (2020). Where is big data when we need Engineering, and Medicine Disease and Alzheimer’s Disease- emergency prices: Problem and potential Orange County Register, Oct. 15. it most? The Hill, Apr. 23. of Sciences, Engineering, and Related Dementias, National benchmarks. Health Affairs, Mar. 23. Eileen Crimmins Medicine Academies of Sciences, Lin, E., K. Erickson and W. Winkelmayer. Zissimopoulos, J., and J. Thunell. Committee on Care Interventions Mulligan, K., and K. Van Nuys. (2020). (2020). The dialysis care-policy issue: (2020). Older adults living alone report for Individuals With Dementia Rosalie Liccardo Pacula Engineering, and Medicine Yes, we need a vaccine to control COVID- Guest editors’ introductory remarks. higher rates of anxiety and depression. 19. But we need new treatments, too. and Their Caregivers, National Technical Expert Committee Seminars in Dialysis, 33: 4. The Evidence Base, Apr. 21. STAT, Aug. 5. Academies of Sciences, on Public Health Risks Associated Lin, E., P. Reese and M. Harhay. (2020). Engineering, and Medicine with Cannabis Use and Cannabis Preparing for the next COVID-19 crisis: Use Disorder, World Health A strategy to save safety-net hospitals. Organization Health Affairs, Jun 22.

48 USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu 49 Fellows and Staff _

Senior Fellows Dana Goldman, PhD Rosalie Liccardo Pacula, PhD Ken S. Wong, PharmD, MPH Eugene Lin, MD, MS Leonard D. Schaeffer Director’s Elizabeth Garrett Chair in Health Associate Professor and Director, Assistant Professor, Keck School Emma Aguila, PhD Chair, USC Schaeffer Center; Policy, Economics and Law; Professor, Healthcare Decision Analysis of Medicine of USC and USC Price Associate Professor, USC Price Interim Dean, USC Price School of USC Price School of Public Policy Program, USC School of Pharmacy School of Public Policy School of Public Policy Public Policy; Distinguished Professor Vassilious Papadoulous, DPharm, Shinyi Wu, PhD Daniella Meeker, PhD of Public Policy, Pharmacy and David Agus, MD PhD, DSC (hon) Associate Professor, USC Suzanne Assistant Professor, Keck School Economics, USC School of Pharmacy Founding Director, USC Ellison Dean, John Stauffer Dean’s Chair in Dworak-Peck School of Social Work; of Medicine of USC and USC Price School of Public Policy Institute for Transformative Medicine; Pharmaceutical Sciences; Professor Associate Professor, USC Viterbi Karen Mulligan, PhD Director, USC Center for Applied Joel W. Hay, PhD of Pharmacology and Pharmaceutical School of Engineering Research Assistant Professor, Molecular Medicine; Director, Professor, USC School of Pharmacy Sciences, USC School of Pharmacy USC Westside Prostate Cancer Center; Julie Zissimopoulous, PhD USC Price School of Public Policy Professor, Keck School of Medicine Michael Hochman, MD, MPH Dima M. Qato, PharmD, MPH, PhD Director of Research Training William Padula, PhD of USC and USC Viterbi School Associate Professor, Clinical Hygeia Centennial Chair and and Co-Director, Aging and Cognition Assistant Professor, of Engineering Medicine, Keck School of Medicine Associate Professor, USC School Program, USC Schaeffer Center; USC School of Pharmacy of USC; Director, USC Gehr Family of Pharmacy Associate Professor, USC Price Wändi Bruine de Bruin, MSc, PhD Center for Health Systems Science School of Public Policy Sze-chuan Suen, PhD Co-Director, Behavioral Sciences John Romley, PhD and Innovation Assistant Professor, Program, USC Schaeffer Center; Associate Professor, USC Price Fellows USC Viterbi School of Engineering Provost Professor of Public Policy, Mireille Jacobson, PhD School of Public Policy and Psychology and Behavioral Science, Co-Director, Aging and Cognition USC School of Pharmacy Jennifer A. Ailshire, PhD Erin Trish, PhD USC Price School of Public Policy; Program, USC Schaeffer Center; Assistant Professor, USC Leonard Associate Director, USC Schaeffer Adam Rose, PhD Behavioral Scientist, USC Dornsife Associate Professor, USC Leonard Davis School of Gerontology Center; Assistant Professor, Research Professor, USC Price Center for Economic and Social Davis School of Gerontology USC School of Pharmacy School of Public Policy; Director, Sarah Axeen, PhD Research Geoffrey Joyce, PhD USC Center for Risk and Economic Director of Data and Analytics Reginald Tucker-Seeley, Alice Chen, PhD Director of Health Policy and Analysis of Terrorism Events and Co-Director, Population Health MA, ScM, ScD Associate Professor, Public Policy, Director, Affordability and Value Policy Program, USC Schaeffer Edward L. Schneider Chair in Seth Seabury, PhD USC Price School of Public Policy Program, USC Schaeffer Center; Center; Assistant Professor, Division Gerontology and Professor, USC Director, Population Health Policy Associate Professor and Chair, of Emergency Medicine Research, Leonard Davis School of Gerontology Program; Associate Professor Eileen Crimmins, PhD Department of Pharmaceutical Keck School of Medicine of USC and Director of Graduate Studies, University Professor; AARP Chair and Health Economics, Bryan Tysinger PhD(c) Pharmaceutical Economics and Policy in Gerontology, USC Leonard Davis USC School of Pharmacy Robynn J.A. Cox, PhD Director, Health Policy Microsimulation, School of Gerontology Program, USC School of Pharmacy Assistant Professor, USC Suzanne USC Schaeffer Center; Research Darius Lakdawalla, PhD Dworak-Peck School of Social Work Assistant Professor, USC Price School Jason Doctor, PhD Neeraj Sood, PhD Director of Research, USC of Public Policy Director, COVID Initiative, Director of Health Informatics, Schaeffer Center; Quintiles Chair Steven Fox, MD, MSc USC Schaeffer Center; Vice Dean USC Schaeffer Center; Co-Director, in Pharmaceutical Development Assistant Research Professor, Karen Van Nuys, PhD for Research, Vice Dean for Faculty + Behavioral Sciences Program, USC and Regulatory Innovation, USC School of Pharmacy Executive Director, Value of Life Affairs and Professor of Public Policy, Schaeffer Center; Norman Topping USC School of Pharmacy; Professor, Sciences Innovation Project; USC Price School of Public Policy Jakub Hlávka, PhD 350 Chair in Medicine and Public Policy, USC Price School of Public Policy Research Assistant Professor, Research Assistant Professor, Associate Professor, and Chair of USC Price School of Public Policy Arthur Stone, PhD USC Price School of Public Policy opinion pieces, blog posts and perspectives the Department of Health Policy and Grant Lawless, RPh, MD, FACP Director, USC Dornsife Center Bo Zhou, PhD Management, USC Price School of Associate Professor, Jessica Ho, PhD by Schaeffer experts have appeared in leading for Self-Reported Science; Professor, Research Assistant Professor, Public Policy USC School of Pharmacy Assistant Professor, USC Leonard USC Dornsife College of Letters, USC School of Pharmacy Davis School of Gerontology outlets since 2009. Susan Enguidanos, PhD, MPH Jeff McCombs, PhD Arts and Sciences Associate Professor, USC Leonard Associate Professor, Daniel Tomaszewski, PharmD, PhD Cameron Kaplan, PhD Distinguished Fellows Davis School of Gerontology USC School of Pharmacy Assistant Professor, USC Gehr Family + Associate Professor, Sir Angus Deaton, PhD 24,000 media mentions since 2009. Center for Health Systems Science Paul Ginsburg, PhD Glenn Melnick, PhD USC School of Pharmacy Presidential Professor of Economics, and Innovation Director, USC-Brookings Schaeffer Blue Cross of California Chair in Reporters regularly rely on Schaeffer experts Barbara Turner, USC Dornsife College of Letters, Initiative for Health Policy; Director Health Care Finance and Professor, MD, MSEd, MA, MACP Alexis Coulourides Kogan, PhD Arts and Sciences of Public Policy, USC Schaeffer Center; USC Price School of Public Policy for comment. Clinical Professor, Medicine, Assistant Professor, Keck School of Professor, Practice of Health Policy Victor Fuchs, PhD Michael B. Nichol, PhD USC Gehr Family Center for Health Medicine of USC and USC Leonard and Management, USC Price School Distinguished Fellow, Professor, USC Price School Systems Science and Innovation, Davis School of Gerontology of Public Policy; Leonard D. Schaeffer USC Schaeffer Center of Public Policy; Associate Vice Keck School of Medicine of USC Chair, Economics Studies, Brookings Provost for Online Education Institution

50 USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu 51 Fellows and Staff

James J. Heckman, PhD Eugene Lin, MD, MS Joseph Grogan, JD Matthew Fiedler, PhD Stephanie Hedt, MPP Patrick Gless, MS, MHA Hanh Nguyen, MA USC Presidential Scholar in Assistant Professor, Keck School Former Director, Fellow, USC-Brookings Schaeffer Director, Communications Program Manager, Master’s Project Specialist Residence, USC Schaeffer Center of Medicine of USC and USC Price Domestic Policy Council Initiative for Health Policy Program in Healthcare Decision Cristina Wilson Desi Peneva, MS School of Public Policy Analysis, USC School of Pharmacy Daniel McFadden, PhD Anupam B. Jena, MD, PhD Jorge Luis García, PhD Senior Director, Finance and Research Management Lead Presidential Professor of Michael Menchine, MD, MPH Ruth L. Newhouse Associate Assistant Professor, John E. Research Administration Alexis Goodly Seema Pessar, MPP Health Economics, USC Price Associate Professor, Clinical Professor of Health Care Policy, Walker Department of Economics, Administrative Project Specialist Health Policy Project Associate School of Public Policy Emergency Medicine, and Vice Chair, Harvard Medical School; Physician, Clemson University Program Directors Hanke Heun-Johnson, PhD Clinical Research, Keck School of Department of Medicine, Samantha Randall Inas Kelly, PhD Affordability and Value Quantitative Analyst Postdoctoral Research Fellows Medicine of USC Massachusetts General Hospital Project Specialist Associate Professor, Geoffrey Joyce, PhD Ryan Imondi Erin L. Duffy, PhD Sonali Saluja, MD, MPH, FACP Matthew Kahn, PhD Loyola Marymount University Rocio Ribero, PhD Aging and Cognition Digital Communications Specialist Postdoctoral Research Fellow, Assistant Professor, Keck School Bloomberg Distinguished Professor Research Scientist Meng Li , PhD Mireille Jacobson, PhD USC Schaeffer Center of Medicine of USC; Health Services of Economics and Business, Khristina Ipapo Lung, MPH Assistant Professor, University of Julie Zissimopoulos, PhD Anna Rodriguez-Vasquez, MPH Researcher, USC Gehr Family Center Johns Hopkins University Research Programmer Jenny S. Guadamuz, PhD Texas MD Anderson Cancer Center Research Project Specialist for Health Systems Science and Behavioral Sciences Postdoctoral Research Fellow, Emmett Keeler, PhD Katrina Kaiser Innovation Christen Linke Young, JD Wändi Bruine de Bruin, MSc, PhD Alison Sexton Ward, PhD USC School of Pharmacy Quality Assurance Director, Research Programmer Fellow, USC-Brookings Schaeffer Sophie Terp, MD, MPH USC Schaeffer Center; Professor, Jason Doctor, PhD Research Scientist Johanna Thunell, PhD Initiative for Health Policy Monica Kim Assistant Professor, Clinical Pardee RAND Graduate School COVID Initiative Victoria Shier, PhD Postdoctoral Research Fellow, Events and Development Specialist Emergency Medicine, Keck School Rebecca Myerson, MPH, PhD Neeraj Sood, PhD USC Schaeffer Center Bob Kocher, MD Research Scientist of Medicine of USC Assistant Professor, University Richard Kipling Partner, Venrock Health Policy Microsimulation Roger Smith Samuel Valdez, PhD of Wisconsin, Madison Executive Director, Center for Brian C. Toy, MD Bryan Tysinger PhD(c) Editor, Center for Health Reporting AHRQ Postdoctoral Research Fellow, Nicole Lurie, MD, MSPH Health Reporting Assistant Professor, Ophthalmology, Kimberly Narain, MD, PhD, MPH UCLA Fielding School of Public Health Strategic Advisor to the CEO, USC Roski Eye Institute at Keck Assistant Professor in Residence, Population Health Patricia St. Clair, ScB and USC Schaeffer Center Coalition for Epidemic Preparedness Angela Klipp, MPP Medicine of USC UCLA David Geffen School of Seth Seabury, PhD Senior Data Advisor Innovations; Senior Lecturer, Project Manager, COVID Initiative Medicine USC-Brookings Schaeffer Initiative Emily Stewart, MPH Clinical Fellows Karen Woo, MD Harvard Medical School; Professor, Tara Knight, PhD Assistant Professor, Surgery, George Washington University Gwyn Pauley, PhD for Health Policy Research Programmer David Armstrong, MD Program Director UCLA; Vascular Surgeon, School of Medicine Visiting Assistant Professor, Paul Ginsburg, PhD Professor, Keck School of Medicine Briana Taylor VA West Los Angeles Medical Center Economics, University of Rani Kotha, JD, MPH of USC; Director, Southwestern Charles Manski, PhD Value of Life Sciences Innovation Program Administrator, Wisconsin-Madison Senior Strategist Academic Limb Salvage Alliance Leah Yieh, MD, MPH Board of Trustees Professor in Karen Van Nuys, PhD Research Training Program Assistant Professor, Keck School Economics, Northwestern University Caroline Kurdian, MA Michelle Ton Sanjay Arora, MD of Medicine of USC Leadership Staff Executive Administrative Assistant Associate Professor, Emergency Samuel Nussbaum, MD Program Administrator for Dana Goldman, PhD Medicine, Keck School of Medicine Professor, Washington University Loren Adler Stephanie Kwack Academic Affairs, Master’s Program Nonresident Senior Fellows Leonard D. Schaeffer Director’s Chair of USC; Chief, Research Division, School of Medicine; Adjunct Professor, Associate Director, USC-Brookings Senior Research Programmer in Healthcare Decision; Analysis, Washington University Olin School Schaeffer Initiative for Health Policy USC School of Pharmacy Emergency Medicine, Keck School David Beier, JD Erin Trish, PhD Duncan Ermini Leaf, PhD of Business of Medicine of USC Managing Director, Bay City Capital Associate Director Ritika Chaturvedi, PhD Research Scientist Audrey Tripp Research Scientist Contracts and Grants Manager Afsaneh Barzi, MD, PhD Jay Bhattacharya, MD, PhD John O’Brien, PharmD, MPH Darius Lakdawalla, PhD Bich Ly Former Senior Advisor to the Secretary Director, Employer Strategy, Professor, Stanford University Center Director of Research Renelle Davis, MS Research Programmer Kukla Vera and Associate Clinical Professor, for Primary Care and Outcomes of Health and Human Services Administrative Assistant Special Advisor City of Hope Research; Director, Stanford Center Anthony Moreaux, MBA Steven M. Teutsch, MD, MPH Management on the Demography and Economics Patricia Ferido Program Administrator, Network Anshu Verma Adjunct Professor, UCLA Fielding Cynthia L. Gong, PharmD, PhD of Health and Aging Sarah Axeen, PhD Senior Research Programmer Management, Master’s Program System Administrator Assistant Research Professor, School of Public Health; Senior Director, Data and Analytics in Healthcare Decision Analysis, Melissa A. Frasco, PhD Irene Vidyanti, PhD Keck School of Medicine of USC Bruce Allen Chernof, MD, FACP Fellow, Public Health Institute USC School of Pharmacy President and CEO, Ann Harada, PhD, MPH Research Scientist Collaborating Programmer; Ashwini Lakshmanan, MD, MPH The SCAN Foundation Nonresident Fellows Managing Director Ellen Nahm Data Scientist/Modeler, L.A. County Laura Gascue, MA Assistant Clinical Professor, Program Administrator, Professional Department of Public Health Brian Harper, PhD Claims Analytics Lead Keck School of Medicine of USC; Charity Dean, MD, MPH&TM Douglas Barthold, PhD Development, Master’s Program Attending Neonatologist, Children’s CEO and Co-Founder, Research Assistant Professor, Assistant Vice President for Jillian Wallis, PhD Sara Geiger in Healthcare Decision Analysis, Hospital Los Angeles The Public Health Company University of Washington Development, USC Office of the Research Data Administrator Provost Executive Administrative Manager USC School of Pharmacy David Gollaher, PhD Cynthia Chen, PhD Gerry Young, MA Daniel George Head of Policy and Government Assistant Professor, Saw Swee Research Programmer IT Manager Affairs, Vir Biotechnology Hock School of Public Health, National University of Singapore

52 USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu 53 Advisory Board _ About the Schools _

Leonard D. Schaeffer Alexander Hardy, MBA Robert D. Reischauer, PhD Advisory Board Chair, Chief Executive Officer, Distinguished Fellow Judge Robert Maclay Widney Genentech and President Emeritus, Chair and Professor, The Urban Institute Gavin S. Herbert University of Southern California Chair Emeritus, Michael L. Ryan, PharmD Drew E. Altman, PhD Allergan Inc. Senior Vice President and Head President and of U.S. and Worldwide Value, Access, Rod Hochman, MD Chief Executive Officer, Pricing and Health Economics President and Henry J. Kaiser Family Foundation and Outcomes Research, Chief Executive Officer, Bristol-Myers Squibb Niranjan Bose, PhD Providence St. Joseph Health Managing Director, Judith A. Salerno, MD, MS Thomas R. Insel, MD Health and Life Sciences Strategy, President, Co-Founder and Adviser, Gates Ventures The New York Academy of Medicine Mindstrong Health Carmela Coyle Jennifer Taubert, MBA Pamela D. Kehaly President and Executive Vice President, USC School of Pharmacy USC Price School of Public Policy President and Chief Executive Officer, Worldwide Chairman, One of the top pharmacy schools nationwide and Since 1929, the USC Sol Price School of Public Policy Chief Executive Officer, California Hospital Association Pharmaceuticals, the highest-ranked private school, the USC School of has defined excellence and innovation in public affairs Blue Cross Blue Shield of Arizona Johnson & Johnson Pharmacy continues its century-old reputation for education. Ranked third nationwide among 275 schools Lloyd H. Dean Bob Kocher, MD Chief Executive Officer, Faye Wattleton innovative programming, practice and collaboration. of public affairs, the Price School’s mission is to improve Partner, CommonSpirit Health Founder, The school created the nation’s first Doctor of the quality of life for people and their communities, Venrock President, EeroQ Pharmacy program, the first clinical pharmacy program, here and abroad. For more than nine decades, the Price Dignity Health Foundation Leigh Anne Leas the first clinical clerkships, the first doctorates in phar- School has forged solutions and advanced knowledge, Timothy M. Wright, MD Vice President and North Carl Dickerson General Partner, maceutical economics and regulatory science, and the meeting timely challenges with purpose, principle and America Head, Public Policy, Founder and Time BioVentures first PharmD/MBA dual-degree program, among other a pioneering spirit. Novartis Chairman of the Board, innovations in education, research and practice. The The school’s programs cut across 14 interdisciplinary Dickerson Insurance Services Philip Lebherz Ex-Officio Members USC School of Pharmacy is the only private pharmacy research centers and five primary departments of study: Founder, John D. Diekman, PhD Dana Goldman, PhD school on a major health sciences campus, which governance and management, health policy and PointCare Founding Partner, Interim Dean, facilitates partnerships with other health professionals management, public policy, real estate development, 5AM Ventures Johanna Mercier USC Price School of Public Policy as well as new breakthroughs in care. It also is the only and urban planning and spatial analysis. With intercon- Chief Commercial Officer, school of pharmacy that owns and operates five nected yet distinct disciplines housed under one roof, Andrew Dreyfus Vassilios Papadopoulos, Gilead Sciences Inc. President and DPharm, PhD, DSc (hon) pharmacies. the Price School brings multiple lenses to bear on Chief Executive Officer, Michael A. Mussallem Dean, USC School of Pharmacy The school is home to the D. K. Kim International critical issues. Blue Cross Blue Shield of Chairman and Center for Regulatory Science at USC and the Center for Solving societal issues of such complexity requires Massachusetts Chief Executive Officer, Quantitative Drug and Disease Modeling, and is a partner not only great minds but also great action. USC Price Edwards Lifesciences Dennis Gillings, CBE, PhD in the USC Leonard D. Schaeffer Center for Health Policy fosters collaboration and partnerships to better under- Co-Founder and Norman C. Payson, MD & Economics and the USC Center for Drug Discovery and stand problems through varied perspectives. The school Former Executive Chair, President, Development. The school pioneered a national model uses the influence of California and Los Angeles as a Quintiles Transnational (IQVIA) NCP Inc. of clinical pharmacy care through work in safety-net resource for setting new paradigms. Every year, the clinics throughout Southern California and is a leader in school calls on a new generation of creative thinkers to Peter Griffith Thomas H. Pike Executive Vice President Former Chief Executive Officer, comprehensive medication management. The school explore beyond the status quo. These graduates go on and Chief Financial Officer, QuintilesIMS (IQVIA) is distinguished by its focus on encouraging innovation, to shape our world as leaders in government, nonprofit Amgen building new research portfolios, increasing diversity agencies and the private sector. Thomas M. Priselac, MPH and preparing students for the careers of tomorrow. Dana Goldman was appointed interim dean in President and Chief Executive Officer, Vassilios Papadopoulos has served as dean since July 2020. Cedars-Sinai Health System October 2016.

54 USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu USC Schaeffer Center Annual Report 2020 healthpolicy.usc.edu 55 About the Schaeffer Center _

In 2016, the Schaeffer Center partnered with the Center for Health Policy at the Brookings Institution to establish the USC-Brookings Schaeffer Initiative for Health Policy. This unique partnership enhances the capacity of both organizations to develop evidence- based solutions to inform policymaking on issues ranging from the future of Medicare to reshaping the Affordable Care Act. The Schaeffer Center offers the human and technical capacity necessary to conduct breakthrough interdisci- plinary research and exceptional policy analysis, with more than 50 distinguished scholars investigating a wide array of topics. This work is augmented by a visiting The Leonard D. Schaeffer Center for Health Policy scholars program and partnerships with other universities & Economics was established in 2009 at the University that allow outside researchers to benefit from the of Southern California through a generous gift from Center’s unparalleled infrastructure and data collections. Leonard and Pamela Schaeffer. The Center reflects The Schaeffer Center actively engages in developing Mr. Schaeffer’s lifelong commitment to solving health- excellent research skills in new investigators who can care issues and transforming the healthcare system. become innovators of the future while supporting the next generation of healthcare leaders in creating strong Today’s ever-changing health policy landscape management, team-building and communication skills. requires creative solutions, robust research methods The Schaeffer Center’s vision is to be the premier and expertise in a variety of fields. Schaeffer Center research and educational institution recognized for fellows excel not only at analyzing the current climate innovative, independent research that makes significant but also in predicting where health trends will lead. contributions to policy and health improvement. Its A collaboration between the USC Price School of Public mission is to measurably increase value in health Policy and the USC School of Pharmacy, the Schaeffer through data-driven policy solutions, research excellence, Center brings together health policy experts, a seasoned and private and public-sector engagement. With an pharmacoeconomics team, faculty from across USC— extraordinary breadth and depth of expertise, the including the Keck School of Medicine, the Dworak- Schaeffer Center has a vital impact on the positive Peck School of Social Work and the Viterbi School of transformation of healthcare. Engineering—and a number of affiliated researchers from other leading universities to solve pressing challenges in healthcare.

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