www.jhsph.edu/dept/hpm/degrees/mha Management Rounds Johns Hopkins Master of Health Administration Program Johns Hopkins Bloomberg School of Public Health Department of Health Policy and Management August 2014

Director’s message The Iron Triangle: Quality, Cost and Access

elcome to the 2014 edition of ealth care and higher education are Taken together, quality, cost and access Management Rounds. I opened two institutions that are key to a form what has been referred to as the Iron Wlast year’s edition as the interim community’s well-being and success. Triangle of health care. The Iron Triangle director of our MHA program and am H Given their importance and costs, our represents a set of relationships where it pleased to announce that Eric Ford, PhD, society’s expectations for both are changing is possible to positively influence one leg, MPH, joined us on July 1 as the associate chair for leadership rapidly. For administrators or even two legs, of the and management charged with ensuring these triangle, but such change programs. Given the institutions’ sustainability in inevitably comes at the increasing importance the 21st century, a major expense of the remaining of this field of study concern is that the public’s element. The recent Veterans in the Department trust and support for these Administration (VA) of Health Policy institutions are in precipitous scandal around appointment and Management and throughout the Bloomberg School, decline. Policymakers, the waiting times is a prime this new position was created with the media and even advocates example of an Iron Triangle MHA director role embedded in it. Eric question our health systems’ trade-off. Access to care comes to us from the University of North and universities’ return on was delayed as a means Carolina at Greensboro, where he had been investment. In the health Eric Ford to control costs. Worse a Distinguished Professor of Health Care sector, above-average inflation still, VA administrators Management in the School of Business coupled with care quality concerns has falsified wait times to cover up the failure and Economics. In this edition of MR, Eric raised numerous questions with too few and received performance bonuses tied to introduces himself to you with his article, “The Iron Triangle: Quality, Cost and Access.” effective answers. By the same token, the deception—allegedly. While the VA Management Rounds is our program’s universities’ reliance on student-borne debt managers’ behaviors are inexcusable, when vehicle for showcasing program initiatives, to finance their activities juxtaposed against employees are given only bad options, faculty and student activities, and for graduates’ diminished career prospects they invariably make bad choices. In such providing updates about our department. In is raising red flags in many quarters. In instances, the Iron Triangle poses not only this edition, HPM faculty report on progress both health care and higher education, a trade-off dilemma but also a trap that with evidence-based gun policy and mental consumers are increasingly concerned that ensnares providers and consumers alike. health. We are also pleased to profile two of product quality is questionable, costs are In higher education, the same quality, our part-time faculty as well as to report on too high and not everyone has access to an innovative residency opportunity in the cost and access Iron Triangle is in play. The MedStar Health System. essential services. In short, health care and two legs currently drawing attention in As we prepare to welcome 26 members of higher education face many challenges the media are quality and cost. On the one the Class of 2016, we wish you the best for that can be broadly categorized into three hand, the proportion of recent graduates the coming year. similar consumer-focused issues—Quality, working in a profession related to their Cost and Access. This begs the question, Do academic credentials is at its lowest point these common challenges have any common in memory. On the other hand, these same Ann-Michele Gundlach solutions? continued on page 11 Faculty Q & A the entry of generic drugs into the market . and FDA regulations that prohibit generic Bloomberg School’s manufacturers from changing inadequately labeled pharmaceutical products. Currently, MHA Team Places I am examining whether purchasing Second at UAB organizations’ use of safe harbor anti-kick Case Competition provisions is responsible for the increasing shortage of critical generic drugs. In addition to these specific research interests, I have been researching the law since the day I walked into law school. What is different now (and what I love) is how I research the law. As a Stacey B. Lee, JD litigator and in-house counsel, my responsibility Our Newest Faculty was to use the law as a tool to advance my clients’ interests. For 10 years, I found that very Avi Handa, Christine Laccay and Emily Associate Lenneville interesting and challenging. However, these his is Stacey Lee’s first year as an cases also presented me with situations when I mily Lenneville, Avi Handa and instructor in the MHA program at wondered, outside my particular client’s needs, Christine Laccay focused on the JHSPH, and she teaches our Legal and what should the law be? Now I get to do that. T sensitive and difficult nature of Ethical Issues in Health Services Management This changed vantage point motivates and E palliative care to place second in the course as well as Negotiations in Health Care inspires me. University of Alabama at Birmingham’s Settings for the School at large. Her primary eighth annual Health Administration appointment as an assistant professor is with MR: What do you enjoy most about teaching Case Competition. Acknowledging the Johns Hopkins Carey Business School. We at JHSPH? that “patient-centered care” can be a asked Stacey to answer a number of questions bit of a buzzword these days, the team SL: I think the best thing about teaching in so that our students and alumni could learn prioritized both the patients’ and families’ this program is the students. Having taught more about her. Here are her responses. needs in their case. law students, MBA students, I thought I had The Bloomberg School’s MHA team encountered basically all the types of students. competed against 35 teams from CAHME MR: What is the key takeaway you would I was wrong. Bloomberg School public health accredited healthcare administration like students to gain from your class? students are a different and inspiring breed. programs located throughout the U.S. SL: The goal of my law classes is to promote I have been blown away by the passion that and Canada. A panel of 12 nationally an understanding of the links between the students bring to the classroom. I love talking recognized healthcare executives were the judges for this event where the team legal environment and the regulatory controls to students who literally “want to change was awarded a cash prize of $6,000. that define, promote and limit business. the world and make it a better place.” Their “Because of the way in which the At the end of the course, I hope students enthusiasm and optimism make our classroom Bloomberg School’s Master of Health take away an expanded capacity for critical discussions thoroughly engaging. Administration program prepared us, the thinking and an enhanced ability to draw three of us had already developed a work appropriate lines with regard to healthcare, MR: When did you know you wanted to process and established a positive team law and business ethics. study the law as a career goal? dynamic,” says Laccay. A key strategy: “We were able to play to each other’s SL: I have always been fascinated by the law MR: What is your primary research focus? strengths.” Success meant differentiating and driven by a deep sense of justice. As I themselves, according to Lenneville. SL: My research focuses on the grew older, becoming an attorney seemed like “[We] wanted our work to reflect our pharmaceutical industry. More specifically, a natural fit. During law school and my early values, so our analysis emphasized the how pharmaceutical manufacturers’ business career as a litigator, what I did not anticipate people, and our presentation told a practices influence access to medicine, both was that my passion for the law would lead story,” she says. “We were taking a risk, domestically and abroad. Recently, I have me to academia. The decision to transition but it was that risk that distinguished our explored the legality of pharmaceutical from practicing to teaching law is the best group from the rest.” companies’ business practices that delay work-related decision I have made in my life. 2 Highlighting MHA Residency Site: MedStar Institute for Innovation/ MedStar Emergency Physicians MI2 Partners with 1776 Global

n April 29, MedStar Health, via the MedStar Institute for Innovation, Oannounced a strategic partnership with 1776 Global LLC, which is based in Washington, DC. Opened in April 2013, 1776 is a global platform for startups that are tackling major world challenges in heavily regulated industries such as health care, education, energy and “smart cities”: http:// www.1776dc.com/. Located a few blocks from the White House, 1776 provides its now 200+ startups with the mentorship, programs and unique access to the right connections to scale up their businesses rapidly. MedStar Health joins Microsoft, Comcast Business and the District of MedStar former and Columbia in becoming the fourth and current residents with final founding partner of 1776. Under Heather Kratz and Hasnain this multifaceted partnership, MedStar Photowala Health clinicians and administrators will But not only is this great news for health impromptu visit to 1776 on July 3 to meet have an ongoing presence at the 1776 care in the Baltimore-Washington DC the entrepreneurs and discuss the economy campus to actively work alongside the region (and ultimately nationally), but it and the role of innovation in job growth. entrepreneurs who are building solutions has specific impact for students in the Johns This MedStar residency program was to major healthcare challenges, as well as Hopkins MHA program. In July MedStar conceptualized in 2010 by two JHSPH other industries that may have a healthcare Health welcomed its fourth consecutive alumni: Jeff Collins (’08) with MI2 and application. MedStar experts will also provide Administrative Resident in Emergency Hasnain Photowala (’04) with MEP educational workshops and experiential Medicine and Innovation from the program. (currently with Surgical Services). The opportunities for innovators seeking to stay Leatt Gilboa (’15) joined program alumni alumni duo realized that given shared senior current with the evolving healthcare delivery Christine Laccay (MHA ’14), Linda leadership between Emergency Medicine landscape. Sobh (’13) and Fadi Rammo (’12) in this and Innovation at MedStar—Mark Smith, As Mark S. Smith, MD, director of the unique practicum that pairs the intensive MD, and Heather Kratz (Hopkins MBA MedStar Institute for Innovation, said, “Our clinical operations of MedStar Emergency ’10)—there was a great opportunity to mission is to catalyze innovation that advances Physicians (MEP) with the future-focused create a distinctive program that would health. True innovation often starts with catalyst of the MedStar Institute for benefit MHA students. “A major reason we an idea from outside the system, is shaped Innovation (MI2). (Note: All three residency wanted to create this residency was because by input from content experts and then graduates have found full-time employment we would have been very interested in it if informed by the friction of real experience at MedStar Health.) Beginning this year it were available when we were in school— in an actual clinical environment. Between on the innovation side of the residency, it covers a lot of ground and exposes 1776 and MedStar Health, we have all three students will be able to engage with 1776 students to both frontline operations and components. Working together, we increase the on projects, access educational opportunities higher-level health system strategy. It’s probability of identifying and testing those new on their campus and network with a diverse really a phenomenal opportunity for the technologies, approaches and business models population that often attracts VIPs—in students, and MedStar gets access to top- that will be big wins for patient care. This fact, Leatt saw President Obama in her notch talent—win, win,” said Jeff Collins, relationship is really something special.” first weeks on the job when he made an administrative director of MI2. 3 Spotlight on Part-Time Faculty Pamela Paulk Honored at the White House as a Champion of Change

amela Paulk, senior vice president second chance at a job and a life. ex-offenders hired by the Johns Hopkins for human resources for the Johns Recognizing a need for stable, reliable Hospital in 2000. Four years later, 73 of the PHopkins Health System and Johns employees in hard-to-fill positions, Paulk 80 were still employed at Johns Hopkins. Hopkins Medicine and associate faculty led an initiative to hire people whose pasts A 2009 study at Johns Hopkins of almost member in HPM, was recognized at the might otherwise disqualify them from 500 ex-offender hires showed a retention White House on Monday, June employment. The initiative, rate after 40 months that was better than a 30, as a Champion of Change which received funding secured matched group of non-offenders. “So from a because of her work and by Sen. Barbara A. Mikulski, is business perspective, you’ve got great workers advocacy in hiring ex-offenders conducted in partnership with who truly are pleased to have a second into the Johns Hopkins local community-based groups chance,” Paulk notes. workforce. that identify individuals who In addition to being responsible for President Barack Obama want to work. Although not all the human resources policies governing instituted the Champions of ex-offenders are suited for the approximately 41,000 employees, Paulk Change program to celebrate program, careful screening has teaches Human Resources in Health Americans whose innovative Pamela Paulk made the program a success. Organizations in the Bloomberg School of ideas have fostered positive “First and foremost, this Public Health. Paulk has had a part-time change. For more than 10 years, Paulk and is a good business decision,” Paulk says. faculty appointment in HPM since 2002. Johns Hopkins Hospital and Health System “These are good, loyal, solid workers. And Her students have learned about strategic President Ronald Peterson have been leaders I have the numbers to prove it.” Paulk and human resources management through a in the push to give qualified ex-offenders a her department conducted a sample of 80 well-experienced practitioner and educator.

Paul Levy Brings His Case Study to Life ne of the highlights of the past academic year was Paul Levy’s visit Oto Ann-Michele Gundlach’s second- term Foundations of Leadership course. The culminating HBR case study used in the course is Paul Levy: Taking Charge Levy shared at Beth Israel Deaconess Medical Center. copies of his The case study CD details the steps Levy most recent book with undertook as the new CEO to turn around students. this failing medical institution and features him discussing progress over his first six A number of leadership lessons stood out in the world,” a goal that they can months in the job. This year the class was from Mr. Levy’s talk. First and foremost, he accomplish through their work in privileged to have Levy attend the last class emphasized the importance of developing healthcare organizations. Of the many of the term to provide an engaging “live trust through transparency and consistency. other points Mr. Levy made about case” experience. True to his persona in the This has been the theme of his blog about leadership, perhaps the most salient case study CD, Levy was stimulating and running a hospital, which he began pub- was that “people want to know there is forthright as he recounted his experience lishing in 2006: http://runningahospital someone in charge who cares about them.” with the BIDMC turnaround. Additionally, .blogspot.com/. The second lesson was Rounding out his talk was the emphasis he offered leadership lessons for building about the importance of creating an Mr. Levy placed on the importance of and revitalizing a healthcare institution in environment in which people can learn patient safety in the delivery of healthcare this age of change. This rare opportunity to and achieve. This is underscored by his services and the leader’s role in ensuring its learn firsthand brought theory to life. philosophy that “people want to do good primacy. 4 The MHA Road Show 2014-2015

very year, the MHA program packs up the first-year students and hits massive Ethe road to reality – the world of practice where the classroom lessons are updated, massaged, tweaked and applied. This year is no different. The open 26 new MHA students will be visiting a wide variety of healthcare providers of one stripe or another. The site visits MOOC help to provide students with the online context in which they will apply the lessons learned in their management, leadership, finance, strategy, operations and other first-year courses. The Class Johns Hopkinscourses Bloomberg School of of 2016 will be visiting the following organizations: Public Health Reaches MOOC Milestone:

n Greater Baltimore Medical Center One Million Enrollees

n Johns Hopkins Home Care Group he Johns Hopkins Bloomberg School MOOCs covering a range of public health n Wilmer Eye Institute, Johns Hopkins of Public Health, long a pioneer in topics, such as “Community Change in n LifeBridge Health System Tonline instruction and among the Public Health,” a six-week course that first to offer Massive Open Online Courses started this spring, and “Health for All n Lutherville Personal Physicians, (MOOCs) through the web-based education Through Primary Health Care,” a six-week Mercy Health System platform Coursera, topped 1 million MOOC course that began in May. n Hopkins tow line enrollees in the spring of 2014, less than The Johns Hopkins Bloomberg School n CareFirst BCBS two years after the School launched its first of Public Health has been active in online MOOC courses in the summer of 2012. public health education since 1997, n University of Maryland Medical “It is exhilarating to pass the 1 million when it began offering for-credit online Center, Shock Trauma mark,” said Michael J, Klag, MD, MPH, dean courses to full- and part-time students. n Nurse manager shadowing of the Bloomberg School of Public Health. The School was among the first to offer an experience “Sharing our knowledge and research with online graduate degree in public health, n Gettysburg battlefield the world is an essential part of our mission with the introduction of its part-time of improving health and saving lives. Master of Public Health (MPH) degree With MOOCs, our faculty can reach more program in 1999. In addition to its 23 learners in one course than they would have current MOOCs, the School currently offers throughout their entire careers.” over 113 for-credit online courses and MOOCs are part of a growing trend in publishes teaching materials from 112 online education that aims to bring high- courses through the Bloomberg School’s Mangement Rounds is published by the level instruction from faculty at leading OpenCourseWare, making it one of the Department of Health Policy and Management, institutions free of charge to anyone who world’s largest providers of online public Johns Hopkins Bloomberg School of Public Health. has the interest and access to the Internet. health education. Editor: Teresa Schwartz The Bloomberg School currently offers 23 Designer: Doug Behr

5 MHA’s Special Friday: May 2, 2014

THE FIRST FRIDAY IN MAY continues to serve as the gift, Ann-Michele and Fadi chose Where Good Ideas Come most special, and longest, day of the MHA year. HPM department From by Steven Johnson. This year’s inductees included Leatt chair Ellen MacKenzie greeted the MHA Class of 2015, program Gilboa, ’15; Natasha Gill, ’15; Alyssa Nardi, ’13; Shivani Patel, ’14; directors, and case competition judges at 8 a.m. in the Wolfe Samantha Pruden, ’14; Sindhusha Ravi, ’15; Chase Roberts, ’15; Street Building. The final round of the program’s sixth annual Case Ashna Saxena, ’14; and Spencer Wildonger, ’14. Competition concluded by mid-afternoon. The first-place team, Three Upsilon Phi Delta Honor Awards were presented by Fadi TriContinent Consulting LLP, pictured above, was composed of at the alumni/preceptor dinner also scheduled for May 2. This Nuriesya Abu Bakar, Anthony DeAngelo and Sophie Holmes. year’s recipients were John Ellis, longtime finance instructor This year’s Upsilon Phi Delta Induction Ceremony once again and preceptor; Brett McCone, alumnus and preceptor; and Ron followed the case competition. In the School’s newly renovated Peterson, president of the Johns Hopkins Hospital and Health Paige Hall, faculty advisor Ann-Michele Gundlach and Fadi Rammo, System. Each of the recipients and their organizations—Greater ’12, welcomed members and inductees. As this year’s induction Baltimore Medical Center, KPMG and Johns Hopkins Medicine—

6 MHA’s Special Friday: May 2, 2014

Clockwise from top left: Ron Peterson, Bill Ward, Charlie Reuland; members of the classes of ‘14 and ‘15; GBMC residents with preceptor John Ellis; Fadi Rammo; Deloitte residents from ‘14 and ‘15 with preceptor Randy Gordon; members of the Class of 2004; alumni from the ’90s; TriContinent Consulting, winning case competition team

have been active supporters of the MHA program and its students. Charlie Reuland, executive vice president and COO of Johns This year’s dinner in Feinstone Hall was well-attended. Several Hopkins Bayview Medical Center. Charlie was the perfect choice alumni from the Class of 2004 chose this as an opportunity to for this year’s speaker. A 1991 graduate of the program who reunite for their 20th reunion, but the highlight of the evening later earned his DrPH from the department of HPM, Charlie was paying a special tribute to Bill Ward for his 17 years as entered the MHS in Health Finance and Management program program director. Ron Peterson recalled his early days working directly from undergraduate school and became Bill’s second with Bill at Bayview Medical Center (originally known as Baltimore administrative resident at Bayview. Bill provided Charlie with City Hospitals) when Johns Hopkins assumed the management numerous opportunities to learn from doing. Charlie had his of the financially troubled hospital. Bill was recognized not opportunity to reciprocate by sharing with attendees how just for making a significant contribution to Bayview but for meaningful and long-lasting Bill’s influence has been on the lives his subsequent role in developing a generation of healthcare of his previous residents. administrators. Following Ron was this year’s alumni speaker:

7 Mental Illness and Guns: Evidence-Based Public Health Policy and Provider Awareness

n the past decade, a series of mass increase the risk of suicide, which accounts for shootings has prompted a national more than half of gun deaths in the U.S. each Idialogue about mental illness and gun year. policy. In the aftermath of these highly On the basis of these consensus points, publicized tragedies, policymakers are often the group—later named the Consortium for faced with conflicting messages that are not Risk-Based Firearm Policy—agreed on a set directly informed by research evidence. Some of detailed policy recommendations to 1) gun violence prevention groups highlight strengthen existing laws to prevent people the link between mental illness and violence with serious mental illness from having guns and call for policies to prevent persons with during periods of heightened risk; 2) prevent mental illness from having guns. In contrast, individuals meeting evidence-based criteria mental health advocates often assert that for risk of future violence, such as substance individuals with mental illness are no more abuse and domestic violence perpetration, likely to be violent than other members of from having guns for a defined time period; the community, and that mental illness– and 3) create a new mechanism, called a “Gun focused gun restrictions further stigmatize Violence Restraining Order,” to provide family persons with mental illness. Faced with these and intimate partners with a civil mechanism conflicting messages, policymakers have to temporarily prohibit the purchase and/or struggled to identify policies in response to the possession of firearms when a family member mass shootings that are increasingly common Gun Violence—a Washington DC–based or intimate partner is in crisis and acting in in communities throughout the U.S. advocacy group—to convene a two-day a dangerous manner. The Consortium also The dialogue around mental illness and meeting at the School of the nation’s leading specified clear guidance for the restoration of guns was particularly strong in the months researchers, practitioners and advocates in gun individuals’ firearm rights at the conclusion following the December 2012 shooting violence prevention and mental health. of their temporary prohibitions. (For the full in Newtown, Connecticut. During this Stakeholders representing more than recommendations, see the Consortium’s period, many gun 15 organizations state and federal reports: http://www.jhsph policy proposals reviewed and .edu/research/centers-and-institutes/johns were based on Faculty from the Johns discussed the hopkins-center-for-gun-policy-and-research/ the common research evidence publications/GPHMI-State.pdf and http:// assumption that Hopkins Center for Gun and came to www.efsgv.org/wp-content/uploads/2014/02/ mental illness Policy and Research partnered consensus on the Final-Federal-Report.pdf). is an important with the Educational Fund to following points: 1) Consortium members have been cause of violence. the large majority participating in educational forums to This assumption Stop Gun Violence to convene of people with promote discussion about gun violence is counter to the a two-day meeting at the mental illness do not prevention, mental health and the evidence available research Bloomberg School. engage in violence base. Policymakers and advocates appear to evidence, which against others, and be paying attention, with significant state and shows that the large most violence is federal legislation under consideration. majority of persons caused by factors The evidence compiled by the Consortium with mental illness are not violent, and (e.g., substance abuse) other than mental demonstrates the complex relationship of that most violence is not caused by mental illness; 2) at certain times, such as the period mental health and gun violence. Leaders and illness. In response to this breach between the surrounding a psychiatric hospitalization or managers in healthcare delivery must recognize research evidence and the policy dialogue, first episode of psychosis, small subgroups of this complexity and establish programs in March 2013 faculty from the Johns individuals with serious mental illness are at within their organizations that address this Hopkins Center for Gun Policy and Research heightened risk of violence; and 3) mental relationship with compassion and care, and partnered with the Educational Fund to Stop illnesses such as depression significantly attention to the available evidence. 8 Joshua M. Sharfstein Named Associate Dean for Public Health Practice and Training

oshua M. Sharfstein, editor at Public Health Senate, he will remain director of the School’s the secretary of the Reports and serves on Risk Sciences and Public Policy Institute. JMaryland Department the Board on Population “As a pediatrician and as a public servant, of Health and Mental Health and Public Health Josh Sharfstein has been committed to Hygiene, will join the Practice of the Institute of children, families and improving people’s full-time faculty of the Medicine. lives,” says Maryland Gov. Martin O’Malley. Johns Hopkins Bloomberg Sharfstein will succeed “As the secretary of health and mental School of Public Health Thomas Burke as associate hygiene, he’s led the way as we have invested as the new associate dean dean. Burke is President in public health and prevention, aligned for public health practice Barack Obama’s nominee the healthcare system to the vision of better and training, effective to lead the Environmental health at lower cost and expanded health- Jan. 1, 2015. Sharfstein’s Protection Agency’s care coverage to hundreds of thousands of faculty appointment will Joshua Sharfstein Office of Research and Marylanders. As a Marylander, I’m thrilled be in the Department of Health Policy and Development. He will serve in his current that he’s going to Johns Hopkins.” Management. role as associate dean until Sharfstein joins While serving as city health commis- As secretary of DHMH, Sharfstein led the School; until his confirmation by the continued on page 10 efforts to modernize Maryland’s all-payer system for hospital payment and has described the outcome of that process in a recent New Health Disparities Present Huge Burdens England Journal of Medicine article. He also for African-American and Hispanic Men serves as a member of the editorial board of JAMA: The Journal of the American Medical and the U.S. Economy Association. Before joining the state, he was recent study by JHSPH Researchers used data from principal deputy commissioner of the U.S. researchers concluded the Agency for Healthcare Food and Drug Administration and, earlier, A that between 2006 Research and Quality’s 2006– Baltimore City’s commissioner of health. He and 2009 African-American 2009 Medical Expenditure began working on health and social policy men incurred $341.8 billion Panel Survey (MEPS) to matters as an advisor to longtime U.S. Rep. in excess medical costs as a determine the prevalence of a Henry A. Waxman of California, where he result of health inequalities, variety of health statuses and and Hispanic men incurred an conditions among each racial/ was responsible for projects related to public additional $115 billion over ethnic group. This information health. Roland Thorpe the four-year period. The study, was incorporated in statistical “Josh Sharfstein has had a distinguished published this winter in the International models to estimate the total direct medical career in public health practice and policy, Journal of Men’s Health, looks at the direct costs and the proportion of costs incurred and we are delighted that he is joining and indirect costs associated with health for each group as a result of health the faculty of the Bloomberg School,” inequalities and projects the potential cost disparities. says Michael J. Klag, dean of the School. savings of eliminating these disparities for The indirect costs of lower worker “Josh will bring a wealth of experience and minority men in the United States. productivity owing to illness and premature insights that will strengthen the practice, “Health disparities have a devastating death were calculated using data from teaching and research opportunities impact on individuals and families, and they MEPS and the CDC’s National Vital Statistics also affect society as a whole,” said Roland System. Over the four-year period, these available to our faculty and students.” J. Thorpe Jr., PhD, lead author of the study factors cost the economy a total of $436.3 A Maryland native, Sharfstein is a and assistant professor in the Department billion. “These stark findings underscore the graduate of Harvard College and Harvard of Health Policy and Management, as well as fact that we can’t afford to overlook men’s Medical School and, during his training in director of the Program for Research on Men’s health disparities that exist in this country,” pediatrics, worked with the Massachusetts Health in the Johns Hopkins Center for Health added Thorpe. “The cost to society—both Department of Public Health and the World Disparities Solutions. moral and economic—is staggering.” Health Organization. He was a contributing 9 Honorable Ronnie Musgrove, Former Governor of Mississippi, Joins the Bloomberg School as the Inaugural Senior Policy Scholar

he Honorable Ronnie Musgrove better communicate the School’s research has joined the Johns Hopkins to policymakers on the state and national TBloomberg School of Public Health level; and acts as a resource for students as the inaugural Senior Policy Scholar and faculty. in the Department of Health Policy and Management. Known as the “Education Governor,” Musgrove championed the Sharfstein Adequate Education Act, which changed continued from page 9 the face of public education in Mississippi sioner, Sharfstein led a campaign warning by ensuring that every public school in parents not to use over-the-counter cough the state received adequate and equitable and cold medications after the deaths of

funding, to deliver on the promise of a Ronnie four city children under the age of 4. He quality education. Musgrove later was the lead author of a petition to “Governor Musgrove is the ideal the FDA that led manufacturers to remove candidate to take on this role and craft discussion on the public health policy cold and cough medications for children an agenda that will resonate with our issues of our time, and offers our students under age 4 from the market. faculty, students and policymakers,” said an amazing opportunity to be part of the “We already know Josh from his lectures Ellen MacKenzie, PhD, the Fred and Julie process.” at our School, his mentorship of our students Soper Professor and Chair of the Johns In his role as Senior Policy Scholar, and our productive collaborations, and Hopkins Bloomberg School of Public Governor Musgrove consults with we look forward to his full-time presence Health’s Department of Health Policy and students and Bloomberg faculty on the and impact at the School,” Klag says. “We Management. “His long-standing career policy implications of their work; advises know that he will build on the very strong in public service—and access to our local, on outreach to people who can help foundation of practice and policy activities state and national leaders—gives us an implement programs or policies coming already here to create new synergies and opportunity to contribute to the national out of their research; recommends ways to increase the impact of our work.”

HPM Updates and Accolades

Karen Davis, PhD, the Eugene and Eric Ford, PhD, MPH, associate chair for Ann-Michele Gundlach, EdD, associate Mildred Lipitz Professor in Health Policy and Management and Leadership and director director, MHA program, received another Management (HPM), has been asked to serve of the MHA program, received the Academy Golden Apple from the JHSPH Student on U.S. Sen. Ben Cardin’s Health Advisory of Management–Health Care Management Assembly for excellence in teaching at the 2014 Group. Division’s Excellence in Teaching Award at Convocation ceremony. the academy’s annual meeting in August. The Lilly Engineer, MD, DrPH ’08, MHA, associate Thomas A. LaVeist, PhD, the William C. and award recognizes innovation and outstanding director, DrPH program in Health Care Nancy F. Richardson Professor in HPM and teaching. Management and Leadership, and Certificate founding director of the Hopkins Center for in Quality, Patient Safety and Outcomes Andrea Gielen, ScD ’89, ScM ’79, professor, Health Disparities Solutions, received the 2014 Research, HPM, and assistant professor, ACCM, Health, Behavior and Society, and director of ICON Award from Associated Black Charities. JHSOM and HPM, was selected as a Baldrige the Johns Hopkins Center for Injury Research Donald Steinwachs, PhD ’73, professor, HPM, Performance Excellence Award examiner by the and Policy, received the 2013 American Public was appointed to the Department of Veterans Maryland Performance Excellence Foundation. Health Association Award for Excellence. Affairs National Research Advisory Council.

10 Experts Confront Rx Drug Abuse Epidemic

President Clinton, MHA’s Doug Hough and others share personal stories and data. n May 13, Doug Hough, associate director of the MHA program, Oparticipated in a town hall meeting co-sponsored by the Bloomberg School and the Clinton Health Matters Initiative of the Clinton Foundation. The session was kicked off by President Clinton himself, who shared

Klobuchar, Hough, Hamburg and Kennedy

our culture finds use of widely available drugs unlikely that people became better drivers,” normal and acceptable. The majority of people Doug said. “Witness the number of people Former who use prescription drugs inappropriately texting while driving.” Rather, it is the President get them free from friends or relatives—only cars—and the roads—that have been made Bill Clinton 5 percent get them from a stranger or drug safer. With prescription drug abuse, instead the personal losses that opened his eyes to dealer, he said, quoting CDC statistics. of trying to change people’s behavior, it might America’s prescription drug abuse. He also noted CDC statistics show that be more effective to change the system so that A year ago, the Clinton Foundation deaths from motor vehicle accidents have drugs like Oxycontin and Vicodin are not announced its prescription drug abuse been cut in half over the past 30 years. “It is readily available. initiative to cut in half the number of young people ages 18 to 26 misusing prescription drugs for the first time—and save 10,000 Iron Triangle lives in three years. President Clinton said he’s looking to continued from page 1 dilemma and ensnared a generation of the Bloomberg School for help in applying graduates have the highest student debt graduates, compromising their abilities to public health expertise to practical action. He levels of any cohort ever. Few things make invest in other life-enhancing acquisitions urged experts to develop ways to increase the a poor decision more visceral than having (i.e., homes and children). Reforms availability and user-friendliness of the drug a bill arrive every month without the designed to right the financial leg of the Naloxone. “That’s what I’m obsessed with, means to pay it. The irony that graduates higher education Iron Triangle are already so if you can help us in that specific way, I are unable to pay for the credential that ensnaring for-profit universities. Like health would be very, very grateful,” he said. was intended to make payment possible care, the current generation of education A panel discussion followed President is lost on no one. The degree-loan trade- providers and consumers will experience the Clinton’s remarks, moderated by Gail Saltz, off dilemma was covered up in a sense Iron Triangle trade-offs to a greater extent a Today Show correspondent. In addition because the perceived degree’s quality was than their predecessors. to Doug Hough, the panel included U.S. not accurately assessed against the cost. While I have painted a bit of a grim Sen. Amy Klobuchar, FDA Commissioner The true magnitude of the problem is picture, I firmly believe that the Iron Triangle Margaret A. Hamburg and Patrick J. further obfuscated by the inability of loan can be broken through innovation. Most Kennedy, a former U.S. representative. recipients to default, and thus no institution importantly, I believe that the Johns Hopkins Runaway opioid prescribing was one of the is put at financial risk for systemic failure community will continue to lead in both the provocative topics taken up during the panel (too big too fail?). Subsidized student healthcare and education endeavors. discussion. Doug, a behavioral economist, said loans masked the Iron Triangle trade-off ­—Eric W. Ford, PhD, MPH 11 Congratulations to the Class of 2014

t exactly 2:30 p.m. on May 20, wearing their peacock blue hoods. This graduates who attended the University-wide MHA graduates followed Graduates year’s convocation speaker was Carol S. Commencement ceremony on May 22 had AMarshal Brad Herring and marched Larson, president and CEO of the David and the opportunity to hear Susan Wojcicki, CEO into the Joseph Meyerhoff Symphony Hall Lucile Packard Foundation. Those JHSPH of YouTube, who was the featured speaker.

Administrative Residency Placements for the MHA Class of 2015

Nuriesya Abubakar Sophie Holmes Noreen Quereshi The Johns Hopkins Hospital Al Noor Hospitals Group, Plc San Francisco Health Plan Department of Anesthesiology/ Abu Dhabi, United Arab Emirates San Francisco, CA Critical Care Medicine Livia Kessler Sindhusha Ravi Baltimore, MD LifeBridge Health Accenture John Adamovich Population Health/Care Transitions Philadelphia, PA The Johns Hopkins Home Care Group Baltimore, MD Chase Roberts Baltimore, MD Arati Kotadia Greater Baltimore Medical Center Alexandra Bono The Johns Hopkins Hospital Baltimore, MD Deloitte Consulting, LLP Department of Medicine Lucas Sater McLean, VA Baltimore, MD Berkeley Research Group, LLC Rebecca David Jordan Kurtzman Hunt Valley, MD Children’s Medical Center Howard County General Hospital Caleb Schwarzbach Dallas, TX Columbia, MD LifeBridge Health Anthony DeAngelo Chelsea Lange Baltimore, MD The Johns Hopkins Health System Johns Hopkins Clinical Practice Jennifer Sung Operations Integration Association/Office of Johns Hopkins KPMG, LLP Baltimore, MD Physicians Baltimore, MD Lucas Divine Baltimore, MD Ashley Thompson Covenant Health System Mario Nelson Lubbock, TX Deloitte Consulting, LLP Sibley Memorial Hospital Washington, DC Leatt Gilboa McLean, VA Medstar — Institute for Innovation (MI2) Katherine Park Allison Winokur & Emergency Physicians (MEP) KPMG, LLP LifeBridge Health Washington, DC Baltimore, MD Project Management Office Baltimore, MD Natasha Gill Sunil Patel The Johns Hopkins Hospital Johns Hopkins Health System Arett Zartarian Department of Surgery Financial Analysis Unit Cigna Medical Group Baltimore, MD Baltimore, MD Phoenix, AZ