for ten
JI Years of Research with Impact 2009-2018
USCSchaeffer Leonard D. Schaeffer Center for Health Policy & Economics A Decade of Research with Relevance for ten
USCSchaeffer
“The Schaeffer Center focuses on the major healthcare challenges facing this country — access, quality and cost. The Center’s goal is to improve access for all Americans to quality care, when they need it, while keeping the cost to families, and the nation, affordable. Through rigorous, evidence-based research, Schaeffer Center faculty produce relevant and effective solutions that inform policymakers and lead to better policy decisions.” – Leonard D. Schaeffer Letter from the Director
OUR MISSION The mission of the Leonard D. Schaeffer Center for Health Policy & Economics is to measurably improve value in health through evidence-based policy solutions, research and educational excellence, and private and public- Improving Value in Health sector engagement. 3 Letter from the Director Ten years ago, Leonard Schaeffer shared a vision with USC
7 CB for CB: Research with Impact leadership for an academic center that would seek solutions to 8 Making Medicare Work Better the seemingly intractable health policy challenges gripping our 10 Investing in America’s Future Health nation. Leonard and his wife, Pamela, made that vision a reality 14 Achieving Healthier Communities Globally 16 Informing the ACA Debate by generously establishing the USC Leonard D. Schaeffer 18 Redefining Value in Cancer Care Center for Health Policy & Economics. 20 Curbing Inappropriate Prescribing 24 Examining Hospital and Health System Productivity and Value Since the Center’s inception, I have had the distinct honor of 26 Improving Performance of Healthcare Markets overseeing a gifted group of faculty, staff and graduate students 30 Combating Infectious Diseases 32 Fostering Better Pharmaceutical Regulation in pursuing evidence-based approaches to make our healthcare system work better. As you will see in the following pages, we 36 Data Report 38 Financial Report have accomplished a great deal in the first decade — even as 40 Supporters we acknowledge that the Center must do so much more in the 42 Research Training Programs years to come. We have made considerable progress in regulatory 46 Conferences and Seminars 50 Publications by Faculty 2017-2018 reform, covering the uninsured and many other issues — but 56 Faculty and Staff new challenges await, including the opioid crisis, a rapidly 60 Advisory Board aging society, market consolidation and drug pricing. 61 About the Schools 62 About the Schaeffer Center
USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu 3 Letter from the Director
Unique Vantage Point and Resources A Guiding Vision
In just one decade, the Schaeffer Center has become a We owe much of our success to Leonard Schaeffer, who is not trusted resource for outstanding analysis of healthcare issues only a benefactor but also an ardent mentor. He has had a for policymakers, media and the private sector. Our unique remarkable career in both the private and public sectors, in- vantage point within both a school of pharmacy and a school cluding shepherding the creation of what became the Centers of public policy gives the Center a singular perspective. for Medicare & Medicaid Services as well as founding WellPoint We are proud to be a part of the USC School of Pharmacy Health Networks. Leonard understood — well before anyone (nationally ranked first among private schools) and the USC else — the power of data to inform debate, answer questions Price School of Public Policy (ranked second among all public and ensure meaningful impact. His example inspires us. affairs schools). Our Advisory Board has also provided a steadfast stream of We also actively collaborate across the university — with support and counsel in advancing our shared mission to faculty from medicine, gerontology, business, social work, measurably improve value in health through evidence-based economics and engineering — and with partners around the policy solutions, research excellence, and public and globe. Our USC-Brookings Schaeffer Initiative for Health Policy private-sector engagement. They have given graciously of expands our presence in Washington, D.C., and has become their time and resources to further our work. a forum for policy analysis and discussion among top officials. Our rigorous, data-driven approach to health policy defines Our data core team mines big data from many sources to everything we do at the Schaeffer Center. We will continue answer questions about efficacy and efficiency of health- to ask the big questions. If we are successful in answering Dana P. Goldman Leonard D. Schaeffer care, and our microsimulation team has lent its expertise to them, a better healthcare system will be the Schaeffer Leonard D. Schaeffer Director’s Chair Advisory Board Chair the Congressional Budget Office, White House, National Center’s most enduring legacy. USC Schaeffer Center USC Schaeffer Center Academy of Sciences and other agencies. The models developed at the Center are being adopted in Europe, Korea, Dana P. Goldman Singapore, Mexico, Japan, Canada and beyond. Leonard D. Schaeffer Director’s Chair and Distinguished Professor of Public Policy, Pharmacy and Economics
4 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu 5 10 for 10: Research with Impact From its inception
a decade ago, the USC Schaeffer Center for Health Policy & Economics has
steadfastly pursued innovative solutions rooted in evidenced-based research
to measurably improve value in health. Schaeffer faculty focus on work
that informs lawmakers, media and private-sector leaders on today’s press-
ing healthcare challenges — and, most importantly, research that makes a
real impact on improving the health of individuals. The following pages feature
10 areas of research that already have made a lasting impact. While they
barely scratch the surface of the breadth and depth of Schaeffer Center efforts,
they are powerful illustrations of the importance of relevant, big-picture
thinking and grounded, collaborative research that move health policy
forward. From predicting the impact of changes in demographics and pro-
moting healthier communities globally to enhancing Medicare, combating
the opioid crisis and redefining value in cancer treatments, the Schaeffer
Center does more than inform policy — it helps drive decisions to improve
delivery of care, foster innovation and enhance healthcare markets. These
efforts span the healthcare landscape and will continue to inform policy.
Then and now: Schaeffer Center faculty and staff in 2018. The team has grown from four in 2009 to 114. Making Medicare Work Better Nearly 60 million older adults and people with disabilities depend on Medicare, which is expected to account for 18 percent of federal spending by 2028. Policymakers rely on Schaeffer Center research as they strive to enhance the program’s effectiveness and sustainability.
% + The nation’s growing debt threatens Medicare and Medicaid, which Goldman, Geoffrey Joyce, Darius Lakdwalla and Neeraj Sood have C @K adding an out-of-pocket cap scholarly citations of have helped countless Americans and reduced poverty. Schaeffer analyzed the impact of Part D formulary and benefit design on patient for all Part D enrollees would Center studies on Part D, Center researchers work with legislators on a bipartisan basis to bol- outcomes and future drug innovation. Their work showing how the raise premiums by only 1 to 4%, including government and ster these vital systems, making them more efficient and effective. coverage gap disrupts prescription drug use was cited in expert Schaeffer experts estimate industry reports testimony and addressed in the Affordable Care Act legislation. Joyce Longer but Less Healthy Lives and Erin Trish have analyzed the impact of the rise in specialty drugs A study led by Dana Goldman using the Schaeffer Center’s Future on drug spending, finding more Medicare beneficiaries use specialty Elderly Model predicts that the average Medicare beneficiary in drugs, resulting in significantly higher spending for both the patient “Policymakers should consider 2030 will be in worse physical shape than in 2010. This is a troubling and the government. implementing an out-of- notion given that the number of Americans aged 65 and older also This research has been instrumental in policy discussions over pocket spending cap in the will nearly have doubled to 67 million. A large portion of these future the past 10 years; it has been cited in government reports, and Center Part D program to provide recipients will be disabled and suffering from chronic health experts have been called upon by federal and state policymakers, true insurance protection for conditions including hypertension and diabetes, and more likely to analysts and CMS leadership. In total, Schaeffer experts have beneficiaries.” – Erin Trish, be female than male. authored more than 20 papers on Medicare Part D that have been Jianhui Xu and Geoffrey Joyce cited over 1,000 times, including in Congressional Budget Office Medicare Part D and Government Accountability Office reports. in Health Affairs, 2018 Schaeffer Center researchers have analyzed numerous aspects of the Medicare pharmacy benefit program (Part D), including its impact Payment Reform on adherence, formulary and benefit design, the coverage gap, As the Center for Medicare & Medicaid Innovation tests the benefits patient out-of-pocket costs, future innovation and the overall of new payment and delivery models, Paul Ginsburg and his impact on the health of Medicare beneficiaries. colleagues have analyzed the impact of these reforms. For example, For example, Nobel laureate Daniel McFadden and colleagues Ginsburg has examined the impact of uneven adoption of alternative have analyzed the impact of consumers not switching to the most payment models and offered proposals for better approaches appropriate benefit plan on out-of-pocket costs, prescription moving forward. These pieces are part of the USC-Brookings Schaeffer adherence and health outcomes. They found only 10 percent of Initiative for Health Policy, which provides guidance to policy- SCHAEFFER CENTER IMPACT enrollees switch plans each year, and many stay in plans that are makers on Medicare reform efforts. The Schaeffer Initiative is led Schaeffer research on payment reform, prescription not optimal based on their care needs. McFadden has presented by Ginsburg, who is also a member of the Medicare Payment adherence, plan formulary, benefit design and the Part D his work to the Centers for Medicare & Medicaid Services (CMS). Advisory Commission. coverage gap has been used in policy analyses conducted by federal agencies, including the Congressional Budget Office and Government Accountability Office. 8 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu Investing in America’s Future Health USC Schaeffer’s microsimulation models effectively demonstrate how demographic, behavioral and policy changes might influence health outcomes — providing invaluable tools for decision-making that can shape the nation’s future health. IA@HB projected savings by 2050 from delaying Alzheimer’s onset A by just one year
Life expectancy has increased in large part because of innovative However, using the FEM and FAM, these Schaeffer Center experts technologies and significant advancements in treatment for cardio- also found that delaying AD’s onset even a little can yield major ben- vascular disease and its risk factors. However, recent evidence efits — both in quality of life and overall costs. Medical advances + suggests that these advances may not extend healthy life, espe- that delay onset by five years would add about 2.7 years of life. By E? peer-reviewed publications, including cially at older ages. The risk of acquiring Alzheimer’s disease and 2050, a five-year delay in onset would result in a 41 percent lower two special issues of Health Affairs other dementias rises as we age. These trends also have financial prevalence of the disease while lowering the overall costs to society and a National Academies report, were implications — spending on individuals with dementia is higher than by approximately 40 percent. devoted to FEM findings the costs of cancer and heart disease combined, and projected In related research, Zissimopoulos, Doug Barthold and colleagues to increase considerably. were the first to compare the association between multiple types The Schaeffer Center’s unique Future Elderly Model (FEM), of blood pressure medications and the risk of acquiring AD across B and its expansion, the Future Adult Model (FAM), are used to different populations. Given the prevalence of high blood pressure predict the consequences of income disparities and changes in life in older U.S. adults, targeted hypertension treatments that also expectancy, as well as quantifying the value of new medical tech- reduce AD risk could both improve cardiovascular health and con- “Even small delays in the onset of Alzheimer’s nologies and assessing the societal benefits of disease prevention. tribute to reducing the growing burden of AD. disease and dementia could have significant impacts These projections help inform crucial decisions made by the Other Schaeffer Center-led research evaluated the impact of for the patient, their family and caregivers, and the Congressional Budget Office, Department of Labor, Social Security statins — commonly prescribed anti-cholesterol drugs — on healthcare system more broadly. Our findings suggest Administration and President’s Council of Economic Advisers. reducing risk. The findings revealed Alzheimer’s incidence dropped by 15 percent among women who regularly took statins and 12 percent there may be preventive measures we can take now, Delaying Onset of Alzheimer’s among men, compared to patients who took the drugs less often. which is exciting.” – Julie Zissimopoulos, 2018 The number of people with Alzheimer’s disease (AD) — the nation’s The findings were published in JAMA Neurology and reported on sixth leading killer — is growing dramatically. Some 5.7 million Amer- CNN and in other media outlets. icans were living with AD in 2018. Research by Julie Zissimopoulos, “We may not need to wait for a cure to make a difference for Patricia St. Clair and Eileen Crimmins shows that costs associated patients currently at risk,” Zissimopoulos says. “Existing drugs, with Alzheimer’s care will nearly quintuple by 2050. Their extensive alone or in combination, may affect Alzheimer’s risk.” investigations noted that the financial burden of AD in the U.S. will increase from $307 billion annually to $1.5 trillion by 2050. Disparities in Life Expectancy SCHAEFFER CENTER IMPACT Medicare and Medicaid, which today foot three-fourths of this bill, Dana Goldman and Bryan Tysinger used the FEM to model gains in Schaeffer’s microsimulation model (the FEM) is recognized as are far from ready. life expectancy by birth cohort and income, finding American men the gold standard in economic forecasting. Its projections have been relied upon by the Social Security Administration, Congressional Budget Office and President’s Council of Economic Advisers. 10 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu in the top income quintile born in 1960 gain seven to eight years in life expectancy at age 50 compared to men born in 1930 — while men in the lowest income quintile gain little or nothing. These find- ings, which were the centerpiece of a National Academy of Sciences report, have significant implications for the progressivity of public programs, including Social Security. The Government Accountability Office relied on this work for a report analyzing the implications of life expectancy trends for retirement planning. The researchers also simulated the effects of proposed Social C Security reforms such as raising the retirement age and modifying the benefit formula to see how they would affect the widening gap in life expectancy. Policymakers have relied on the Center’s insight- ful findings as they debate modifications to these public programs. I Early Education and Future Health F.B? Nobel laureate James Heckman used the FAM to estimate the ben- ROI for every $1 efits of high-quality early childhood education on lifetime health invested in early childhood outcomes. He compared data from low-income African-American education for at-risk children children who attended two North Carolina preschools in the early 1970s to control groups who did not attend preschool. The findings, featured in The Washington Post, The New York Research led by Nobel laureate James Heckman Times and National Public Radio, among more than 140 other (pictured above) and media mentions, determined that investing in high-quality early Dana Goldman was men- childhood education for at-risk children — as well as employment tioned in more than 140 support for their mothers — yields $7.30 for every dollar spent. The media stories, including calculation factors in such long-term benefits as reduced taxpayer Julie Zissimopoulos has The New York Times and presented her research on The Washington Post. costs for crime, welfare and healthcare, as well as the advantages the burden of Alzheimer’s of a better-prepared workforce. to national audiences, including a congressional briefing organized by Research!America. “In America today we have a lot of single-parent families. What we’ve done is shown the benefits across two genera- tions of the study of these enriched early child care programs. If you count all of the benefits that accrue from this program in terms of reduced healthcare costs, reduced crime, greater earnings, more education, higher IQ — we can compute a rate of return of about 13 percent per annum. This is a huge, huge investment return.” – James Heckman, in an NPR interview in 2016
USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu 13 “This World Bank study clearly shows how this program benefits the health of the poor in Karnataka.” – U.T. Khader, Minister for Health and Family Welfare of Karnataka, India, on the 2014 Schaeffer Center Achieving Healthier study led by Neeraj Sood. Communities Globally From epidemics to changing demographics and chronic disease, healthcare challenges keep growing — as do ways to confront them. Schaeffer collaborations % span the world to improve policies for healthier C? of India’s population will communities everywhere. be covered by the country’s new health insurance scheme, a decision informed by Sood’s study
Universal Care in India inadequate care in these countries — accounting for 10 to 15 percent Research conducted by Neeraj Sood and colleagues proved foun- of total fatalities overall. dational to India’s National Health Protection Scheme (NHPS), The work quickly became one of the National Academies’ most which is expanding healthcare to the nation’s underserved. Sood downloaded reports. Its recommendations include: increasing examined the Vajpayee Arogyashree Scheme (VAS), established in accountability, leveraging universal coverage to improve care, the Indian state of Karnataka in 2010 to increase access to tertiary redesigning healthcare systems to improve their capacity and care for poor households. adaptability, combating corruption, and increasing investment in Sood found that VAS substantially reduced the region’s mortality research and development. rate and eased families’ financial burdens. Meanwhile, taxpayers’ costs could be kept reasonable through bundled payments, prior Aging Populations authorization and focusing on the conditions carrying the highest Around the world, people are living longer, which — although pos- burden. He also noted the importance of patient outreach and itive overall — strains the resources of families and society. It also making enrollment easy. is a major factor in the rising rates of Alzheimer’s and chronic NHPS took up this advice, offering free health insurance to nearly diseases. To help governments grapple with these trends as they 500 million people — 40 percent of India’s population. Dubbed consider spending on healthcare, pensions and other programs, GM the “world’s biggest experiment in universal healthcare” by U.K.’s the Schaeffer Center has developed a global network of collabo- up to 8 million people die from poor quality care in low- and middle- The Independent, the program will ensure that people below the rators, including researchers with the Organisation for Economic income countries, noted the NAS study poverty line are no longer charged for advanced treatments that Cooperation and Development, who are building country-level committee on which Sood served would have previously pushed them even deeper into debt. FEM-based models in 17 nations to assess how current income inequalities affect people throughout their life spans. Consensus on Care “FEM is a powerful tool to predict the consequences of public Sood also served as expert health economist for a consensus policy for health outcomes, population aging and fiscal sustainability,” report from the National Academies of Sciences, Engineering and Schaeffer Center Director Dana Goldman says. “As societies continue Medicine (NAS) calling attention to the poor quality of healthcare their demographic transitions, these country-specific models will in low- and middle-income nations. He and his colleagues on the provide policymakers around the world with forecasts to make Committee on Improving the Quality of Health Care Globally found better, evidence-based decisions.” SCHAEFFER CENTER IMPACT that between 5.7 million and 8.4 million people die each year from Using the Schaeffer Center Future Elderly Model tool, 17 countries around the globe are forecasting long-term trends, allowing for better resource allocation and greater impact on population health. 14 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu Informing the ACA Debate BD As contention swirled around replacing the analyses by Schaeffer Center experts on the Affordable Care Act in 2017, Schaeffer work bridged the ACA in 2017 alone political divide with timely, data-driven analysis aimed at maximizing healthcare’s value and reach. Providing real- time analysis of fast-moving @E?K legislation page views on Schaeffer Initiative perspectives on the ACA in the New England Journal of Medicine
Engaging policymakers on bold plans to rethink the entire system H?K downloads of the Schaeffer Initiative analyses on the ACA repeal- and-replace proposals IABEB cost to government due to tax- Repeal and Replace Coverage Alternatives protected status of employer-based Winning the White House gave the GOP an avenue to pursue scaling Schaeffer experts also produced alternative healthcare reform health insurance that could be back or repealing the Affordable Care Act (ACA). As the Senate and plans. Dana Goldman proposed a bold plan for providing cata- used to rewrite the system the House worked on replacement bills, experts from the USC- strophic insurance to every American not covered by Medicare and Brookings Schaeffer Initiative for Health Policy informed the debate Medicaid. with pivotal analysis. As congress pushed forward a repeal bill in “Being bold means asking for big changes,” Goldman wrote. “The “The analysis may be the 2017 before the Congressional Budget Office could score the ex- current system of employer-based insurance would lose its tax- best estimates the public pected ramifications, Schaeffer Initiative experts estimated the size protected status, which currently costs the federal government and Republican senators of health insurance coverage losses that would result if the bills $236 billion. Those savings would be used to underwrite the new will see before they vote on were passed into law. They also showed how proposed changes to system.” the ACA’s Essential Health Benefits requirements would effectively the Graham-Cassidy plan.” eliminate protection against catastrophic costs for people with Media Reach – Vox, September 2017, coverage through large employer plans. In addition to meeting with policymakers, Schaeffer experts pub- about the timely Schaeffer In many instances, Schaeffer research was the only published lished influential articles in The New York Times, Fortune, the New Initiative analysis analysis ahead of a major congressional vote. Schaeffer experts, England Journal of Medicine, the Journal of the American Medical including Paul Ginsburg, Loren Adler and Matthew Fiedler, were Association and other outlets covering healthcare reform. Addi- the go-to resource for explaining the current state of components tional media citing Schaeffer work include HBO’s Last Week of the ACA for media, the public and legislators. Tonight with John Oliver, the BBC and American Public Media’s All told, Schaeffer experts, with the leadership of the USC-Brookings Marketplace, the country’s most popular business show. Schaeffer Initiative, produced more than 35 articles and reports on SCHAEFFER CENTER IMPACT the ACA in the year following the 2016 presidential elections. The rigorous and timely analyses led by the Schaeffer Initiative moved the policy debate and positioned Schaeffer experts as the go-to source for elected officials. 16 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu Redefining Value in Cancer Care By determining what is truly important to patients and by developing innovative payment models addressing value, price and access, the Schaeffer Center is redefining value in cancer care.
ABM additional life-years created by increasing cancer survival DD+ rates between 1988–2000 peer-reviewed studies % on value in cancer care G? survival gains attributable to improved treatments, compared + with 20% attributable to @,AD? better detection scholarly citations of Quantifying Gains Cost and Value Schaeffer studies on cancer How do you effectively quantify the gains to society and patients Since cancer is not one disease but many, it requires innumerable of new cancer therapies over time? A pivotal 2012 study headed treatments that often carry great costs. By quantifying gains, stake- by Dana Goldman was one of the first to show that the life ex- holders can better measure value and cost. pectancy of cancer patients was rising more rapidly in the U.S. than To account for the value that patients place on outcomes, a in Europe. Building on this finding, he and colleagues compared research team including Lakdawalla and John Romley developed “Value should be defined mortality rates in countries spending less on healthcare with those a framework of “hopeful gambles” — riskier treatments offering a from the viewpoint of the patient.” spending more. They found a difference of nine percentage points potentially longer period of survivability — in contrast to “safe in cancer deaths between the nations with the lowest and highest bets,” in which the results were more assured but also more lim- – Darius Lakdawalla, John spending increases. ited. Some 77 percent of surveyed patients preferred to take the Romley and colleagues in a 2012 In other pioneering research, Seth Seabury, Goldman, Darius risk, suggesting hope should be incorporated into calculating the Health Affairs study Lakdawalla and others showed how improved cancer treatments value of, and access to, therapies. The investigators’ framework and early detection led to significant survival gains of 16.7 percent can also identify treatments in which costs outweigh value. among patients diagnosed between 1997 and 2007. More breakthrough therapies are on the horizon. When the first These two studies were part of a special cancer issue of Health gene therapy for cancer was released in 2017, Goldman and David Affairs. Over 1 million stakeholders interacted with the special Agus argued for innovative, value-based pricing models that cap- issue, and the associated video was downloaded more than ture the true gains to society from such drugs and ensure access. 35,000 times. The briefing drew a record number of congressional As more therapies for cancer are introduced, Schaeffer research attendees, and more than 100 news outlets featured the studies, continues foundational work in evaluating their impact on society. including The Wall Street Journal, The New York Times, Politico, SCHAEFFER CENTER IMPACT Reuters, Fox Business and NPR. The following year, the Economic Schaeffer Center research on value in cancer care has been cited in Report of the President cited the research. government policy documents, including the Economic Report of the President. National media outlets have referenced the studies hundreds of times, including in The Wall Street Journal and The New York Times. 18 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu Curbing Inappropriate Prescribing Antibiotics prescribed inappropriately waste resources, can cause health complications and have helped give rise to antibiotic-resistant “superbugs,” while the opioid crisis claims more than 115 lives every day.
2M people affected by antibiotic-resistant “superbugs” in the U.S. each year
Schaeffer Center researchers Jason Doctor and Daniella Meeker Following the publication of the study in Science, multiple local % have employed theories of behavioral economics — or nudges — and state agencies reached out to Doctor for guidance on imple- 81 to influence provider prescribing behavior without reducing their mentation, including the L.A. County Board of Supervisors, which reduction in antibiotic overprescription using + autonomy. Their research has proved so effective in reducing unneces- voted unanimously in favor of a feasibility study on how to implement peer comparison saryprescriptions that the Centers for Disease Control and Prevention such an intervention in Los Angeles. The results are particularly 515 media mentions of Science has lauded one strategy — posted pledges — as a “best practice.” exciting given that more traditional state regulations involving study on opioid prescribing A growing number of public health departments in the U.S. as mandated limits on opioids have not had much impact. 5 well as the United Kingdom have reached out to Doctor to better The authors point to the simplicity of the new approach, which health departments understand nudges and how to implement the interventions he provides an important missing piece of clinical information to in four states and the U.K. has developed. In recent years, Doctor has leveraged these insights physicians. This intervention is easily scalable nationwide as exist- are using nudges to reduce “Our studies suggest that in new research targeted at opioid prescribing. “Our studies sug- ing state and national resources already track overdose deaths inappropriate antibiotic prescribing simple and inexpensive gest that simple and inexpensive tactics, grounded in scientific in- associated with prescription and illicit drugs. tactics, grounded in scientific sights about human behavior, can be extremely effective in insights about human addressing public health problems,” Doctor says. Novel Nudges Before opioids, Doctor led studies aimed at identifying solutions behavior, can be extremely Opioid Reduction for unnecessary antibiotics prescriptions. He and colleagues, effective in addressing Published in Science, a study conducted by Doctor highlighted an including Meeker and Tara Knight, analyzed the effects of easily public health problems.” important gap in the care system: Many clinicians never learn of adopted “nudges” to reduce over-prescribing, including: – Jason Doctor and the deaths of patients from opioid overdose, as they simply disappear • Posted pledges — having physicians hang posters in their ex- colleagues in The New from their practice. The nudge was simple — the researchers amination rooms that explain safe antibiotic use and that include York Times, 2016 randomly selected half the study participants to receive a notification a signed promise to adhere to proper prescription guidelines from the county medical examiner when a patient to whom they • Accountable justification — programming a prompt to appear had prescribed opioids suffered a fatal overdose. when physicians update a patient’s electronic chart that asks In the three months after they received the letter, the clinicians’ them to justify any antibiotic prescriptions for acute respiratory opioid prescribing decreased by nearly 10 percent compared to infections the group not receiving a letter. In addition, they were 7 percent • Peer comparison — periodically emailing participating physi- SCHAEFFER CENTER IMPACT less likely to start a new patient on opioids and less likely to prescribe cians with their inappropriate antibiotic prescription rates com- Following publication of the Schaeffer study on posted pledges, higher doses. pared to those of top-performing doctors the Centers for Disease Control and Prevention identified the nudge as a “best practice.” Other federal agencies, multiple states and the U.K. are using these techniques to improve prescribing. 20 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu Findings show that these measures are making a difference — Following the publication of the study in Science, multiple and can accomplish even greater results as more states and regions implement the strategies. local and state agencies reached out to Doctor for guidance “These interventions are low-cost and allow the prescribing clinician to retain their decision-making authority while nudging on implementation, including the L.A. County Board of them toward better practices,” Doctor says. Another study showed that simply regrouping how prescription Supervisors, which voted unanimously in favor of a feasibility options are displayed in treatment menus makes a difference. Physicians were roughly 12 percent less likely to order antibiotics study on how to implement such an intervention in Los unnecessarily if the options were grouped together rather than listed individually. Furthermore, Doctor and his colleagues have Angeles. The results are particularly exciting given that more analyzed such factors as time of day to evaluate other influences on a prescriber’s habits. traditional state regulations involving mandated limits on Proven Results opioids have not had much impact. This intervention The effectiveness of these nudges was further demonstrated when Schaeffer Center research partners, including RAND Corp. and Northwestern University, examined what happened after the is easily scalable nationwide. nudges were stopped. In a follow-up study published in the Journal of the American Medical Association, the team found that, 12 months after ending the peer-comparison intervention, clinicians increased their antibiotic prescription rate from 4.8 to 6.3 percent. The rate also increased from 6.1 to 10.2 percent among clinicians who were no longer asked to justify their prescriptions. These results underscore the need to adopt these interventions over the long term to ensure continued success. Jason Doctor, who employs insights from behavioral economics, is a resource for policymakers as they grapple with how to change provider behavior. Nobel-winning economist Sir Angus Deaton participated in a Schaeffer Initiative event 30K to discuss policy solutions number of deaths to the opioid crisis. from opioid overdoses in 2017
@?% reduction in opioid prescribing following receipt of Schaeffer Center-recommended physician nudge
USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu 23 Examining Hospital and Health System Productivity and Value Schaeffer experts analyze trends facing hospitals and health systems — and the patients they serve — from managing policy changes to the growing cost of care and new technologies.
Surprise Medical Bills declines — but which did not factor in trends in care quality and Even with health coverage, countless Americans still receive mas- illness severity that were accounted for in the Schaeffer study. “It’s unacceptable that people sive medical bills from providers outside their insurance networks. in the country are faced with USC-Brookings Schaeffer Initiative Director Paul Ginsburg co-wrote Administrative Decisions and Care Patterns the influential white paper “Solving Surprise Medical Bills” and nu- Administrative decisions by hospitals and healthcare systems D surprise medical bills for care merous follow-up pieces analyzing the conditions in which surprise can often have unintended (and overlooked) consequences for pieces of federal legislation they thought was covered or bills occur and proposing solutions. patients. Romley co-authored the first long-term investigation of addressing surprise medical bills in-network. This is a fight Ginsburg and colleagues including Loren Adler, Matthew Fiedler a reform that established a maximum number of hours a resident authored since watershed 2016 Schaeffer Initiative report between the insurance plan and Erin Trish are resources for federal and state policymakers, in- could work in a week and its effects on high-risk patients. Review- and the provider, with the cluding staff at the Department of Health and Human Services, the ing nationwide data from people hospitalized for life-threatening patient stuck in the middle.” House Ways and Means Committee, the House Energy and Com- conditions, he and colleagues found that mortality rates declined – Senator Maggie Hassan merce Committee, and the Senate Finance Committee. Acting on in both teaching and nonteaching hospitals. However, the rates these ideas, a bipartisan group of senators proposed the Protecting lowered more quickly at teaching hospitals. When limiting analysis (D-NH) in Vox. Solutions Patients from Surprise Medical Bills Act. It includes provisions to elderly and other high-risk patients, the percentages improved proposed by Sen. Hassan setting payment standards and limiting patients’ costs to what even more dramatically. and others were informed would be owed to in-network providers. In another creative study, Goldman and colleagues from Harvard by Schaeffer research. and Columbia analyzed mortality and treatment differences among Hospital Productivity and Patient Outcomes cardiovascular patients admitted when national cardiology meet- When the Affordable Care Act linked Medicare reimbursement ings are held, compared to nonmeeting dates. They found that, in rates to overall economic productivity, concerns were raised teaching hospitals, adjusted 30-day mortality was lower among regarding whether hospitals could balance their budgets without high-risk heart patients admitted during such meetings and the rate compromising quality or services. However, research by the Schaeffer of high-intensity procedures among these high-risk patients was Center’s John Romley, Dana Goldman and Neeraj Sood suggested also substantially lower. The implication of these findings may be hospitals — and the nation’s healthcare system more broadly — an example of “less is more,” meaning for high-risk patients with were performing better than previously thought. cardiovascular disease, the harms of this more invasive care may Examining data from Medicare beneficiaries who suffered heart outweigh the benefits. The research became the most-viewed study conditions or pneumonia between 2002 and 2011, the team found of the year on the JAMA Internal Medicine website, as well as being that annual rates of productivity growth had improved in dealing highlighted in more than 50 media reports. SCHAEFFER CENTER IMPACT with each condition. This contrasted with previous studies showing Schaeffer Initiative experts are a pivotal, trusted resource for federal and state policymakers tackling healthcare challenges including surprise medical bills. 24 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu “When insurers merge, there’s almost always an increase in premiums. … Improving Performance of At the same time, though, consolidation among insurers Healthcare Markets could mean a stronger position in negotiating lower rates Both provider and payer markets have substantially with hospitals.” – Erin Trish changed over the past decade. Schaeffer Center experts in the Los Angeles Times have examined the impact of consolidation and healthcare reform on cost and functioning of the system.
The U.S. spends nearly twice as much on healthcare per person as of Justice, Federal Trade Commission, and Health and Human other high-income countries, yet Americans do not have better out- Services’ Office of the Assistant Secretary for Planning and Evalua- comes. This higher spending is not because we use more healthcare tion on insurer consolidation. She presented evidence suggesting services but because we pay higher prices. Meanwhile, increasing that consolidation has resulted in higher prices for patients without consolidation and insurance complexity are getting in the way of increasing quality. She also testified before the California Assembly good commerce and putting patients at a disadvantage. Select Committee on Health Care Delivery Systems and Universal Rising medical costs threaten the economic security of many Coverage regarding the pitfalls of a single-payer system. Americans and, despite all the resources being spent, the nation’s Had there been a public option, a government-run insurance healthcare system remains unable to function as well as it could. plan offered alongside private plans, “it would have protected con- Schaeffer Center analysts explore ways to remove obstacles to sumers by pushing the effects of consolidation onto providers,” + efficiency while reducing costs and promoting optimal care. The said Paul Ginsburg in the Los Angeles Times. C? Congressional Budget Office has cited this work, and Schaeffer leading private and public-sector experts experts have shared their insights through testimony before Congress High-Deductible Drawbacks participated in a private roundtable and the California State Senate. High-deductible health plans (HDHPs), which offer lower premiums convened by the Schaeffer Initiative to address issues of competition in exchange for higher out-of-pocket payments, have grown in popu- and consolidation Making Markets Work larity. Theoretically, they encourage patients to shop for better deals. Lack of competition is a major factor in the dysfunction of health- But studies led by Neeraj Sood reveal that pushing patients to have care markets, and increased consolidation may worsen this trend. “skin in the game” can actually discourage them from seeking preven- Research by Paul Ginsburg and colleagues suggests reforms such tive care and buying drugs to properly manage their conditions, which as increased federal and state scrutiny, removing barriers to price may increase both the physical and financial risks to patients. competition, preventing anticompetitive practices and easing the Sood showed that these higher payments would leave more than path to financial viability for independent physician practices. State half of low-income enrollees and more than one-third of those with and federal policymakers, including the U.S. Department of Jus- chronic conditions with excessive financial burdens. Nor do HDHPs tice, have called upon Ginsburg for expert testimony on competi- actually encourage comparative shopping: Only 4 percent of HDHP tion and consolidation in provider and payer markets. His analysis enrollees said they compared prices or providers — a percentage was cited in a 2018 rule proposed by the Department of Health and just slightly higher than the number of people with conventional Human Services. coverage who claimed they shopped around. Erin Trish shared her expertise on the matter with staffers from Sood has been called upon by the California State Senate Health SCHAEFFER CENTER IMPACT U.S. House Energy and Commerce Committee’s Subcommittee on Committee to testify at informational hearings in Sacramento on The Federal Trade Commission, the U.S. Department of Justice Oversight and Investigations. She has also briefed the Department the impact to consumers of high-deductible health plans. and other agencies have called upon Schaeffer Center experts to provide insight in understanding trends in consolidation and competition in healthcare markets. 26 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu Increasing hospital consolidation has led to nearly half of all markets being highly concen- trated, which typically leads to higher pricing for consumers, according to Schaeffer Center 25% research. increase in middle-class family spending on healthcare since 2007
Erin Trish testified in Sacramento at a hearing on healthcare delivery systems and universal coverage. She has provided insight about Paul Ginsburg testified insurance markets for state before a U.S. Senate panel and federal officials. focused on health insurer mergers. Ginsburg is a nationally recognized expert in competition and consolidation. Supply and Demand “Driven by lack of competition, ever higher prices are Alice Chen has analyzed the impact on labor markets of various healthcare reform efforts, including examining whether providers being paid to hospitals, doctors and insurers without leading changed their practices after the Children’s Health Insurance Program (CHIP) was reauthorized and how fallout from the 2008 to better outcomes. It’s time to implement a competition recession has affected the labor market for young physicians seek- ing their first job. She found the impact to be far less than other policy for healthcare before Americans crumple under fields that require high levels of education and training. Chen’s study revealed that the reauthorization of CHIP in 2009 a system that is devouring family and government budgets. was associated with newly trained pediatricians being 8 percent more likely to subspecialize and 17 percent more likely to enter a Middle-class families’ spending on healthcare has increased private practice. The research also found evidence suggesting that reauthorization made new pediatricians more likely than adult gen- 25 percent since 2007, crowding out spending on clothes, eral practitioners to find jobs in private practices and rural areas. food and housing. We are paying the price for steady Public Options As the California Assembly weighs whether or not the state should consolidation in the hospital and insurance arenas.” turn to a single-payer healthcare system, its members have called upon Trish to testify about the differences between public and – Paul Ginsburg and colleagues in a 2017 Forbes op-ed private payment levels. For example, private insurers reimburse hos- pitals at rates 75 percent higher than Medicare or Medicaid. Trish pointed to the difficulties in choosing optimal payment levels in a uniform system, which could stifle innovation in contracting and care. However, the shift would offer opportunities to reduce prices, simplify administrative costs and align provider incentives overall.
USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu 29
Combating Infectious “We didn’t initially Diseases treat HIV aggressively enough in part because the Schaeffer Center research has been pivotal science wasn’t there to justify it. to finding practical, evidence-based strategies that With hepatitis C, we have the science. We just need to expand access to breakthrough infectious disease find a way to finance it.” treatments while keeping costs in line. – Dana Goldman, $G?B 2015 value of life expectancy gains due to access to early treatment of HIV/AIDS less than B% of the Medicaid and prison population with hep C currently have access to the cure
HIV/AIDS Prevention “Many policymakers have focused on what they see as a high Development of innovative therapies for AIDS significantly altered price for three months of therapy, but the value of curing hepatitis the disease’s trajectory: Patients can now manage it like a chronic lasts a lifetime,” Darius Lakdawalla said in a congressional briefing condition instead of a death sentence. These drugs initially were in 2016. Lakdawalla and Goldman’s research demonstrates that expensive, but Dana Goldman and colleagues found that early the value of expanding access, even slightly, far outpaces the cost initiation — even with high costs — paid both individual and societal of the drugs. In the years following, the Schaeffer Center leveraged dividends. Access to early treatment led to life expectancy gains partnerships with Brookings as well as The Hill to engage thought valued at $80 billion and prevented another 188,000 people from leaders in discussions of who benefits from and who bears the contracting the virus between 1996 and 2002. costs of such breakthrough treatments. Yet even with improvements in care, HIV still infects nearly 40,000 The Schaeffer Center provided policymakers with solutions that people annually in the U.S. alone. Research by Neeraj Sood and Joel increase access while encouraging future innovation. As part of the W. Hay outlined the most cost-effective method for reducing this National Academies of Science, Engineering and Medicine, Sood toll in Los Angeles County, where 1 in 4 men who have sex with men devised a novel payment strategy for Medicaid to leverage com- are infected. The county is relying on this work to bolster its strate- petition among drug companies. The company offering the best gies of HIV/AIDS reduction. deal would receive an exclusive contract for a set period. When a federal solution lost traction, he refocused on states. Louisiana al- Hepatitis C Solutions ready plans to implement this innovative model for providing treat- When a cure for hepatitis C came on the market, the tension between ments to its vulnerable populations and other states have cost, value and access took center stage in the national conversation. expressed interest. The high price tag put widespread use beyond the reach of most pa- Working with the Department of Veterans Affairs, Jeff McCombs tients and payers, leaving the vast majority of the nearly 4 million af- and Steven Fox developed more data-driven strategies for testing, flicted Americans without access. Five years after a cure was available, managing and treating the disease. SCHAEFFER CENTER IMPACT the disease still kills more people nationwide than any other virus. Schaeffer experts have provided congressional testimony and been called upon by policymakers for advice on how to improve access to lifesaving drugs. 30 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu “If … the United States could persuade its trading partners to tilt their policies modestly in favor of higher prices, to stimulate innovation, they could help their future patients without unduly harming existing ones.” Fostering Better – The Washington Post Editorial Board, citing Schaeffer research, May 12, 2018 Pharmaceutical Regulation State and federal agencies turn to the Schaeffer Center’s research and innovative pricing models, which balance the competing priorities of affordability and access while appropriately incentivizing future medical innovation and fostering better policy.
Innovative Pricing Schemes Copay Clawbacks Historically, prices for prescriptions as well as healthcare proce- Patients overspend when prescription copays exceed a drug’s dures more often have been figured per dose rather than by effec- actual price, with pharmacy benefits managers “clawing back” the tiveness or outcome, which can distort incentives for payers, difference. Research by Van Nuys, Geoffrey Joyce, Rocio Ribero providers and patients. Schaeffer Center faculty, including Dana and Goldman gained national attention by revealing how common % Goldman, Karen Van Nuys and Darius Lakdawalla, suggest a range clawbacks actually are. AD of innovative pricing schemes, including value-based, outcomes- Analyzing payments for 9.5 million prescriptions, the team found of privately insured based and reference pricing to more accurately align incentives. that customers would be better off paying in cash instead of using consumers had copayments Schaeffer experts have acted as resources for manufacturers, pay- their insurance 23 percent of the time and would save an average that exceeded the cost of their prescription ers and policymakers as they consider implementing these complex of $7.69 per prescription. “Industry lobbyists have called the practice but effective strategies. of clawbacks rare and an ‘outlier,’” Van Nuys says. “But I wouldn’t call nearly one in four an outlier practice.” Global Expense Joyce, Neeraj Sood and colleagues found that uninsured patients @?? Patients around the world benefit from profit-driven drug innova- pay even higher amounts and can save significant money by buying media stories, including PBS tion, for which U.S. consumers pay a disproportionately high share. their drugs at independent pharmacies and by using discount and NPR, mentioning the Schaeffer study on copay clawbacks A study by Goldman and Lakdawalla found that up to 78 percent coupons. Their research demonstrated that the cash price for a of worldwide pharmaceutical profits are made from the U.S. market. common antibiotic can vary on average $52 within a single zip code. Using an economic-demographic microsimulation, Goldman Some 100 news outlets reported on the findings, including PBS, and Lakdawalla estimate that a 20 percent increase in European Kaiser Health News and NPR. Van Nuys also discussed the findings pharmaceutical prices would generate $7.5 trillion in welfare gains with federal policymakers, who frequently cited the report in their for that continent and $10 trillion in gains for the U.S. over the next discussion of the bills. 50 years. Such savings also could increase philanthropic subsidies One policy solution proposed by Van Nuys and colleagues would to improve healthcare in developing nations. Since published, the be to ban gag clauses, which are placed in contracts by pharmacy paper has been cited numerous times by policymakers, including benefit managers and prohibit pharmacists from telling customers SCHAEFFER CENTER IMPACT two reports by the President’s Council of Economic Advisers. when they could save money by paying out of pocket instead of Following the Schaeffer Center study quantifying clawbacks, using insurance. In response to the Schaeffer Center report, Senators policymakers in both the House and Senate started looking for a solution. In fall 2018, President Trump signed a bill banning gag clauses, a policy solution identified in the report. 32 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu Susan Collins (R-ME), Claire McCaskill (D-MO) and Debbie A Schaeffer Center analysis of the pharmaceutical distribution Stabenow (D-MI) introduced bipartisan legislation to ban such clauses. These bills, the Patient Right to Know Drug Prices Act and system has proven pivotal in policy discussions of drug pricing the Know the Lowest Price Act, were quickly signed into law by Pres- ident Trump. In addition, a number of states, including California, since it was published in 2017. The researchers estimate have introduced and passed legislation to protect consumers. intermediaries capture $41 of every $100 spent on retail Follow the Money Any prescription drug price interventions should be predicated on prescription drugs. Lead author Neeraj Sood has briefed state a clear understanding of the economic forces driving increases and the parties responsible for them. Sood led research that analyzed and federal policymakers, including the Federal Trade the pharmaceutical distribution system, along with the cost and profit margins of each system player. He and co-authors Goldman Commission, about the analysis. It has been cited in reports and Van Nuys found that intermediaries — insurers, wholesalers, pharmacies and pharmacy benefit managers — capture $41 of by the National Academies of Sciences, Engineering and every $100 spent on retail prescription drugs. While this complex and opaque system allows competition to regulate prices, it also can lead to market distortions dispropor- Medicine and the White House Council of Economic Advisers. tionately benefiting certain parties. “While the current analysis cannot say definitively whether any sectors make excessive profits, greater scrutiny of pricing policies of each sector and more com- petition throughout the distribution system is warranted,” the authors conclude. Sood personally briefed the Federal Trade Commission about “One paper that I wanted to the team’s analysis, and the research has been cited in multiple highlight is the Schaeffer Center government reports since its release. piece on the pharmaceutical distribution chain. I can tell you we learned a lot from it.” – CMS Administrator Seema Verma at a USC-Brookings Schaeffer Initiative conference on drug pricing reforms. Darius Lakdawalla moderated a panel on access, affordability and disparities at The Hill.
@B citations of Schaeffer research on pharmaceutical policy in three 2018 White House reports
USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu 35 Data Report Countries Using Schaeffer Center Models Complete: Austria Difference Belgium after diagnosis Canada CD.I% Denmark Disability Before and After France a Diagnosis of Heart Failure Germany EB.D% Italy Using the FEM, Schaeffer researchers Difference Difference Japan found that rates of disability significantly before diagnosis after diagnosis Korea increase after a diagnosis of heart failure, CC.I% J.G% Mexico widening already existing disparities Netherlands between races and sexes. Singapore DB.E% DB.B% Spain Before heart failure CI.F% CI.G% Sweden diagnosis Difference Switzerland After heart failure before diagnosis B.E% In Progress: diagnosis CC.G% Ireland K.H% Taiwan J.H% I.F% I.C%
Total Population Black Women White Women Black Men White Men
BY THE NUMBERS Data Core and Microsimulation Teams The centerpiece effort is the Future Elderly Model (FEM), which Partnerships and Collaborations The Data Core and Microsimulation teams within the Schaeffer projects a rich set of health and economic outcomes for the U.S. The Schaeffer Center’s Date Core and Microsimulation teams part- Center are experts in the methods and programming necessary to population aged 50 and older. The Future Adult Model (FAM) extends ner with local, state, federal and international collaborators to de- 160million rigorously analyze big data. The teams include programmers, mi- the FEM to the adult population aged 25 and older in the United velop data projects and models. Key collaborations include the lives represented in Schaeffer Center data crosimulation modelers, analysts and a data resource administra- States. Since 2004, the National Institute on Aging has supported Organisation for Economic Co-operation and Development; the tor who bring unique backgrounds from a variety of fields, including this work as one of 13 prestigious Edward R. Roybal Centers for National Academies of Sciences, Engineering and Medicine; the A team of 12 data scientists statistics and microeconometric theory. These researchers also Translation Research. Findings using the FEM and FAM models have Los Angeles County Department of Public Health; and the Los An- provide support to faculty, students and fellows on specific projects. been published more than 60 times and cited — or commissioned geles Homeless Services Authority. provides expert support for each — by government agencies, the White House, the National Academy of the Center’s research projects. Data Collection of Sciences and private organizations interested in aging policy. Microsimulation Global Collaborator Network The data library maintained at the Schaeffer Center includes survey A multidisciplinary group of research institutions, nonprofit organ- data, public and private claims, contextual data and electronic Data Security izations and government agencies have collaborated with the health network data feeds. The Schaeffer Center Data Core is a state-of-the-art information Schaeffer Center Microsimulation team to build models based on 17 resource and computing environment that meets exacting stan- the FEM and FAM framework. Today, this network is building out country-level, Future Elderly Model-based Microsimulation Models dards of excellence in data security. The Data Core manages a mix country-level FEM-based models in 17 countries. The Center has microsimulation models For more than a decade, the Schaeffer Center has developed an of security measures, from an air-gapped workstation to state-of- also worked to build models for Los Angeles County and California. economic demographic microsimulation model to effectively the-art, Health Insurance Portability and Accountability Act model future trends in health and longevity and answer salient (HIPAA)-compliant systems that include 24/7 monitoring to ensure questions in health policy. private health data resources are protected.
36 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu 37 Financial Report For fiscal year 2018 (July 1, 2017–June 30, 2018), total expenditures Conflict of Interest Policy on the operating budget were $10.5 million. The operating budget The USC Leonard D. Schaeffer Center for includes compensation for faculty, scholars and staff, programmatic Health Policy & Economics conducts innovative, independent research that makes significant expenses and general operating costs. Faculty salaries that are contributions to policy and health improvement. covered by the schools are not included in these totals. Expenses Center experts pursue a range of priority by function are outlined in the graph below left. research areas focused on addressing problems In fiscal year 2018, the Center funded the $10.5 million in operating within the health sphere. Donors may request expenses with $11.5 million current revenue. University support that their funds be used to address a general does not include faculty salaries covered by the schools. Since its research priority area, including: • Improve the performance of inception, the Schaeffer Center has raised nearly $109 million, the healthcare markets majority of which has come from federal grants. • Increase value in healthcare delivery • Improve health outcomes and reduce disparities • Foster better pharmaceutical policy and regulation
Schaeffer Center funding comes from a range of sources, including government entities, foundations, corporations, individuals and endowment. At all times, the independence and integrity of the research is paramount and the Center retains the right to publish all findings from its research activities. Funding Operating Expenses Revenue sources are always disclosed. The Center for Fiscal Year 2018 since inception does not conduct proprietary research. $10.5 million $108.9 million* As is the case at many elite academic institutions, USC Schaeffer Center faculty are sought after for their expertise by corporations, K% I% government entities and others. These external activities (e.g., consulting) are governed by the CJ% USC Faculty Handbook and the university’s CG% Conflict of Interest in Professional and Business Practices and Conflict of Interest in Research policies. All outside activities must be disclosed via the university’s online disclosure system, F% diSClose, and faculty must adhere to all measures put in place to manage any appearance of GF% GE% conflict. CJ% DD% FEDERAL FUNDING The Schaeffer Center has been supported in large part by funding from federal agencies, including the National Institutes of Health and Research, $5.6M Government, $58.1M the Centers for Medicare & Medicaid Services. Salaries, research expenses, initiatives and special projects NIH, CMS and other government sources Data Core & Health Informatics, $1.9M Corporations, $24M Salaries, data and data infrastructure Industry $58.1 million External Affairs, $1.6M Individuals and Foundations, $19.2M in government funding since the Center’s inception Salaries, development, communications, travel Foundations, family foundations and individuals and event expenses USC and Others, $7.6M Administration, $0.9M University support and miscellaneous income 44 projects Salaries and general operating expenses *through 12/31/18 spanning topics including Alzheimer’s disease, Research Training Programs, $0.5M Medicare Part D and health disparities Salaries and training expenses
38 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu 39 Supporters 5AM Ventures Centers for Medicare Pamela and Thomas Jackson Murali Naidu Pamela and Leonard D. & Medicaid Services Schaeffer Abbott Laboratories Jaeb Center for National Cancer Institute Cindy Chen and Bob Kocher Health Research Genell and David Schlotterbeck Agency for Healthcare National Institute for The Center is supported by a wide range of Research and Quality Children's Hospital Los Angeles Jana Partners Health Care Management Sentara Healthcare public and private funders providing grants, gifts Alkermes Columbia University Johns Hopkins University National Institute of Child Health Sue Siegel and Robert Reed and Human Development and sponsorships. The Schaeffer Center gratefully Allergan Alliance Advocacy Commonwealth Fund Johnson & Johnson Kathleen and James Skinner acknowledges the following supporters who National Institute of American Diabetes Association Stephanie and John Robert Wood Johnson Social Security Administration Diabetes and Digestive have given over the past 10 years. Connaughton Foundation American Medical Association and Kidney Diseases Neeraj Sood Cornell University Geoffrey Joyce American Society of National Institute of Neurological Sprint Foundation Retina Specialists Nancy-Ann DeParle Henry J. Kaiser Disorders and Stroke Sutter Health Family Foundation Amgen Susan and John Diekman National Institute of Takeda Pharmaceuticals Kaiser Permanente Nursing Research Anthem Blue Cross Dignity Health Cindy and Jim Trish Pamela D. Kehaly National Institute on Aging Laura and John Arnold Jason Doctor Erin Trish Foundation Carole King National Institute on Alcohol Edwards Lifesciences Abuse and Alcoholism Walter Jay Unger Axovant Sciences Komoto Family Foundation eHealth National Institute on University of California, Laura and Adam Bach Jayne Koskinas Emory University Drug Abuse Los Angeles Ted Giovanis Foundation Paul Barkus EpiVax for Health and Policy National Pharmaceutical University of California, Baxter International Council San Diego Adam Feinstein Maria and David Kretschmer Bessemer Trust Novartis Pharmaceuticals University of California, Fink & Associates LA Homeless Services Authority Corporation San Francisco Blue Cross Blue Shield First 5 LA Darius Lakdawalla of Arizona Sam Nussbaum University of Michigan Steven Fox Curtis Lane Blue Cross Blue Shield Patricia and James P. OConor University of Pittsburgh of Massachusetts Steven Fradkin Carol and Leland Launer Paladin Healthcare University of Southern California Marian and Richard Bott Stella and Joel Freedman Leigh Anne Leas Panel Study of Income Dynamics, Urban Institute David Brailer Sara Geiger Philip Lebherz University of Michigan USC Dornsife Center for Brewster Foundation Genentech Jeffrey A. Leerink Patient-Centered Outcomes Economic and Social Research Research Institute Perry Bridger General Electric Company April and Dirksen Lehman Karen Van Nuys Melinda and Norm Payson Bristol-Myers Squibb George Mason University Lockheed Martin Corporation Kukla Vera Stefano Pessina Brookings Institution Gilead Sciences Michael J. Lohnberg Verily Life Sciences Peter G. Peterson Foundation Your support contributes to the work of the Cathy and Drew Burch Paul Ginsburg John D. and Catherine T. Walgreens Boots Alliance Center — from groundbreaking, multidisciplinary MacArthur Foundation Pfizer California Department Dana P. Goldman Jillian Wallis and research to national conferences to fellowships of Public Health Martha Tapias Mansfield Pharmaceutical Research Bryan Tysinger for young scholars — that pursues innovative Kenneth Goulet and Manufacturers of America California Endowment Lisa and Robert Margolis Faye Wattleton solutions to improve healthcare delivery, policies Burton G. & Anne C. PharMedQuest and outcomes. California Health Care Greenblatt Foundation Massachusetts Institute Gary and Mary West Foundation of Technology Tom Pike Foundation David L. Grumman For more information about how to make California Hospital Association Mathematica Policy Research Jane G. and Mark A. Pisano Cristina Wilson Toni and Chase Haddix a gift, please contact: California Institute for Jeff McCombs Jody Z. and Thomas M. Priselac Mary E. Wilson and Regenerative Medicine Ann and Kent Harada Harvey V. Fineberg Ann S. M. Harada Medica Research Institute Quintiles Transnational California Schools VEBA Brian Harper Corporation Louise and Derek Winstanly Schaeffer Center Managing Director Mental Health Services John A. Hartford Foundation (213) 821-1764 Cambia Health Solutions Oversight and Accountability RAND Corporation Timothy Wright Commission CareFusion Ninetta and Gavin S. Herbert Research!America Julie Zissimopoulos Merkin Family Foundation Cedars-Sinai Julie and Peter Hill Barbara Zoller Riegel ZS Associates Jeanie and Robert Ingram Michigan Retirement and John Romley Disability Research Center, Institute for Health University of Michigan Lisa and Casey Safreno Technology Studies Gordon and Betty Judith A. Salerno Moore Foundation
40 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu 2015–16 USC-RCMAR Research Training Fellow Uchechi Mitchell is now an assistant professor Programs in the University of Illinois (Chicago) School of Public Health, where she continues her work on the impacts of health inequalities among older adults.
Developing leaders in collaboration with two leading institutions: USC Price School of Public Policy USC School of Pharmacy F D A training programs master’s programs doctor of philosophy programs
BY THE NUMBERS A preeminent educational destination for current and emerging Postdoctoral Fellowships Alzheimer’s disease and dementia. The program provides mentor- One hundred percent of Schaeffer leaders in health policy and economics, the Schaeffer Center de- Postdoctoral researchers at the Schaeffer Center focus completely ship to RCMAR scholars in multidisciplinary training, launching new velops innovators for positions in higher education, research, gov- on research, with no teaching requirement. This select group of lines of research, and tracking and evaluating the success of Center trainees move into academic ernment and healthcare by: scholars evenly splits time during the first year on completing their pilot investigations. USC-RCMAR is housed within the Schaeffer or private-sector careers. dissertation and collaborating on a new Schaeffer Center research Center and led by Schaeffer Center Director Dana Goldman and • Creating a nurturing, interdisciplinary and resource-rich learning project. Postdocs are considered full members of the Schaeffer Julie Zissimopoulos. environment for students, scholars and professionals Center community, receive one-on-one mentoring and also have • Sharpening fellows’ and students’ analytical skills and helping access to all faculty associated with the center. 2018–2019 USC-RCMAR Fellows $9.5 million them advance their scholarly agendas through extensive re- Alice Chen, PhD amount of federal funding awarded to USC-RCMAR search training and access to sophisticated data analysis tools 2018–2019 Postdoctoral Fellows Assistant Professor, USC Price School of Public Policy Fellows under Schaeffer mentorship • Offering one-on-one mentorship and significant collaboration Meng Li, PhD Sze-chuan Suen, PhD with distinguished investigators in the field Rajan Sonik, PhD, JD, MPH Assistant Professor, USC Viterbi School of Engineering • Recruiting diverse, high-quality fellows, junior faculty, research Johanna Thunell, PhD assistants and interns Reginald Tucker-Seeley, MA, ScM, ScD 84% Edward L. Schneider Assistant Professor of Gerontology, • Assisting trainees in securing influential positions in prestigious USC Resource Center for Minority Aging Health of Schaeffer Center Postdoctoral and USC-RCMAR academic, public and private settings and earning recognition Economics Research Fellowships (USC-RCMAR) USC Leonard Davis School of Gerontology Fellows are from underrepresented groups from major players in the field Funded through a grant from the National Institute on Aging, the • Ensuring numerous professional development opportunities, in- Minority Aging and Health Economics Research Center was estab- Pre-doctoral Fellowships cluding support for grant writing, publication in peer-reviewed lished at the USC Schaeffer Center in 2012. Since its launch, USC- Pre-doctoral economics students in the graduate certificate pro- journals and travel to present at or attend major conferences RCMAR has funded 18 junior researchers. The program aims to gram in health economics conduct research at the Schaeffer Center • Providing dedicated, full-time administrative and data support increase the number, diversity and academic success of junior faculty under the guidance of a faculty member, gaining knowledge and at the Schaeffer Center, and access to a host of university-wide who are focusing their research on the health and economic well- expertise relevant to their upcoming doctoral program. educational and career-development resources being of minority elderly populations, with a particular focus on
42 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu 43 Campus seminars and conferences provide opportunities for students, faculty and the community to hear presentations by leading researchers, elected officials and journalists. In 2015, The New York Times columnist David Leonhardt spoke at a Center event.
Clinical Fellowships MS in Healthcare Decision Analysis Schaeffer Center offers The Quintiles Clinical Fellows program fosters collaboration be- This newly emerging branch of applied research focuses on the in- one-on-one mentorship as well as extensive professional tween Schaeffer Center faculty and exceptional junior scholars or tersection of health economics, applied international health policy, development opportunities prominent researchers and thought leaders in health policy, eco- insurance design, competitive business intelligence and pricing. for current and emerging nomics and medicine. The program provides training and support Housed at the Schaeffer Center, the degree is offered through the leaders in health policy and on grants, papers and ongoing research projects. The fellowship School of Pharmacy. economics. Students and is co-directed by Sarah Axeen, assistant professor at the Keck early-career researchers benefit from the Center’s School of Medicine of USC, and Julie Zissimopoulos. MS in Biopharmaceutical Marketing vibrant Data Core and Micro- The Master of Science in Biopharmaceutical Marketing is an inter- simulation teams, which Internships disciplinary graduate program in precision marketing aimed exclu- include 12 data scientists. Each summer, the Schaeffer Center enables outstanding college sively at careers in the biopharmaceutical and payer industries. undergraduate and high school students to gain hands-on experi- ence and mentorship in health policy research and data analysis Master of Health Administration as well as an introduction to the broader field of health economics. Offered through the USC Price School of Public Policy, the Master The summer internship program is led by Julie Zissimopoulos. of Health Administration program has trained leaders in health management policy for nearly four decades. Research Assistantships EDUCATIONAL LEADERSHIP Students from relevant disciplines such as economics, public policy, Executive Master of Health Administration (Online) health policy, statistics, medicine and psychology work directly with Developed for both mid-career clinical and management profes- A preeminent educational destination for current Schaeffer Center faculty on specific research projects, garnering in- sionals, the Executive Master of Health Administration program from valuable experience and skills to further their research prowess. the Price School delivers a transformative graduate-level educational and emerging leaders in health policy and economics, experience designed to prepare the nation’s leading healthcare Visiting Scholars professionals. Young researchers from leading institutions around the world come the Schaeffer Center develops innovators for positions to the Schaeffer Center each year as visiting scholars to collaborate PhD in Public Policy and Management with faculty and gain access to the center’s unique data core and re- Offered through the Price School, the degree produces researchers in higher education, research, government and sources. The visiting scholars program is led by Julie Zissimopoulos. and scholars who shape the direction of public affairs research. healthcare by creating a nurturing, interdisciplinary Degrees PhD in Health Economics Faculty associated with the Schaeffer Center teach in the following This doctoral program integrates curricula from the Department and resource-rich learning environment for students, degree programs: of Economics in the Dornsife College, the Department of Preventive Medicine in the Keck School of Medicine, and the Department of scholars and professionals. MS in Pharmaceutical Economics and Policy Pharmaceutical and Health Economics in the School of Pharmacy. This Master of Science program emphasizes pharmaceutical com- It offers two distinct tracks: merce and policy and is taught by faculty affiliated with the USC • Microeconomics School of Pharmacy and the Department of Economics in the USC • Pharmaceutical Economics and Policy Dornsife College of Letters, Arts and Sciences.
44 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu Conferences and Seminars
2014 Fifth Biennial Conference 2010 of the American Society of Health Reform and Health Economists (ASHEcon) the Economy: Are They Good for Each Other? More than 800 participants “The beauty of the time period 2012 attended the four-day conference we live in is there’s a vast number Policymakers, analysts and industry “Significant savings Global Healthcare Regulation hosted at USC. All told, more than of different models, and so there’s executives from across the country probably require fundamental and Innovation Conference 190 presentations were given. A an enormous amount of work to be and beyond discussed the recently changes in the organization More than 200 people attended Attendees included academics, roundtable plenary session brought done to understand which models passed healthcare reform legislation and delivery of healthcare,” the two-day global healthcare con- members of the pharmaceutical together the four scholars holding are working,” Michael Chernew said. and measured its impact on the over- Douglas Elmendorf said. ference in Beijing, jointly hosted by and insurance industries, and Schaeffer endowed chairs of health “I don’t think there’s going to simply all economy at the first conference the Schaeffer Center and Guanghua government officials from the policy throughout the nation: Dana be one answer. There’s going to hosted by the Schaeffer Center. School of Management at Peking U.S. and China. Goldman, USC Schaeffer Center be such diversity in where we move Speakers included Douglas University. director, who served as moderator; ahead, that there’s going to be Elmendorf, director of the Congres- Michael Chernew of Harvard; Alice enormous amount of opportunity sional Budget Office, and Sir Rivlin of the Brookings Institution; for academics to look at it in a Michael Rawlins, chair of the and James Robinson of UC Berkeley. rigorous way.” National Institute for Health and Care Excellence in Great Britain. DA conferences
Highlights from the Center’s First 10 Years 2011 2013 2014 Promoting Biomedical The Schaeffer Center co-hosted two The Cost and Value of In the 10 years since its launch, the Schaeffer Center Innovation and Economic conferences in 2013 focused on the Biomedical Innovation: has produced more than 180 events to move forward the Value: New Models for impact of the Affordable Care Act, Implications for Health Policy Reimbursement and including Covered California: Panelists — including Kavita Patel, conversation on important healthcare topics. From Evidence Development The Challenges and Opportuni- biopharmaceutical innovation to insurance market reforms — director of policy for the Office of Hosted by the Brookings Institution ties of the California Health Intergovernmental Affairs and Public and from Los Angeles to Washington, D.C., and from Paris in Washington, D.C., and covered Benefit Exchange in Sacramento. Engagement in the Obama adminis- to Beijing — the Schaeffer Center has informed and provided live on C-SPAN, former House The panel included Peter Lee, tration, and WellPoint Chief Medical executive director of Covered Cali- space for important debates. Following are just a few Speaker Newt Gingrich and former 2014 Officer Sam Nussbaum — discussed fornia; Dana Goldman, Schaeffer highlights from the first decade of impact. Office of Management and Budget The Health and Economic who benefits from and who bears Director Peter Orszag offered Center director; and Bob Kocher, Value of Comprehensive the costs of “breakthrough” treat- keynote remarks. former special assistant to President Diabetes Management ments in hepatitis C. Obama on Healthcare Policy and “What you are struggling with in Economics. The conversation Dana Goldman presented at the this room [containing healthcare was moderated by Jay Hansen, congressional briefing in Washing- costs and biomedical innovation] California Medical Association. ton, D.C., hosted by the Congres- is the crucial long-term fiscal sional Diabetes Caucus. California problem facing the United States,” Attorney General Xavier Becerra Peter Orszag said. “We cannot (then a state representative and afford open-ended, continued cost vice chair of the Diabetes Caucus) increases driven largely or primarily praised USC as a “real champion” by technology. But, on the other in diabetes research. hand, we don’t want to lose the advances in health outcomes that are associated with a variety of technological improvements.”
46 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu 47 2016 Bridging the Gulf: Challenges of End-of-Life Care in California The National Academies of Sciences, 2018 Engineering and Medicine and A Conversation with Cedars-Sinai partnered with the Seema Verma Schaeffer Center to host a one-day 2017 Fostering Competition Centers for Medicare & Medicaid conference for healthcare profes- 2016 in the Pharmaceutical Services’ Administrator Seema sionals, payers, patient advocates Chronic Care: Distribution Chain Verma highlighted Schaeffer Center and policymakers. Getting Its Complexity research and discussed the impor- “For many patients, the clear In the face of growing popular “Is any player making more and Cost Under Control tance of bodies like the Schaeffer desire is for final days to be spent concern over prescription drug money than they ought to be? 2015 Initiative in her remarks on under palliative care at home. We The event launched the USC- “There is a striking lack of prices, opportunities may exist for Is any player making excessive Fixing America’s Mental Medicare Part D. need to identify the changes that Brookings Schaeffer Initiative for attention to what dominates significant savings in the drug distri- returns, and what should we Healthcare System need to be made and the stake- Health Policy. More than 140 American healthcare,” Senator bution chain, according to findings do about it?” Neeraj Sood asked. Seth Seabury presented his work holders who can make it happen,” policymakers, Capitol Hill staff and Ron Wyden (D-OR) said. from two papers presented at this on barriers to mental healthcare at Leonard D. Schaeffer said. media attended the event, while “And that is chronic care.” USC-Brookings Schaeffer Initiative the conference co-hosted with The 330 watched the live webcast. event in Washington, D.C. Hill. Senator Chris Murphy (D-CT) and Representative Tim Murphy (R-PA) spoke at the event. The Schaeffer Center has partnered with The Hill to produce three events. GG @GA seminars total events
2015 2017 2018 2018 Strengthening Medicare Value of a Cure: Medicare Drug Impact of Inequality for 2030 Ensuring Access and Pricing Proposals on the Future Elderly: Encouraging Innovation Policy Tools and Actions U.S. Secretary of Health and The half-day forum, co-sponsored Speakers included two members “We need better economic policies Human Services Alex Azar delivered Working with Schaeffer Center ex- by the Schaeffer Center and the “We’ll be living longer of the House of Representatives, for ordinary Americans. We need remarks on proposed reforms to perts, economists and researchers Brookings Institution, brought to- but spending more time Diana DeGette (D-CO) and Fred to be able to share and not just let Medicare Part B drug pricing from Europe, Asia and North Amer- gether a distinguished list of econo- with disability,” Dana Upton (R-MI). “Drug pricing needs it all go to the top,” Sir Angus policies and then participated in ica have collaborated to develop mists and former administrators of Goldman said. a robust debate,” Representative Deaton said. a fireside chat with Paul Ginsburg, country-level economic-demo- the Centers for Medicare & Medicaid DeGette said. director of the Schaeffer Initiative. graphic models based on the Scha- Services and its predecessor, the 2016 2017 Protecting Patients from Policy Approaches to effer Center’s Future Elderly Model. Health Care Financing Administra- Surprise Medical Bills the Opioid Crisis Early results of the research were tion. In conjunction with the confer- presented at an event held at the ence, the Schaeffer Center and A new paper outlining the extent The event featured remarks from Organisation for Economic Co- Brookings co-published five working of surprise medical bills and policy Sir Angus Deaton, Congresswoman operation and Development papers on strengthening Medicare. interventions to mitigate them was Ann McLane Kuster (D-NH) and headquarters in Paris. presented at the Schaeffer Initiative Harvard Professor Bertha K. Madras. event held at the Brookings Institu- “The complexity of this crisis tion. More than 150 attended and is well beyond the capacity of any another 500 tuned in to the live one state or any one community,” webcast. said Kuster in her opening remarks Since then, Schaeffer Initiative at the conference, noting that the experts have published numerous crisis doesn’t pick political parties. op-eds and blog posts on the issue, “We need a nationally coordinated and federal and state policymakers response.” have turned to these authorities to discuss policy solutions.
48 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu 49 Publications Improve the Performance Eisenberg, M. D., A. M. Haviland, A. McLaren, C. F., R. T. Reville and S. A. Trish, E., P. Ginsburg, L. Gascue and Cefalu, W. T., D. E. Dawes, G. Gavla, D. Jena, A. B., A. Olenski, D. M. Blumenthal, of Healthcare Markets Mehrotra, P. J. Huckfeldt and N. Sood. Seabury. (2017). How effective are G. Joyce. (2017). Physician reimburse- Goldman, W. H. Herman, K. Van Nuys R. W. Yeh, D. P. Goldman and J. Romley. by Schaeffer (2017). The long-term effects of employer return to work programs? ment in Medicare Advantage compared ... and A. L. Yatvin. (2018). Insulin access (2018). Acute myocardial infarction Center Faculty Aaron, H. J., L. J. Blumberg, P. B. “consumer-directed” health plans International Review of Law and with traditional Medicare and commer- and affordability working group: Conclu- mortality during dates of national inter- Ginsburg and S. Zuckerman. (2017). on preventive care use. Journal of Economics 52 (Oct): 58-73. cial health insurance. JAMA Internal sions and recommendations. Diabetes ventional cardiology meetings. Journal 2017–2018 Building a better “Cadillac.” Schaeffer Health Economics 55 (Sep): 61-75. Medicine 177 (9): 1287-95. Care 41 (6): 1299-1311. of the American Heart Association 7 Initiative White Paper. Mehrotra, A., K. Dean, A. Sinaiko and (6): e008230. Fiedler, M., H. J. Aaron, L. Adler, N. Sood. (2017). Americans support Weissblum, L., P. Huckfeldt, J. Escarce, Chen, C. X., J. R. Baker and M. B. Aaron, H. J., M. Fiedler, P. B. Ginsburg, P. B. Ginsburg. (2017). Moving in the price shopping for health care, but few P. Karaca-Mandic and N. Sood. (2018). Nichol. (2017). Economic burden of Kabiri, M., M. Brauer, J. Shafrin, J. L. Adler and A. M. Rivlin. (2017). wrong direction: Health care under actually seek out price information. Skilled nursing facility participation in illness among persons with hemophilia Sullivan, T. M. Gill and D. P. Goldman. Turmoil in the individual insurance the AHCA. New England Journal of Health Affairs 36 (8). Medicare’s bundled payments for care b from HUGS Vb: Examining the associa- (2018). The long-term health and market: Where it came from and how Medicine 376 (Jun): 2405-7. improvement initiative: A retrospective tion of severity and treatment regimens economic value of improved mobility to fix it. New England Journal of Melnick, G., K. Fonkych and J. study. Archives of Physical Medicine with costs and annual bleed rates. among older adults in the United States. Medicine, 377 (4): 314-15. Frakes, M.D., M. B. Frank and S. A. Zwanziger. (2018). The California com- and Rehabilitation (October). Value in Health 20 (8): 1074-82. Value in Health 21 (7): 792-98. Seabury. (2017). The effect of malprac- petitive model: How has it fared, and Adler, L., H. J. Aaron, P. B. Ginsburg tice law on physician supply: Evidence what’s next? Health Affairs 37 (9) 1417-24 Zhang, X., A. Haviland, A. Mehrotra, Chen, A., Blumenthal, D.M., Jena, Kalet, A. M., J. N. Doctor, J. H. Gennari and M. Fiedler. (2017). The Graham- from negligence-standard reforms. P. Huckfeldt, Z. Wagner and N. Sood. A.B. (2018). Characteristics of Physicians and M. H. Phillips. (2017). Developing Cassidy plan: The most harmful ACA- National Bureau of Economics, w23446. Ning, N., E. Trish, S. Axeen, D. P. (2018). Does enrollment in high- Excluded From US Medicare and State Bayesian networks from a dependency- repeal bill yet. New England Journal Goldman and J. A. Romley. (2018). deductible health plans encourage Public Insurance Programs for Fraud, layered ontology: A proof-of-concept of Medicine, 377 (16), e23. Gaynor, M., F. Mostashari, P. B. Ginsburg. Do commercial health care prices price shopping? Health Services Health Crimes, or Unlawful Prescribing in radiation oncology. Medical Physics (2017). Making health care markets influence Medicare spending? Value Aguila, E., C. Kapteyn and F. Perez- Research 53: 2718-34 of Controlled Substances. JAMA 44 (8): 4350-59. work: Competition policy for health in Health 21 (suppl. 1): S263. Network Open. 1(8):e185805. Arce. (2017). Consumption smoothing care. JAMA ViewPoint 317 (13): 1313-14. Zhang, X., E. Trish and N. Sood. Kwatkar, A. A., L. Chu and M. B. Nichol. and frequency of benefit payments of Reid, R. O., B. Rabideau and N. Sood. (2018). Financial burden of healthcare Chen, F., X. Jiang, S. Wang, L. M. (2017). Association of clinical complica- and K. K. Patel. (2017). (2017). Impact of consumer-directed cash transfer programs. American Ginsburg, P. B. utilization in consumer-directed health Schilling, D. Meeker, T. Ong ... and J. tions and surgery treatment on recur- Economic Review 107 (5): 430-35. Physician payment reform: Progress health plans on low-value healthcare. plans. American Journal of Managed Vaidya. (2018). Perfectly secure and rence of acute diverticulitis. Value in to date. New England Journal of American Journal of Managed Care Care 24 (4): e115-21 efficient two-party electronic-health- Health 20 (5): A181. Arora, S., N. Sood, S. Terp and G. Medicine 377 (3): 285-92. 23 (12): 741-48. Joyce. (2017). The price may not be record linkage. IEEE Internet Computing 22 (2): 32-41. Kwatkar, A. A., L. Chu, M. B. Nichol. right: The value of comparison shopping Goldman, D. P. and K. Hagopian. Schaffer, A. C., A. B. Jena, S. A. Seabury Increase the Value (2017). Association of socio-demo- for prescription drugs. American Journal (2018). It is time for universal coverage et al. (2017). Rates and characteristics in Healthcare Delivery Chou, J. W., A. R. Silverstein and graphics and clinical complications with of Managed Care 23 (7): 410-15. without breaking the bank. Journal of paid malpractice claims among US Axeen, S. (2018). Trends in opioid use D. P. Goldman. (2018). Impact of future medical expenditures in divertic- of Policy Analysis and Management physicians by specialty, 1992-2014. Medicaid treatment access policies ulitis. Value in Health 20 (5): A181. Barnes, K., A. Mukherji, P. Mullen, N. 37 (1): 182-88. JAMA Internal Medicine 177 (5): 710-18. and prescribing in Medicare, 2006-2012. Sood. (2017). Financial risk protection Health Services Research 53 (5): on the hepatitis C epidemic. Value in Health 21: S87. Kwatkar, A. A., L. Chu and M. B. Nichol from social health insurance. Journal Goldman, D. P. and K. Hagopian. Schwarcz, D., P. Siegelman, T. Baker … 3309-28. (2017). Comparative effectiveness of PROLIFIC PUBLISHERS of Health Economics 55 (Sep): 14-29. (2018). Medicare-for-all: Not our only and J. J. Heckman. (2017). The law Axeen, S., S. A. Seabury and M. Deaton, A. and B. Atten. (2017). Trying surgical management of complicated option for universal coverage. Journal and economics of insurance. The Oxford to understand the PPPs in ICP2011: Why diverticulitis. Value in Health 20 (5): A184. Schaeffer Center faculty Carrera, M., D. P. Goldman, G. Joyce of Policy Analysis and Management Handbook of Law and Economics, Menchine. (2018). Emergency depart- ment contribution to the prescription are the results so different? American and N. Sood. (2018). Do physicians 37 (1): 195-98. Volume 2: Private and Commercial Kwatkar, A. A., L. Chu and M. B. Nichol. have authored more than 1,020 respond to the costs and cost-sensitivity opioid epidemic. Annals of Emergency Economic Journal: Macroeconomics Law, ed. F. Parisi. Oxford: Oxford 9 (1): 243-64. (2017). Evaluation of age, multimorbidity of their patients? American Economic Huckfeldt, P. J., B. A. Weissblum, University Press. Medicine 70 (5) 623-31. and clinical complications as risk factors papers in the past 10 years. J. J. Escarce, P. Karaca-Mandic and Journal: Economic Policy 10 (1): 113-52. Doctor, J. N., A. Nguyen, R. Lev, J. Lucas, for urgent surgical treatment for diverti- . (2018). Do skilled nursing , A. Alpert, K. Barnes, P. Huck- Baldassano, R. N., A. Shahabi, S. A. N. Sood Sood, N. T. Knight, H. Zhao and M. Menchine. culitis. Value in Health 20 (5): A181 Chatterjee, C., R. Joshi, N. Sood and facilities selected to participate in feldt and J. J. Escarce. (2017). Effects of Seabury, D. Lakdawalla ... and G. R. LEADING JOURNALS Lichtenstein. (2018). P014 Average (2018). Opioid prescribing decreases P. Boregowda. (2017). Government preferred provider networks have payment reform in more versus less Kwatkar, A. A., L. Chu and M. B. Nichol. health insurance and spatial peer ef- annual healthcare costs for pediatric after learning of a patient’s fatal over- higher quality and lower costs? competitive markets. Journal of Health dose. Science 361 (6402): 588-90. (2017). Incremental expenditures asso- fects: New evidence from India. Social Health Services Research. Economics 51: 66-83. and adult patients with Crohn’s disease ciated with recurrence of diverticulitis. 620+ Science and Medicine 196 (Jan): 131-41. or ulcerative colitis. Inflammatory Enguidanos, S. and J. A. Ailshire. Value in Health 20 (5): A182 Over half the papers were Huckfeldt, P. J., J. J. Escarce, B. Terp, S., S. A. Seabury, S. Arora, Bowel Diseases 24 (suppl. 1): S6. (2017). Timing of advance directive Chen, A. J., A. J. Graves, M. J. Resnick Rabideau, P. Karaca-Mandic and A. Eads, C. N. Lam and M. Menchine. Kwatkar, A. A., L. Chu and M. B. Nichol. Barnett, M. L., A. R. Olenski, completion and relationship to care published in top-tier journals. and M. R. Richards. (2018). Does spend- N. Sood. (2017). Less intense postacute (2017). Enforcement of the Emergency A. B. (2017). Trajectories of expenditures ing more get more? Health care delivery Jena, M. D. Menchine, S. Axeen, L. preferences. Journal of Pain and care, better outcomes for enrollees in Medical Treatment and Labor Act, Symptom Management 53 (1): 49-56. associated with acute gastrointestinal and fiscal implications from a Medicare Medicare Advantage than those in fee- 2005 to 2014. Annals of Emergency Plantmason and S. Seabury. (2017). diseases. Value in Health 20 (5): A182. Opioid prescribing by emergency fee bump. Journal of Policy Analysis for-service. Health Affairs 36 (1): 91-100. Medicine 69 (2): 155-62. Gong, C. L., K. M. Zangwill, J. W. Hay, physicians and risk of long-term use. Kwatkar, A. A., , W. Stohl and 19.8K+ and Management 37 (4): 706-31. D. Meeker and J. N. Doctor. (2018). J. W. Hay Lakdawalla, D., J. Reif and D. Bauer. Terp, S., B. Wang, B. Raffetto, S. A. New England Journal of Medicine Behavioral economics interventions to M. B. Nichol. (2018). Consistent estima- These studies have amassed close to Chen, A., A. T. Lo Sasso and M. R. (2018). Mortality risk, insurance, and the Seabury and M. Menchine. (2017). 376 (May): 1895-96. tion of polychotomous treatment effects Richards. (2018). Supply-side effects improve outpatient antibiotic prescrib- 20,000 citations in academic journals. value of life. Unpublished manuscript. Individual physician penalties resulting ing for acute respiratory infections: with selection-bias and unobserved from public insurance expansions: from violation of Emergency Medical Baumgardner, J., A. Shahabi, M. T. heterogeneity using panel data corre- Evidence from physician labor markets. Lin, C., C. Carlin and J. A. Romley. Linthicum, S. Vine, C. Zacker and A cost-effectiveness analysis. Journal Treatment and Labor Act: A review of of General Internal Medicine: 1-9. lated random coefficients model. Health Health Economics, 27 (4): 690-708. (2017). Health care utilization and Office of the Inspector General patient D. N. Lakdawalla. (2017). Hematologic Services and Outcomes Research expenditures for children with special cancers more costly and have fewer dumping settlements, 2002-2015. Heckman, J. J., M. L. Holland, K. K. Methodology 18 (2): 75-95. 100+ Chen, A., A. L. Sasso and M. Richards. health care needs: A cross-sectional savings options than solid tumors under (2017). Graduating into a downturn: Academic Emergency Medicine 24 Makino, R. Pinto and M. Rosales-Rueda. This research has been referenced analysis for medicaid and private (4): 442-46. the OCM. Blood 130 (suppl. 1): 4713. (2017). An analysis of the Memphis Kendall-Taylor, N. and P. Levitt. (2017). Are physicians recession proof? insurance enrollees. Value in Health Beyond hat in hand: Science advocacy more than 100 times in influential Health Economics 27 (1): 223-35. Carlson, M., C. L. P. Vigen, S. Rubayi … Nurse-Family Partnership Program. 20 (5): A372. Trish, E., J. Xu and G. Joyce. (2018). National Bureau of Economics, w23610. is foundational for policy decisions. Growing number of unsubsidized Part D and J. W. Hay. (2017). Lifestyle inter- Neuron 94 (4): P708-12. government reports and documents. Ederhof, M. and P. B. Ginsburg. (2017). Ly, D.P., and . vention for adults with spinal cord injury: S. A. Seabury A. B. Jena beneficiaries with catastrophic spending Heckman, J. J. and R. Pinto. (2017). Improving hospital incentives with (2017). Hours worked among U.S. dual Results of the USC-RLANRC Pressure better cost data. New England Journal suggests need for an out-of-pocket cap. Unordered monotonicity. National physician couples with children, 2000 Health Affairs 37 (7): 1048-56. Ulcer Prevention Study. Journal of Bureau of Economics, w23497. of Medicine 376 (11): 1010-11. to 2015. JAMA Internal Medicine 177 Spinal Cord Medicine (Apr): 1-18. (10): 1524-25.
50 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu 51 Khodyakov, D., S. Grant, D. Meeker et al. Ramirez, M., S. Wu, G. W. Ryan, A. St. Clair, P., E. Gaudette, H. Zhao, B. Nobel laureate Daniel (2017). Comparative analysis of stake- Towfighi and B. Vickrey, B. (2017). Tysinger, S. Seyedin and D. P. Goldman. McFadden presented his holder experiences with an online ap- Using beta-version Mhealth technology (2017). Using self-reports or claims to research on Medicare Part D proach to prioritizing patient-centered for team-based care management to assess disease prevalence. Medical to the Centers for Medicare research topics. Journal of the American support stroke prevention. JMIR Re- Care 55 (8): 782-88. & Medicaid Services. The Medical Informatics Association 24 search Protocols 6 (5): e943. study has been widely cited, , J. W. Chou, A. Silverstein, (3): 537-43. Van Nuys, K. including in a 2019 Health , É. Gaudette, R. Brookmeyer and . (2017). Seabury, S. A. D. P. D. P. Goldman and Human Services Shahabi, FRI-462: The impact of broader hepatitis Lichtenstein, G. R., A. S. A. Goldman ... and K. Boase. (2018). As- proposed rule. Seabury, D. N. Lakdawalla et al. sessment of follow-up care after emer- C treatment strategies on population (2017). The total direct cost of health- gency department presentation for mild health and social value in England. care in the United States in patients traumatic brain injury and concussion: Journal of Hepatology 66(1): S407. with Crohn’s disease and ulcerative Results from the TRACK-TBI study. colitis: An age specific analysis. JAMA Network Open 1 (1): e180210. Wang, Y., B. P. Yan, M. B. Nichol, B. Gastroenterology 152 (5): S448. Tomlinson and V. W. Lee. (2017). Real- Seabury, S. A., K. Bognar, Y. Xu, et al. world study of low-density lipoprotein Linder, J. A., D. Meeker, C. R. Fox, M. W. (2017). Regional disparities in the quality cholesterol levels and cardiovascular Friedberg, S. D. Persell, N. J. Goldstein of stroke care. American Journal of outcomes in Chinese: A retrospective and J. N. Doctor. (2017). Effects of be- Emergency Medicine 35 (9): 1234-39. cohort study in post-percutaneous havioral interventions on inappropriate coronary intervention acute coronary antibiotic prescribing in primary care Seabury, S. A., M. A. Frasco, E. V. syndrome patients. International 12 months after stopping interventions. Eijndhoven, S. Sison and C. Zacker. Journal of Cardiology 249: 18-24. Journal of the American Medical (2017). The impact of self- and physi- Association 318 (14): 1391-92. cian-administered cancer treatment Wen, C. K. F., S. Schneider, A. A. Stone, on work productivity and healthcare D. Spruijt-Metz. (2017). Compliance MacEwan, J. P., A. R. Silverstein, J. utilization. Research in Social and with mobile ecological momentary Shafrin, D. N. Lakdawalla, A. Hatch Administrative Pharmacy 14 (5): 434-40. assessment protocols in children and and F. M. Forma (2018). Medication adolescents: A systematic review and adherence patterns among patients Segbroeck, M. V., A. T. Knoll, P. Levitt meta-analysis. Journal of Medical with multiple serious mental and and S. Narayanan. (2017). MUPET— Internet Research 19 (4): e132. physical illnesses. Advances in Mouse Ultrasonic Profile ExTraction: Therapy 35 (5): 671-85. A signal processing tool for rapid and Xie, Z., D. Goldman, A. L. Peters and unsupervised analysis of ultrasonic J. A. Romley. (2018). Estimating the Anna, N. R., B. Mathew B. and S. Cox, R., B. Henwood, S. Rodnyansky, Fuchs, V. (2017). Social determinants Heckman, J. J. and J. L. Garcia. (2017). Mulligan, K., T. Ton, L. Yoon … and vocalizations. Neuron 94 (3): 465-85. effects of extended-release formulations Enguidanos. (2017). Quality of physician S. Wenzel and E. Rice. (2017). Roadmap of health: Caveats and nuances. Social policy: Targeting programmes effec- . (2017). Measuring in- on adherence, HBA1C control and hospi- D. N. Lakdawalla orders for life-sustaining treatment to a unified measure of housing insecu- JAMA 317 (1): 25-26. tively. Nature Human Behaviour 1 (Jan). direct costs (productivity and caregiver Shafrin, J., K. Bognar, K. Everson, tal outcomes. Value in Health 21: S79. M. Brauer, D. N. Lakdawalla and forms completed in nursing homes. rity. Washington Center for Equitable burden) in the ACC/AHA guideline statin García, J. L., J. J. Heckman, D. E. Leaf Kamitakahara, A., H. Wu and P. Levitt. F. M. Forma. (2018). Does knowledge Journal of Palliative Medicine 20 (5): Growth, Working Paper Series (Jul). benefit groups. Value in Health 20 (5). and M. J. Prados. (2017). Quantifying (2017). Distinct projection targets define of patient non-compliance change Improve Health and Reduce 538-41. Crimmins, E. M., Y. Saito, J. K. Kim et the life-cycle benefits of a prototypical subpopulations of mouse brainstem , , L. D. prescribing behavior in the real world? Disparities Throughout Myerson, R. M. D. Lakdawalla Auerbach, A. J., K. K. Charles, C. C. al. (2018). Educational differences in early childhood program. National vagal neurons that express the autism- Colantonio, M. Safford and D. Meltzer. A claims-based analysis of patients with the Lifespan Coile, W. Gale, D. P. Goldman, et al. the prevalence of dementia and life Bureau of Economics, w23479. associated met receptor tyrosine kinase. (2018). Effects of expanding health serious mental illness. ClinicoEconomics Aguila, E., C. Kapteyn and C. Tassot. (2017). How the growing gap in life expectancy with dementia: Changes Journal of Comparative Neurology 525 screening on treatment: What should we and Outcomes Research 10: 573-85. (2017). Designing cash transfer expectancy may affect retirement from 2000 to 2010. Journals of Gaudette, É., G. C. Pauley and J. M. (18): 3787-808 expect? What can we learn? National Zissimopoulos. (2017). Lifetime conse- Shafrin, J., F. Forma, E. Scherer, A. programs for an older population: benefits and reforms. National Bureau Gerontology: Series B 73 (1) S20-28. Bureau of Economic Research, w24347. The Mexican case. Journal of the quences of early-life and midlife access Kast, R. J., H. H. Wu, P. Williams, P. Hatch, E. Vytlacil and D. N. Lakdawalla. of Economic Research, w23329. Economics of Ageing 9 (Jun): 111-12. Crimmins, E. (2017). Introduction to health insurance: A review. Medical Gaspar and P. Levitt. (2017). Specific Myerson, R. M., L. D. Colantonio, (2017). The cost of adherence mismea- Brown, L., B. Needham and J. Ailshire. to issue on gender dynamics and Care Research and Review (Nov). connectivity and unique molecular M. M. Safford and E. S. Huang. (2017). surement in serious mental illness: Aguila, E. and A. Vega. (2017). Foreign (2017). Telomere length among older disparities in health and mortality. identity of MET receptor tyrosine kinase Does identification of previously A claims-based analysis. American retirement income among new older US adults: Differences by race/ethnicity, Journal of Biodemography and Social Goldman, D. P., C. Chen, J. expressing serotonergic neurons in undiagnosed conditions change care- Journal of Managed Care 23 (5): e156. immigrants. International Migration gender, and age. Journal of Aging and Biology 63 (1): 1-2. Zissimopoulos, J. W. Rowe ... and J. the caudal dorsal raphe nuclei. ACS seeking behavior? Health Services Jackson. (2018). Opinion: Measuring Shafrin, J., S. G. May, A. Shrestha, 55 (3): 38-56. Health 29 (8): 1350-66. Chemical Neuroscience 8 (5): 1053-64. Research 53 (3): 1517-38. Deaton, A. (2017). Where in the world how countries adapt to societal aging. C. Ruetsch, N. Gerlanc, F. Forma, A. Aguila, E. and A. Vega. (2017). Social Case, A. and A. Deaton. (2017). Mortal- is the world heading? Journal of Policy Proceedings of the National Academy Landers, R. and J. J. Heckman. (2017). Ni, W., D. Colayco, J. Hashimoto, K. Hatch, and J. P. D. N. Lakdawalla Security contributions and return migra- ity and morbidity in the 21st century. Modeling 39 (4): 603-7. of Sciences 115 (3): 435-37. The Scandinavian fantasy: The sources Komoto, C. Gowda, B. Wearda and Lindenmayer. (2017). Access to credible tion among older male Mexican immi- Brookings Papers on Economic Activity of intergenerational mobility in Denmark . (2018). Budget impact information on schizophrenia patients’ J. McCombs grants. Gerontologist 57 (3): 563-74. (Mar): 23-24. Eagleson, K. L., Z. Xie, P. Levitt. (2017). Gonzalez-Gonzalez, C., B. Tysinger, and the US. Scandinavian Journal of analysis of a pharmacist-provided medication adherence by prescribers The pleiotropic MET receptor network: D. P. Goldman and R. Wong, R. (2017). Economics 1 (119): 178-230. transition of care program. Journal can change their treatment strategies: Ailshire, J. A., A. Karraker, P. Clarke. Chen, C., D. P. Goldman, J. Zissi- Circuit development and the neural- Projecting diabetes prevalence among of Managed Care and Specialty Evidence from an online survey of (2017). Neighborhood social stressors, mopoulos and J. W. Rowe. (2018). medical interface of autism. Biological Mexicans aged 50 years and older: Langa, K. M., E. B. Larson, E. Crimmins, Pharmacy 24 (2): 90-96. providers. Patient Preference and fine particulate matter air pollution and Multidimensional comparison of coun- Psychiatry 81 (5): 424-33. The Future Elderly Model-Mexico (FEM- et al. (2017). A comparison of the preva- Adherence 2017 (11): 1071-81. cognitive function among older U.S. tries’ adaptation to societal aging. Mexico). BMJ Open 7 (10): e017330. lence of dementia in the United States Ni, W., D. Colayco, J. Hashimoto, adults. Social Science and Medicine Proceedings of the National Academy Espeland, M. A., E. M. Crimmins, B. R. in 2000 and 2012. JAMA International K. Komoto, C. Gowda, B. Wearda and Shafrin, J., T. T. Schwartz, T. Okoro and J. 172 (Jan): 56-63. of Sciences 115 (37): 9169-74. Grossardt, et al. (2017). Clinical trials Hai, R. and J. J. Heckman. (2017). Medicine 177 (1): 51-58. J. McCombs. (2017). Impact of a phar- A. Romley. (2017). Patient versus physi- targeting aging and age-related multi- Inequality in human capital and endoge- macy-based transitional care program cian valuation of durable survival gains: Alexis K. C., W. Kobashigawa W. and Chu, L., N. Sood, M. Tu, K. Miller, L. Ray morbidity. Journals of Gerontology: nous credit constraints. Review of Le, Q. A., J. N. Doctor, L. A. Zoellner on hospital readmissions. American Implications for value framework assess- S. Enguidanos. (2017). “Unless you and J. N. Sayles. (2017). Reduction of Series A 72 (3): 355-61. Economic Dynamics 25 (Apr): 4-36. and N. C. Feeny. (2018). Effects of Journal of Managed Care 23 (3): 170-76. ments. Value in Health 20 (2): 217-23. bring it up, you won’t know the reactions emergency department use in people treatment, choice and preference on of the people”: Older Japanese Ameri- with disabilities. American Journal of Fröbert, O. M. Götberg, O. Angerås … and Harawa, N. T., S. M. Manson, C. M. Man- health-related quality-of-life outcomes Ning, N., A. Haynes, A. Gawande, Shin, E. and . (2017). J. A. Romley cans’ perceptions toward hospice care Managed Care 23 (12): e409-15. D. B. Agus. (2017). Design and rationale gione … and J. Zissimopoulos. (2017). in patients with post-traumatic stress and . (2017). Trends Effects of physician-hospital integration N. Sood J. Romley and advance care discussion and plan- for the Influenza vaccination After My- Strategies for enhancing research in disorder (PTSD). Quality of Life Research in quality, cost and productivity in surgi- on treatment productivity: Evidence ning. Journal of Palliative Medicine 20 ocardial Infarction (IAMI) trial. A registry- aging health disparities by mentoring 27 (6) 1555-62. cal care. Value in Health 20 (5): A47. from chemotherapy in lung cancer. (5): 445-47. based randomized clinical trial. American diverse investigators. Journal of Clinical Value in Health 20 (5): A127. Heart Journal 189 (Jul): 94-102. and Translational Science 1 (3): 167-75.
52 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu 53 Lee, H., D. Myers, G. Painter, J. Thunell Shrestha, A., A. Eldar-Lissai, N. Hou, Foster Better Pharmaceutical Cheng, W., J. P. Hlavka, E. Snowberg, Goldman, D. P., H. Fillit and P. Neumann. Lakdawalla, D., A. Malani and J. Reif. Skudlareka, J. W., C. N. DiMarcoa, K. and J. Zissimopoulos. (2018). The role D. N. Lakdawalla and K. Batt. (2017). Policy and Global Regulation K. Van Nuys and D. P. Goldman. (2018). Accelerating Alzheimer’s disease (2017). The insurance value of medical Babaoglub … and S. V. Fox. (2017). of parental financial assistance in the Real-world resource use and costs of (2018). Three-part pricing to reward drug innovations from the research innovation. Journal of Public Economics Investigation of orexin-2 selective recep- transition to homeownership by young haemophilia a-related bleeding. Baumgardner, J., A. Shahabi, M. pharmaceutical innovation and increase pipeline to patients. Alzheimer’s & 145 (Jan): 94-102. tor antagonists: Structural modifications adults. Journal of Housing Economics. Haemophilia 23 (4): e267-75. Linthicum, S. Vine, C. Zacker and access: Case of PCSK9 inhibitors. Dementia 14 (6): 833-36. resulting in dual orexin receptor antago- D. Lakdawalla. (2018). Greater spending Value in Health 21 (suppl. 1): S65. Lee, S., D. B. Martinez-Arguelles, E. nists. Bioorganic and Medicinal Chem- Levine, M. E., E. M. Crimmins, D. R. Singer, A., D. E. Leaf, M. Patel, K. Lorenz associated with improved survival for Goldman, D., and D. Lakdawalla. Campioli and V. Papadopoulos. (2017). istry Letters 27 (16): 1364-70. Weir and S. W. Cole. (2017). Contempo- and D. Meeker. (2017). Projecting the some cancers in OCM-defined episodes. Cheng, W. H., É. Gaudette and D. P. (2018). The global burden of medical Fetal exposure to low levels of the plasti- raneous social environment and the impact of implementing palliative care Journal of Managed Care and Specialty Goldman. (2017). PCSK9 inhibitors show innovation. USC Leonard D. Schaeffer cizer DEHP predisposes the adult male Snider, J. T., M. Brauer, K. Batt, P. Karaca- architecture of late-life gene expression for older adults: What does the evidence Pharmacy 24 (6): 504-13. value for patients and the U.S. health Center for Health Policy & Economics adrenal gland to endocrine disruption. Mandic, J. Zhang and D. P. Goldman. profiles. American Journal of Epidemiol- support? Journal of Pain and Symptom care system. Value in Health 20 (10): Working Paper. Endocrinology 158 (2): 304-18. (2018). The social value of tisagenlecleu- ogy 186 (5): 503-9. Management 53 (2): 378-79. Berndt, E. R., D. P. Goldman and J. 1270-78. cel, a CAR-T cell therapy, for the treat- Rowe. (2019). “Introduction.” Economic Goldman, D.P., K. Van Nuys, W. Cheng, Lee, V. W., Y. Wang, J. Wu, B. P. Yan, ment of relapsed or refractory pediatric Marler, S., B. J. Ferguson, E. B. Lee … Sood, N., D. Ung, A. Shankar and Dimensions of Personalized and Preci- Clair, P. S., É. Gaudette, H. Zhao, J. Hlavka, L. Pani, S. Chassang, and M. B. Nichol and B. Tomlinson. (2017). acute lymphoblastic leukemia in the and P. Levitt. (2017). Association of B. L. Strom. (2018). A novel strategy sion Medicine. Chicago, IL: University B. Tysinger, R. Seyedin and D. P. E. Snowberg. (2018). A New Model for The impact of low-density lipoprotein United States: What are consequences rigid-compulsive behavior with func- for increasing access to treatment for of Chicago Press. Goldman. (2017). Using self-reports or Pricing Drugs of Uncertain Efficacy. cholesterol goal attainments on cardio- of treatment delays? Journal of Clinical tional constipation in autism spectrum hepatitis c virus infection for Medicaid claims to assess disease prevalence: NEJM Catalyst. vascular outcomes: A retrospective Oncology 36 (15 suppl.): 10529. disorder. Journal of Autism and Devel- beneficiaries. Annals of Internal Biroli, P., D. Boca, J. J. Heckman et It’s complicated. Medical Care 55 (8): cohort study in Chinese acute coronary Gross, M. E., T. B. Dorff, D. I. Quinn, P. M. opmental Disorders 47 (6): 1673-81. Medicine 169 (2): 118-19. al. (2017). Evaluation of the Reggio ap- 782-88. syndrome patients. Value in Health Sood, N., T. Shih, K. Van Nuys and Diaz, O. O. Castellanos and . proach to early education. National D. B. Agus 20 (5): A262. D. P. Goldman. (2017). Follow the money: Myerson, R., T. Lu, I. Tonnu-Mihara Sood, N. and Z. Wagner. (2018). Bureau of Economic Research, w23390. Crimmins, E. M., S. N. Austad and C. (2017). Safety and efficacy of docetaxel, The flow of funds in the pharmaceutical and E. S. Huang. (2018). Medicaid eligi- Social health insurance for the poor: E. Finch. (2017). Accrediting gerontology bevacizumab and everolimus for castra- May, S. G., A. H. Chung, D. K. Vania … distribution system. Health Affairs, Jun. 13. bility expansions may address gaps Lessons from a health insurance Blumenthal, D. M., D. P. Goldman and programs in Canada? Let’s do it! tion-resistant prostate cancer (CRPC). and D. P. Goldman. (2017). Abstract P4- in access to diabetes medications. programme in Karnataka, India. A. B. Jena. (2017). Outcomes-based Innovation in Aging 1 (S1): 1079. Clinical Genitourinary Cancer S1558- 20-02: Value of cancer care for metasta- Turakhia, M. P., J. Shafrin, K. Bognar, Health Affairs 37 (8): 1200-7. BMJ Global Health 3 (1). pricing as a tool to ensure access to 7673 (17): 30200-8. tic breast cancer patients and providers. J. Trocio, Y. Abdulsattar, D. Wiederkehr , J. Vaidya, X. Jiang ... and novel but expensive biopharmaceuti- Doctor, J. N. Cancer Research 77 (4). and D. P. Goldman. (2018). Estimated Nuckols, T., C. Conlon, M. Robbins … Soto, M., S. I. Bang, J. McCombs and cals. Annals of Internal Medicine 166 D. Meeker. (2018). Efficient determina- Hu, X. and D. P. Goldman. (2017). prevalence of undiagnosed atrial fibrilla- and S. A. Seabury. (2017). Quality of K. E. Rodgers. (2017). Renin angiotensin (3): 219-20. tion of equivalence for encrypted data. First-line pembrolizumab in PD-L1 Phelps, C. E., D. N. Lakdawalla, A. tion in the United States. PloS One 13 care for work-associated carpal tunnel system-modifying therapies are associ- arXiv preprint arXiv:1803.03760. positive non-small cell lung cancer: Basu, M. F. Drummond, A. Towse, and (4): e0195088. syndrome. Journal of Occupational and ated with improved pulmonary health. Blumenthal, D. M., D. P. Goldman, A cost-effectiveness analysis from P. M. Danzon. (2018). Approaches to and J. P. MacEwan. (2017). Environmental Medicine 59 (1): 47-53. Clinical Diabetes and Endocrinology A. B. Jena. (2017). Tying reimbursement Doctor, J. N. a UK healthcare perspective. Value aggregation and decision making—a Van Nuys, K., G. Joyce, R. Ribero and Limitations of traditional health technol- 3 (1): 6. to outcomes is an ideal strategy for in Health 20 (9): A399. health economics approach: an ISPOR D. P. Goldman. (2018). Frequency and Payán, D. D., L. B. Lewis, M. R. Cousineau PCSK9 inhibitors. JAMA Cardiology 2 ogy assessment methods and implica- Special Task Force report [5]. Value magnitude of co-payments exceeding and M. B. Nichol. (2017). Advocacy Sullivan, J., A. S. Ward, B. Korytowsky, (10): 1063-64. tions for the evaluation of innovative Jena, A. B. and D. N. Lakdawalla. in Health 21(2): 146-54. prescription drug costs. JAMA 319 (10): coalitions involved in California’s menu D. Peneva, J. Benner, D. Lakdawalla, therapies. SSRN (May). (2017) Value frameworks for rare 1045-47. labeling policy debate: Exploring coali- et al. (2017). Demonstrating life ex- Bognar, K., J. A. Romley, J. P. Bae, J. diseases: Should they be different? Romley, J. and T. Shih. (2017). Product Doyle, O., C. Harmon, , tion structure, policy beliefs, resources, pectancy gains with immuno-oncology Murray, J. W. Chou and D. N. Lakdawalla. J. J. Heckman Health Affairs, Apr. 12. safety spillovers and market viability Van Nuys, K., G. Joyce, R. Ribero and C. Logue, S. H. Moon. (2017). Early skill and strategies. Social Science & Medicine (IO) therapies. Journal of Thoracic (2017). The role of imperfect surrogate for biologic drugs. International Journal D. P. Goldman. (2018). Overpaying for 177: 78-86. Oncology 12 (1): S426. endpoint information in drug approval formation and the efficiency of parental Jena, A. B., J. Zhang and D. N. of Health Economics and Management prescription drugs: The copay clawback and reimbursement decisions. Journal investment: A randomized controlled Lakdawalla. (2017). The trade-off 17 (2): 135-58. phenomenon. USC Leonard D. Schaeffer Perez, C. and J. A. Ailshire. (2017). Van Nuys, K. E., Z. Xie, B. Tysinger, of Health Economics 51 (Jan): 1-12. trial of home visiting. Labour Economics between speed and safety in drug ap- Center for Health Policy & Economics Aging in Puerto Rico: A comparison of M. A. Hlatky and D. P. Goldman. (2018). 45 (Apr): 40-58. provals. JAMA Oncology 3 (11): 1465-66. Sachs, R., N. Bagley and D. N. White Paper. health status among island Puerto Rican Innovation in heart failure treatment: Brown, L., U. Mitchell and J. A. Ailshire. Lakdawalla. (2017). Innovative contract- and mainland US older adults. Journal Life expectancy, disability and health (2017). Aging in minority and diverse Ell, K., M. P. Aranda, S. Wu, H. Oh, P. Lee Jiang, Y., J. S. McCombs and S. H. ing for pharmaceuticals and Medicaid’s Ward, A. S., M. Kabiri, A. Yucel ... and and J. Guterman. (2017). Promotora as- Park. (2017). A retrospective cohort of Aging and Health 29 (6): 1056-78. disparities. JACC: Heart Failure. populations: Race/ethnic disparities in best-price rule. Journal of Health Politics, D. P. Goldman. (2018). The long-term so- exposure to chronic stressors varies by sisted depression and self-care manage- study of acute kidney injury risk associ- Policy and Law 43 (1): 5-18. cial value of better targeting G-Csf ther- Portanova J., J. A. Ailshire, C. Perez, Woo, K., L. Gascue, D. P. Goldman, J. age among older adults. Innovation in ment among predominantly Latinos with ated with antipsychotics. CNS Drugs apy to cancer patients at risk of febrile A. Rahman and S. Enguidanos. (2017). A. Romley. (2017). Variations in out- Aging 1 (S1): 118. concurrent chronic illness: Safety net 31 (4): 319-26. Sachs, R. E., P. B. Ginsburg and D. P. neutropenia. Value in Health 21: S42-43. Ethnic differences in advance directive comes of hemodialysis vascular access care system clinical trial results. Con- Goldman. (2017). Encouraging new uses completion and care preferences: What by race/ethnicity in the elderly. Journal Chai-Adisaksopha, C., A. Lorio, R. Curtis, temporary Clinical Trials 61 (Oct): 1-9. Kani, K., C. Garri, K. Tiemann … and for old drugs. Journal of the American Yao, L. L., A. Ramirez, A. J. Roecker, . (2017). JUN-mediated has changed in a decade? Journal of of Vascular Surgery 65(3): 783-92. N. Frick, M. B. Nichol, et al. (2017). D. B. Agus Medical Association 318 (24): 2421-22. S. V. Fox … and A. L. Gotter. (2017). The the American Geriatrics Society 65 Treatment of acute bleeding in acquired Franco, A., D. Goldman, A. Leive and downregulation of EGFR signaling is dual orexin receptor antagonist, DORA- (6): 1352-57. Zissimopoulos, J. M., D. Barthold, haemophilia A with recombinant acti- D. McFadden. (2017). A cautionary tale associated with resistance to gefitinib in Senicourt, L., L. Duma, V. Papadopoulos 22, lowers histamine levels in the lateral R. D. Brinton and G. Joyce. (2017). vated factor VII: Analysis of 10-year in comparative effectiveness research: EGFR-mutant NSCLC cell lines. Molecu- and J. J. Lacapere. (2017). Solid-state hypothalamus and prefrontal cortex Ramirez, M. and S. Wu. (2017). Phone Sex and race differences in the associa- Japanese postmarketing surveillance Pitfalls and perils of observational data lar Cancer Therapeutics 16 (8): 1645-57. NMR of membrane protein reconstituted without lowering hippocampal acetyl- messaging to prompt physical activity tion between statin use and the inci- data. Hemophilia 23: 50-51. analysis. Measuring and Modeling in proteoliposomes: The case of TSPO. Lakdawalla, D. N., J. A. Doshi, L. P. choline. Journal of Neurochemistry 142 and social support among low-income dence of Alzheimer disease. JAMA Health Care Costs, ed. A. Aizcorbe, C. Membrane Protein Structure and (2): 204-14. Latino patients with type 2 diabetes: Neurology 74 (2): 225-32. Chen, A. J. and D. P. Goldman. (2018). Baker, E. Berndt and D. Cutler, 55-80. Garrison, C. E. Phelps, A. Basu and P. M. Function Characterization 1625: 329-44. Danzon. (2018). Defining elements of A randomized pilot study. JMIR Productivity benefits of medical care: Chicago: University of Chicago Press. Zissimopoulos, J. M., B. C. Tysinger, , B. Blaylock, value in health care—a health econom- Shafrin, J., D. Kantor, M. Brauer, J. Ko, Diabetes 2 (1): e8. Zissimopoulos, J. D. P. Evidence from US-based randomized P. A. St. Clair and E. C. Crimmins. Goldman and J. W. Rowe. (2017). Rais- clinical trials. Value in Health 21 (8): Garrison, L. P., P. J. Neumann, R. J. ics approach: An ISPOR Special Task V. Herrera and D. P. Goldman. (2017). (2018). The impact of changes in popu- Seabury, S. A., S. Terp and L. I. Boden. ing the Social Security entitlement age: 905-10. Willke, A. Basu, P. M. Danzon, J. A. Force report [3]. Value in Health 21 (2): Do multiple sclerosis cost-effectiveness lation health and mortality on future (2017). Racial and ethnic differences in Implications for the productive activities Doshi, M. F. Drummond, D. N. Lak- 131-39. studies follow best practice guidelines? Chen, A. J., X. Hu, A. B. Jena and prevalence of Alzheimer’s disease and the frequency of workplace injuries and of older adults. Research on Aging 39 dawalla … and M. C. Weinstein. (2018). A review of 5 case studies. Neurology other dementias in the United States. prevalence of work-related disability. (1): 166-89. D. P. Goldman. (2018). Trends in the A health economics approach to US Lakdawalla, D., J. P. MacEwan, R. 88 (16): P3.399. economic value of newly approved Dubois, K. Westrich, M. Berdud and A. Journals of Gerontology: Series B 73 Health Affairs 36 (2): 266-73. value assessment frameworks: Sum- (1): S38-47. Chen, C., and J. M. Zissimopoulos, cancer therapies in the US. Value in mary and recommendations of the Towse. (2017). What do pharmaceuticals Shafrin, J., D. N. Lakdawalla, J. P. Shafrin, J., J. Sullivan, D. P. Goldman (2018). Racial and ethnic differences in Health 21 (suppl. 1): S3. ISPOR Special Task Force report [7]. really cost in the long run? American MacEwan, A. R. Silverstein, A. Hatch and and T. M. Gill. (2017). The association trends in dementia prevalence and risk Value in Health 21 (2): 161-65. Journal of Managed Care 23 (8): F. Forma. (2017). MH2: Adherence pat- between observed mobility and quality factors in the United States. Alzheimer’s 488-93. terns among patients using oral atypical of life in the near elderly. PLoS ONE & Dementia: Translational Research & antipsychotics and other medications. 12(8): e0182920. Clinical Interventions. Value in Health 20 (9): A403.
54 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu 55 Faculty and Staff Faculty Paul Ginsburg, PhD Karen Van Nuys directs Director, USC-Brookings Schaeffer the Center’s Value of Life Emma Aguila, PhD Initiative for Health Policy; Director Sciences Innovation project, Assistant Professor, of Public Policy, USC Schaeffer Center; which focuses on drug pricing, USC Price School of Public Policy Professor, USC Price School of Public innovation, benefit design David Agus, MD Policy; Leonard D. Schaeffer Chair and value frameworks. She Founding Director, USC Ellison Institute in Health Policy Studies, Center for and Neeraj Sood wrote for Transformative Medicine; Director, Health Policy at Brookings an influential white paper USC Center for Applied Molecular on how money flows through Dana Goldman, PhD Medicine; Director, USC Norris West- the pharmaceutical Leonard D. Schaeffer Director’s side Cancer Center; Professor, Keck distribution system. Chair, USC Schaeffer Center; USC School of Medicine of USC and USC Distinguished Professor of Public Viterbi School of Engineering Policy, Pharmacy & Economics Jennifer A. Ailshire, PhD Joel W. Hay, PhD Assistant Professor, USC Davis Professor, USC School of Pharmacy School of Gerontology; Assistant Professor, Sociology, USC Dornsife James J. Heckman, PhD College of Letters, Arts and Sciences USC Presidential Scholar-in-Residence, USC Schaeffer Center; Henry Schultz Sarah Axeen, PhD Distinguished Service Professor of Assistant Professor of Research, Economics and Director, Center for Emergency Medicine, Keck School the Economics of Human Development, of Medicine of USC University of Chicago Alice Chen, PhD Michael Hochman, MD, MPH Assistant Professor, USC Price Associate Professor, Clinical Medicine, School of Public Policy Keck School of Medicine of USC; Robynn J. A. Cox, PhD Director, USC Gehr Family Center Assistant Professor, USC Suzanne for Health Systems Science Dworak-Peck School of Social Work Pat Levitt, PhD Rebecca Myerson, MPH, PhD Arthur Stone, PhD Shinyi Wu, PhD Mireille Jacobson, PhD W. M. Keck Provost Professor of Assistant Professor, USC School Director, USC Dornsife Center for Associate Professor, USC Susanne Eileen Crimmins, PhD Co-Director of Aging Program, Neurogenetics, Neuroscience, Psychia- of Pharmacy Self-Report Science; Professor of Dworak-Peck School of Social Work AARP Professor of Gerontology, USC Schaeffer Center; Associate try and Pharmacy; Vice President, Psychology, Economics and Public Associate Professor, Daniel J. Epstein Michael B. Nichol, PhD USC Davis School of Gerontology; Professor, USC Leonard Davis School Chief Scientific Officer and Director, Policy, USC Dornsife College of Department of Industrial and Systems Vice Dean, Faculty Affairs, Director, USC/UCLA Center on Biode- of Gerontology The Saban Research Institute, Children’s Letters, Arts and Sciences Engineering, USC Viterbi School and Professor, USC Price School mography and Population Health Hospital Los Angeles; Simms/Mann of Engineering Neeraj Sood presented the Schaeffer paper Geoffrey Joyce, PhD of Public Policy Sze-chuan Suen, PhD Chair in Developmental Neurogenetics, on the pharmaceutical distribution system Sir Angus Deaton, PhD Director of Health Policy, USC Schaeffer Assistant Professor, Industrial Bo Zhou, PhD Institute for the Developing Mind, William Padula, PhD at a Schaeffer Initiative conference, and Presidential Professor of Economics, Center; Chair and Associate Professor, and Systems Engineering, Research Assistant Professor, Children’s Hospital Los Angeles Assistant Professor, USC School also briefed the FTC on the study. USC Dornsife College of Letters, Arts Department of Pharmaceutical and USC Viterbi School of Engineering USC School of Pharmacy of Pharmacy and Sciences Health Economics, USC School of Eugene Lin, MD, MS Erin Trish, PhD Julie Zissimopoulos, PhD Pharmacy Assistant Professor, Division of Vassilios Papadopoulos, Jason Doctor, PhD Associate Director, USC Schaeffer Director of Training, Co-Director of Nephrology and Hypertension, PharmD, PhD, DSc (hon) RELIEDCUPON EXPERTS Director of Health Informatics, Cameron Kaplan, PhD Center; Assistant Professor, Aging Program, USC Schaeffer Center; Keck School of Medicine of USC Dean, John Stauffer Dean’s Chair in USC Schaeffer Center; Norman Assistant Professor, Gehr Family USC School of Pharmacy Vice Dean for Academic Affairs and Pharmaceutical Sciences, and Profes- Topping Chair in Medicine and Public Center for Health Systems Science, Jeff McCombs, PhD Associate Professor, USC Price School sor of Pharmacology and Pharmaceuti- Reginald Tucker-Seeley, 13.4K Policy, and Associate Professor, Keck School of Medicine of USC Associate Professor, of Public Policy cal Sciences, USC School of Pharmacy MA, ScM, ScD USC Price School of Public Policy; USC School of Pharmacy Frequently relied upon by the media, Edward D. Kleinbard, JD Edward L. Schneider Assistant Chair, Department of Health Policy John A. Romley, PhD Robert C. Packard Trustee Chair Daniel McFadden, PhD Professor of Gerontology, USC Directors Schaeffer experts were quoted and Management, USC Price Associate Professor, USC Price School in Law, USC Gould School of Law Presidential Professor of Health Leonard Davis School of Gerontology School of Public Policy of Public Policy; Associate Professor, Dana Goldman, PhD in the news more than 13,400 times Economics, USC Price School Jack H. Knott, PhD USC School of Pharmacy Barbara Turner, Leonard D. Schaeffer Director’s Chair Susan Enguídanos, PhD, MPH of Public Policy in the past decade. C. Erwin and Ione L. Piper Dean MD, MSEd, MA, MACP Associate Professor and Assistant Sandra Rozo, PhD Jason Doctor, PhD and Professor, USC Price School Daniella Meeker, PhD Professor, Gehr Family Center Dean of Diversity and Inclusion, Assistant Professor, Finance and Director of Health Informatics of Public Policy Assistant Professor, Preventive for Health Systems Science, USC Davis School of Gerontology Business Economics, USC Marshall Paul Ginsburg, PhD Darius Lakdawalla, PhD Medicine, Pediatrics, Keck School Keck School of Medicine of USC Steven Fox, MD, MSc School of Business Director of USC-Brookings 200 Director of Research, USC Schaeffer of Medicine of USC; Director, Bryan Tysinger, PhD(c) Research Assistant Professor, Clinical Research Informatics, Seth A. Seabury, PhD Schaeffer Initiative for Health Policy; Center; Professor, USC Price School Director of Health Policy Schaeffer experts have authored USC School of Pharmacy Southern California Clinical and Assistant Professor, USC School of Director of Public Policy of Public Policy; Quintiles Chair in Microsimulation, USC Schaeffer 200 opinion pieces, blog posts and Translational Science Institute Pharmacy; Director, Keck-Schaeffer Victor Fuchs Pharmaceutical Development and Center; Research Assistant Professor, Ann Harada, PhD, MPH Initiative for Population Health Policy perspectives in leading outlets Distinguished Fellow, USC Schaeffer Regulatory Innovation, USC School Glenn Melnick, PhD USC Price School of Public Policy Managing Director Center; Henry J. Kaiser Jr. Professor of Pharmacy Blue Cross of California Chair Neeraj Sood, PhD including the The New York Times, Karen Van Nuys, PhD Mireille Jacobson, PhD Emeritus, Stanford University in Health Care Finance and Professor, Strategic Advisor to the Director, Grant Lawless, RPh, MD Executive Director, Value of Life Co-Director of Aging Program The Washington Post and STAT. USC Price School of Public Policy USC Schaeffer Center; Vice Dean Director of Business and Industry, Sciences Innovation Project, for Research and Professor, Geoffrey Joyce, PhD USC Schaeffer Center; Associate Karen Mulligan, PhD USC Schaeffer Center; Research USC Price School of Public Policy Director of Health Policy Professor, USC School of Pharmacy; Research Assistant Professor, Assistant Professor, USC Price Program Director, Healthcare Decision USC Price School of Public Policy School of Public Policy Analysis, USC School of Pharmacy
56 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu 57 Darius Lakdawalla, PhD Catherine Ishitani Geoffrey Joyce, Erin Trish Director of Research Research Assistant and doctoral student Jianhui Xu discuss their Grant Lawless, RPh, MD Katrina Kaiser paper on the need for an Director of Business and Industry Research Programmer out-of-pocket cap for Seth Seabury, PhD Monica Kim Medicare Part D beneficiaries Director, Keck-Schaeffer Initiative Events and Development Specialist with colleague Grant for Population Health Policy Lawless. The paper was Richard Kipling, MA published in Health Affairs. Neeraj Sood, PhD Executive Director, Strategic Advisor to the Director Center for Health Reporting Erin Trish, PhD Tara Knight, PhD Associate Director Program Manager Bryan Tysinger, PhD(c) Caroline Kurdian Director of Health Policy Executive Administrative Assistant Microsimulation Stephanie Kwack Karen Van Nuys, PhD Senior Research Programmer Executive Director, Value of Duncan Ermini Leaf, PhD Life Sciences Innovation Project Research Scientist Kukla Vera Bich Ly Director of External Affairs Research Programmer Cristina Wilson Gretchen A. Meier Director of Finance and Digital Communications Specialist Research Administration Anthony Moreaux Julie Zissimopoulos, PhD Program Administrator, Healthcare Director of Training and Decision Analysis MS Program Co-Director of Aging Program Quintiles Senior Fellows Inas Kelly, PhD Jorge Luis García Michael Menchine, MD, MPH Ellen Nahm Associate Professor, Economics, Assistant Professor, John E. Walker Associate Professor, Clinical Emergency David Beier, JD Staff Program Administrator, Healthcare Loyola Marymount University Department of Economics, Clemson Medicine, Keck School of Medicine of USC; Managing Director, Bay City Capital Decision Analysis MS Program University; Visiting Research Fellow, Executive Vice Chair, Clinical Research, Loren Adler Bob Kocher, MD Ernst Berndt, PhD Social Science Research Institute, Keck School of Medicine of USC Geoffrey Joyce presented the findings Associate Director, USC-Brookings Hanh Nguyen, MA Partner, Venrock Professor in Applied Economics, Duke University; Senior Visiting from a Schaeffer Center study on Medicare Schaeffer Initiative for Health Policy Project Specialist Sonali Saluja, MD, MPH MIT Sloan School of Management Richard Kronick, PhD Fellow, Briq Institute on Behavior Part D at a Schaeffer Initiative conference Assistant Professor of Medicine, Gehr Tommy Chiou Rocio Ribero, PhD Professor, Department of Family and Inequality, University of Bonn on patient cost sharing. Jay Bhattacharya, MD, PhD Family Center for Health Systems Sci- Research Assistant Senior Research Associate Medicine and Public Health, Professor of Medicine, Stanford Inas Kelly, PhD ence, Keck School of Medicine of USC University of California, San Diego Seema Choksy, MPP Martha Ryan University Center for Primary Care Associate Professor of Economics, Sophie Terp, MD, MPH Project Specialist Project Specialist and Outcomes Research; Director, Charles F. Manski, PhD Loyola Marymount University A DECADE OF DRAMATIC GROWTH Assistant Professor, Clinical Emergency Stanford Center on the Demography Board of Trustees Professor in Marika Csapo, PhD Victoria Shier, PhD Gwyn Pauley, PhD Medicine, Keck School of Medicine and Economics of Health and Aging Economics, Northwestern University The Schaeffer Center has quickly Research Programmer Research Scientist Visiting Assistant Professor of Econom- of USC; Associate Director, Medical Deborah Freund, MA, MPH, PhD Samuel R. Nussbaum, MD ics, University of Wisconsin-Madison Student Research, Keck School of developed a critical mass of leading Renelle Davis Roger Smith University Professor, Economic Professor, Clinical Medicine, Washington Medicine of USC Administrative Assistant Editor, Center for Health Reporting experts in the field, from a team Sciences, School of Social Science, University School of Medicine; Quintiles Clinical Fellows Karen Woo, MD Patricia Ferido Patricia St. Clair, ScB Policy and Evaluation, Claremont Adjunct Professor, Washington of four in 2009 to over 110 faculty, Associate Professor, Surgery, Research Programmer Senior Data Advisor Graduate University University Olin School of Business Sanjay Arora, MD staff and affiliated fellows working Associate Professor, Clinical UCLA; Vascular Surgeon, Briana Taylor to advance healthcare in 2019. Laura Gascue, MA David Gollaher, PhD Steven M. Teutsch, MD, MPH Emergency Medicine, Keck School VA West Los Angeles Medical Center Claims Analytics Lead Program Administrator, Adviser and Member, Health Policy Adjunct Professor, UCLA Fielding of Medicine of USC; Chief, Research Leah Yieh, MD, MPH Today the team includes: Research Training Advisory Board, Gilead Sciences School of Public Health; Sara Geiger Division, Emergency Medicine, Assistant Professor of Clinical Pedi- Senior Fellow, Public Health Institute Executive Administrative Manager Michelle Ton Anupam B. Jena, MD, PhD Keck School of Medicine of USC atrics, Keck School of Medicine of USC; 49 faculty from 9 USC schools Program Administrator, Healthcare Ruth L. Newhouse Associate Attending Neonatologist, Children’s Daniel George Cynthia L. Gong, PharmD, PhD Decision Analysis MS Program Quintiles Fellows Hospital Los Angeles IT Manager Professor of Health Care Policy, Research Assistant Professor 3 Nobel laureates Irene Vidyanti, PhD Harvard Medical School; Douglas Barthold, PhD of Medicine, Keck School of Medicine Patrick Gless Collaborating Programmer; Physician, Department of Medicine, Research Assistant Professor, of USC and Children’s Hospital 26 affiliated fellows and scholars Associate Director, Healthcare Data Scientist/Modeler, Los Angeles Massachusetts General Hospital University of Washington Los Angeles Decision Analysis MS Program County Department of Public Health Robert Kaestner, PhD Cynthia Chen, PhD Ashwini Lakshmanan, MD, MPH 39 staff Stephanie Hedt, MPP Jillian Wallis, PhD Professor, School of Public Policy/ Assistant Professor, Health Assistant Clinical Professor, Senior Manager of Communications Research Data Administrator Department of Economics, Economics, Saw Swee Hock School Pediatrics, Keck School of Medicine University of California, Riverside of Public Health, National University of USC; Attending Neonatologist, Hanke Heun-Johnson, PhD Gerry Young, MA of Singapore Children’s Hospital Los Angeles Research Associate Research Programmer Emmett Keeler, PhD Quality Assurance Director, Matthew Fiedler, PhD Eugene Lin, MD, MS Khristina Ipapo, MPH Dina Zein USC Schaeffer Center; Professor, Fellow, USC-Brookings Schaeffer Assistant Professor, Division Research Programmer Project Specialist Pardee RAND Graduate School Initiative for Health Policy of Nephrology and Hypertension, Henu Zhao, PhD Keck School of Medicine of USC Senior Quantitative Analyst
58 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu 59 Advisory Board Leonard D. Schaeffer Pamela D. Kehaly About the Schools Chair, Schaeffer Center President and CEO Advisory Board; Blue Cross Blue Shield of Arizona Founding Chair and CEO Bob Kocher, MD WellPoint Partner Drew E. Altman, PhD Venrock President and CEO Leigh Anne Leas Henry J. Kaiser Family Foundation Vice President and U.S. Country Gregg H. Alton, JD Head, Public Policy Chief Patient Officer Novartis Pharmaceuticals Company Gilead Sciences Inc. Robert Margolis, MD William N. Anderson, MSc CEO Emeritus Chief Executive Officer HealthCare Partners LLC Roche Pharmaceuticals Michael A. Mussallem Robert A. Bradway, MBA Chair and CEO Chair and CEO Edwards Lifesciences Corporation Amgen Murali N. Naidu, MD Carmela Coyle Principal President and CEO Oak Executive Advisors California Hospital Association Norman C. Payson, MD Lloyd H. Dean President President and CEO NCP Inc. Dignity Health Thomas H. Pike John D. Diekman, PhD Former Vice Chair and President Founding Partner Research & Development Solutions 5AM Ventures QuintilesIMS The Schaeffer Center is grateful Andrew Dreyfus Thomas M. Priselac, MPH for the advice and support of President and CEO President and CEO Blue Cross Blue Shield Cedars-Sinai Health System its distinguished Advisory Board, of Massachusetts Robert D. Reischauer, PhD USC School of Pharmacy USC Price School of Public Policy whose members provide invaluable Joel Freedman Distinguished Fellow/ insights that enhance the Center’s Chief Executive Officer President Emeritus One of the top 10 pharmacy schools nationwide and the highest- Since 1929, the USC Sol Price School of Public Policy has defined important work. American Academic Health System The Urban Institute ranked private school, the USC School of Pharmacy continues its excellence and innovation in public affairs education. Ranked second Mark B. Ganz, JD Mike L. Ryan, PharmD century-old reputation for innovative programming, practice and nationwide among 282 schools of public affairs, the Price School’s President and CEO Senior Vice President, Worldwide collaboration. mission is to improve the quality of life for people and their com- Cambia Health Solutions Value, Access, Policy and Health The school created the nation’s first Doctor of Pharmacy pro- munities, here and abroad. For nine decades, the Price School has Economics and Outcomes Research Dennis Gillings, CBE, PhD gram, the first clinical pharmacy program, the first clinical clerk- forged solutions and advanced knowledge, meeting each generation Bristol-Myers Squibb Co-Founder and ships, the first doctorates in pharmaceutical economics and of challenges with purpose, principle and a pioneering spirit. Former Executive Chair Judith A. Salerno, MD regulatory science, and the first PharmD/MBA dual-degree pro- The school’s three pillars — social and healthcare policy, gover- Quintiles Transnational President gram, among other innovations in education, research and prac- nance and urban development — cut across 16 interdisciplinary re- New York Academy of Medicine Alexander Gourlay tice. The USC School of Pharmacy is the only private pharmacy search centers and six primary fields of study: health policy and Co-Chief Operating Officer Jennifer Taubert, MBA school on a major health sciences campus, which facilitates part- management, public policy, public management, nonprofit leader- Walgreens Boots Alliance Inc. Executive Vice President and Worldwide Chairman, Pharmaceuticals nerships with other health professionals as well as new break- ship, urban planning and real estate development. With intercon- Gavin S. Herbert Johnson & Johnson throughs in care. It also is the only school of pharmacy that owns nected yet distinct disciplines housed under one roof, the Price Chair Emeritus Allergan Inc. Faye Wattleton and operates five pharmacies. School brings multiple lenses to bear on critical issues. Partner The school is home to the International Center for Regulatory Sci- Solving societal issues of such complexity requires not only John Hernandez, PhD Co-Head, Governance Practice Research Scientist ence at USC and a partner in the USC Center for Drug Discovery and great minds but also great action. USC Price fosters collaboration Buffkin/Baker Google Health Development. The school pioneered a national model of clinical and partnerships to better understand problems through varied Timothy Wright, MD pharmacy care through work in safety-net clinics throughout South- perspectives. The school uses the influence of California and Rod Hochman, MD Chief R&D Officer President and CEO ern California. A focus on clinical pharmacy, community outreach, greater Los Angeles as a resource for setting new paradigms. Regulus Therapeutics Providence St. Joseph Hospital regulatory science, drug discovery and development, and health These challenges also call on a new generation of creative thinkers Thomas Insel, MD economics and policy positions the USC School of Pharmacy as a to explore beyond the status quo. The school’s graduates go on Co-Founder and President leader in the safe, efficient and optimal use of medication therapy to shape our world as leaders in government, nonprofit agencies Mindstrong Health that can save lives and improve the human condition. and the private sector. In October 2016, noted scientist Vassilios Papadopoulos became Jack H. Knott has served as dean of the Price School since 2005. the school’s new dean after leading major research initiatives at He previously was director of the Institute of Government and Public McGill University Health Centre and Georgetown University. Affairs at the University of Illinois at Urbana-Champaign and Chicago.
60 USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu USC Schaeffer Center Tenth Anniversary Report healthpolicy.usc.edu 61 About the Schaeffer Center
OUR VISION The vision of the Leonard D. Schaeffer Center for Health Policy & Economics is to be a premier research and education institution recognized for innovative, independent Dana Goldman, research that makes USC Price School Dean Jack Knott, USC School significant contributions of Pharmacy Dean to policy and health Vassilios Papadopoulos and Leonard D. improvements. Schaeffer The Leonard D. Schaeffer Center for Health Policy & Economics was established in 2009 at the University of Southern California through a generous gift from Leonard and Pamela Schaeffer. The Center reflects Mr. Schaeffer’s lifelong commitment to solving healthcare issues and transforming the healthcare system.
Today’s ever-changing health policy landscape requires creative so- exceptional policy analysis and leading-edge training, with more lutions, robust research methods and expertise in a variety of fields. than 30 distinguished scholars investigating a wide array of topics. Schaeffer Center faculty members excel not only at analyzing the This work is augmented by a visiting scholars program and part- current climate but also in predicting where health trends will lead. nerships with other universities that allow outside researchers to A collaboration between the USC Price School of Public Policy and benefit from the Center’s unparalleled infrastructure and data col- the USC School of Pharmacy, the Schaeffer Center brings together lections. The Schaeffer Center actively engages in developing ex- health policy experts, a seasoned pharmacoeconomics team, other cellent research skills in new investigators who can become faculty from across USC — including the Keck School of Medicine, innovators of the future. At the same time, the Center supports the the Dworak-Peck School of Social Work and the Viterbi School of next generation of healthcare leaders in creating strong manage- Engineering — and a number of affiliated researchers from other ment, team-building and communication skills. leading universities to solve the pressing challenges in healthcare. The Schaeffer Center’s vision is to be the premier research and In 2016, the Schaeffer Center partnered with the Center for educational institution recognized for innovative, independent Editors Stephanie Hedt Health Policy at the Brookings Institution to establish the Leonard research that makes significant contributions to policy and health Kukla Vera D. Schaeffer Initiative for Innovation in Health Policy. This unique improvement. Its mission is to measurably increase value in health Susan L. Wampler partnership enhances the capacity of both organizations to develop through data-driven policy solutions, research excellence, trans- evidence-based solutions to inform policymaking on some of the formative education, and private and public-sector engagement. Design Rick Simner Design most pressing healthcare challenges facing the U.S. today — from With an extraordinary breadth and depth of expertise, the Scha- the future of Medicare to reshaping the Affordable Care Act. effer Center has a vital impact on the positive transformation of Photography The Schaeffer Center offers the human and technical capacity healthcare. David Ahntholz Tracy Boulian necessary to conduct breakthrough interdisciplinary research, Printing ColorGraphics
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