DECEMBER 2021
Director's Note
The renowned health economist Uwe Reinhardt once wrote: “There are three other explanations that are widely — but erroneously — thought among non-experts to be cost drivers in the American health spending. To wit: (1) that the aging of our population drives health spending, (2) that we get better quality from our health system than do other nations, and (3) that we get better health outcomes from our system.” Uwe was one of many economists who recognized that the linkage between spending on healthcare and population health is tenuous at best. My own training is in economics – with a focus on public finance and labor economics – which draws my attention to the fact that the U.S.’s wasteful health spending “crowds out” spending on other important public goods like education, infrastructure, and the environment.
 
Thus, I’m particularly excited about this month’s IHPS News focus on healthcare value and economics. We highlight multiple faculty whose research, leadership, and teaching aim to improve health outcomes while also reducing costs. In fact, much of their work has illustrated that “doing less” can result in better health outcomes. They also have drawn the spotlight to the importance of value-focused innovation and dissemination of tools to help clinicians make wiser decisions.
 
As we move into 2022, I look forward to new opportunities to thoughtfully debate the different approaches we can take to improve health and healthcare for everyone. Our application of evidence to inform healthcare policy and practice has had a lasting impact, and our community is devoted to advancing evidence-informed healthcare in the future. 

Joanne Spetz
PRL-IHPS Focus On:
Health Care Value and
Health Economics
Many PRL-IHPS faculty are working on policy related to healthcare value and health economics. Catherine Chen, MD, Grace Lin, MD, Kathryn Phillips, PhD,
Sanket Dhruva, MD, George Sawaya, MD, Jahan Fahimi, MD, MPH, Ralph Gonzales, MD, MSPH, Catherine Lau, MD, and Joanne Spetz, PhD are some of our faculty working in this area. Learn more about their current work.

Upcoming Events
PRL-IHPS Health Policy Grand Rounds
Challenges to controlling health care spending in Massachusetts

Jan 19, 12 - 1 pm PT

David Auerbach, PhD

David Auerbach, PhD is a health economist and currently Senior Director for Research and Cost Trends at the Massachusetts Health Policy Commission. His team analyzes data from the state’s all-payer claims database, hospital discharge data, survey data, and other sources to understand and report on salient and policy-relevant trends and cost drivers in Massachusetts and to make recommendations to reduce the cost of health care in the state. Prior to working at the HPC, he was a senior policy researcher at the RAND Corporation in Boston and prior to that, he was a principal analyst at the Congressional Budget Office in Washington DC where he co-developed the model used to analyze the Affordable Care Act. He is also a national expert on the nursing workforce and an honorary fellow of the American Academy of Nursing. He has a PhD in Health Policy from Harvard University.

2022 Emerging Scholars
Congratulations to the UCSF 2022 Emerging Scholars, Tasce Bongiovanni, MD and Elaine Khoong, MD, MAS. The Emerging Scholars Exchange Program is designed to provide career development opportunities for UCSF early career faculty via invited presentations at our partner peer Institutes, the University of Pennsylvania Leonard Davis Institute and the University of Michigan Institute for Healthcare Policy & Innovation. In exchange, scholars from these universities are selected to present at UCSF. Presentations will occur in Spring, 2022.
Presenting, University of Michigan
Presenting, University of Pennsylvania
Research Highlights

As the population in the United States ages, there is also an expected increase in the incidence of dementia. Developing successful, low-cost, and practical strategies for promoting brain health is important, particularly those that can be employed within populations that are disproportionately impacted by dementia. In a recent study that Alissa Bernstein Sideman, PhD, MPH, MS, Daniel Dohan, PhD and colleagues published in The American Journal of Geriatric Psychiatry, they sought to understand the perspectives of first generation Latin American immigrants on brain health and aging.  


 

In a recent Annals of Family Medicine article, Taressa Fraze, PhD, Laura Gottlieb, MD and colleagues give an overview of approaches and detail potential pitfalls for health care organizations implementing social care. Social factors, such as food, housing, and economic insecurity affect health outcomes. As a result, social care which refers to efforts to intervene in patients’ social conditions within medical settings, has emerged and currently clinicians, policy makers, payers and commercial entities are all exploring ways health care can better intervene in social risks of patients. Primary care practices may be especially motivated to address patients’ social needs because of mounting pressure to assume responsibility for quality, utilization, and cost outcomes.

Fraze also shared findings using the same set of interviews in a recent paper that teases out the nuance surrounding motivations and tensions among health care leaders to deliver social care, “It’s Not Just the Right Thing . . . It’s a Survival Tactic”: Disentangling Leaders’ Motivations and Worries on Social Care", published in Medical Care and Review.



PRL-IHPS faculty Courtney Lyles, PhD and Urmimala Sarkar, MD, with their colleague Robert Wachter, MD, share their thoughts on digital health equity in a recent JAMA Perspective. Patients who experience systemic, structural, institutional, and social barriers within society want and need better and more convenient health and health care access. The opportunity to design systems that address these critical needs should be foremost while building out the digital tools and platforms that will transform health care over the next generation.

PRL-IHPS faculty are responding to policy challenges raised by the
COVID-19 pandemic with rapid-cycle research and technical assistance. A compilation of their work to date is available on a regularly updated webpage. 



IHPS Faculty Spotlight
Taressa Fraze is an Assistant Professor in the Department of Family and Community Medicine at UCSF and affiliated faculty in the Philip R. Lee Institute for Health Policy Studies. Dr. Fraze studies the configuration of health care delivery systems and the adoption of care delivery innovations across care settings. Her research has focused on how health care organizations implement care transformation activities, such as home visits, advanced care planning, team-based care, and social care, to improve outcomes for patients with clinical and social complexities. Much of Dr. Fraze’s research has studied the effectiveness of payment and delivery system reforms including accountable care organizations, medical homes, and accountable health communities. In addition, Dr. Fraze’s work considers the configuration and delivery of primary care across rural settings. Dr. Fraze’s work aims to improve the quality and accessibility of care.
Ceremony for Dr. Philip R. Lee
at Arlington Cemetery
On October 27, 2021, the ashes of Dr. Philip R. Lee, founding director of our Institute, were laid to rest in Arlington Cemetery following a solemn and majestic ceremony. It was “a moving, meaningful, and memorable tribute to Dr. Lee by the country he served so well in so many ways”, (Dr. Roz Lasker, Phil’s widow).


(video, gun salute)
Urn and flag being
brought to cemetery
Flag folding ceremony
Urn with inscription
Media Mentions