and practical policy prescriptions to change the trajectory of the cost of healthcare in America.
The country is in the midst of a critical political and policy debate that could reshape healthcare in America for generations to come. Some people are focused on who will pay for healthcare and whether or not we can afford it. However, fewer are focused on why healthcare costs so much in the first place and what we can do about it.
West Health is convening an innovation summit in the nation’s capital focused on solving America’s healthcare cost crisis. The Summit features leaders from many sectors of healthcare including policymakers, healthcare providers, health systems, researchers, economists, insurers, government, industry and advocacy groups and patients. The goal is to fuel the best ideas, innovations and practical policy solutions to change the trajectory of the cost of healthcare in America.
The Healthcare Costs Summit is the fifth installment of West Health’s Health Care Innovation Day (HCI-DC) series. Previous HCI-DC events have highlighted wireless and telehealth innovations with the Department of Veterans Affairs (2010), wireless medical device regulation with the U. S. Food and Drug Administration and Federal Communications Commission (2011), care delivery and payment solutions with the Centers for Medicare and Medicaid Services (2012), and interoperability with the Office of the National Coordinator for Health Information Technology (2014).
Atul Gawande’s bold visions for improving performance and safety in healthcare have made him one of the most sought-after speakers in medicine. His three books, Complications, Better, and The Checklist Manifesto, have all been highly praised inside and outside the medical community. His new book is Being Mortal: Medicine and What Matters in the End. TIME placed him among the world’s 100 most influential thinkers.
Atul Gawande is a MacArthur “Genius” Fellowship winner, a New Yorker columnist, an author — but, most of all, a physician, with a practitioner’s grasp of the everyday challenges of healthcare delivery.
Atul explains that medical practice and philosophy has not kept pace with the changes in healthcare over the last hundred years. We need reform — and Atul is on a lifelong search to discover what shape that reform should take. What does an effective healthcare system look like in the 21st century? How can we improve quality, manage risk, and measure performance more effectively? Atul brings an eloquence and an intellect to these questions that allow him to offer deeply considered and beautifully expressed solutions with implications for healthcare and beyond.
Dr. Gawande is broadly known for his influential articles, two of which won him the National Magazine Award. He has written about the shift from lone-ranger physicians to teams of co operating specialists, and the new values this shift requires. He popularized the checklist as a means of co-ordinating complex work in hospitals. His ideas about how to rein in healthcare costs while increasing efficiency and quality have transformed the national discussion of these issues. His writing sets itself apart by its depth of thought and research, but also by its willingness to look outside of healthcare and see how other fields have delivered high-quality service in complex industries.
Atul is a general and endocrine surgeon at Brigham and Women’s Hospital in Boston, and a professor in both the Department of Health Policy and Management at Harvard School of Public Health and the Department of Surgery at Harvard Medical School. He is the Executive Director of Ariadne Labs, a joint center for health systems innovation, and chairman of Lifebox, a nonprofit making surgery safer globally. He has won AcademyHealth’s Impact Award for highest research impact on health care, and the Lewis Thomas Award for Writing about Science.
Andy Slavitt has decades of private and public sector leadership in health care. Over his career, Andy has shaped some of the most significant and successful initiatives in health care impacting millions of Americans and the shape of the health care system. For the last two years, he served as the Acting Administrator for the Centers for Medicare & Medicaid Services (CMS) under President Obama. In that role, Slavitt oversaw programs that provide access to quality health care for 140 million Americans, including Medicaid, Medicare, the Children’s Health Insurance Program, and the Health Insurance Marketplace.
Andy came into the public spotlight in October of 2013 when he was asked by the Obama Administration to lead the turnaround of Healthcare.gov from the private sector. Slavitt’s tenure at CMS was marked by the successful execution of a number of large new programs– the Affordable Care Act, the significant shift to pay-for-value payment models, and the implementation of MACRA. Under his leadership, the U.S. health care system saw record reductions in the uninsured rate, nationwide improvements in quality, record low cost growth, and a re-birth of private sector innovation and progress. Andy’s tenure was also marked by a cultural shift towards a more engaged, transparent, and collaborative period of cooperation between the public and private sectors.
Andy’s ability to spearhead complex management challenges stems from over two decades of experience working as a leader in the health care and technology private sector. Throughout his career, Andy’s work centered on improving the consumer experience and access to care, new care delivery models, health equity, data and technology, and program integrity. From 2003 to 2013, Andy worked at UnitedHealth Group, eventually serving as the Group Executive Vice President for Optum where he oversaw the delivery of clinical, technology and operational solutions to health care clients and consumers. Over his career at Optum, the company grew by tens of billions in revenue. Andy served in a number of different capacities which drove its growth, including as CEO of OptumInsight and overseeing mergers and acquisitions, corporate strategy, marketing, international business and business integration.
Andy has an entrepreneurial background, having founded and served as CEO of HealthAllies, a technology-based consumer health care company. HealthAllies served people who are uninsured or underinsured by via an online marketplace for health care services. He was also a consultant with McKinsey & Company, and an investment banker with Goldman Sachs.
Slavitt has helped lead a number of national priorities from Vice President Biden’s Cancer Moonshot Task Force to President Obama’s National Heroin Task Force. He has served in a number of leadership and board capacities in public, private and non-profit organizations in health care, education and the arts. Slavitt has been recognized as one of the 10 most influential people in health care by Modern Healthcare magazine, and has received similar recognition from other health care and technology publications and organizations. He appears frequently in the media and is viewed as a nonpartisan explainer of complex health care topics– including on his Twitter feed.
Andy lives in Minnesota with his family. He is a graduate of the Wharton School and The College of Arts & Sciences at the University of Pennsylvania, and received an MBA from Harvard Business School.
Mark McClellan, MD, PhD, is the Robert J. Margolis Professor of Business, Medicine, and Health Policy, and Director of the Duke-Margolis Center for Health Policy at Duke University with offices at Duke and in Washington DC. The new Center will support and conduct research, evaluation, implementation, and educational activities to improve health policy and health, through collaboration across Duke University and Health System, and through partnerships between the public and private sectors. It integrates the social, clinical, and analytical sciences to integrate technical expertise and practical capabilities to develop and apply policy solutions that improve health and the value of health care locally, nationally, and worldwide.
Dr. McClellan is a doctor and an economist, and his work has addressed a wide range of strategies and policy reforms to improve health care, including such areas as payment reform to promote better outcomes and lower costs, methods for development and use of real-world evidence, and more effective drug and device innovation. Before coming to Duke, he served as a Senior Fellow in Economic Studies at the Brookings Institution, where he was Director of the Health Care Innovation and Value Initiatives and led the Richard Merkin Initiative on Payment Reform and Clinical Leadership. He also has a highly distinguished record in public service and in academic research. Dr. McClellan is a former administrator of the Centers for Medicare & Medicaid Services (CMS) and former commissioner of the U.S. Food and Drug Administration (FDA), where he developed and implemented major reforms in health policy. These include the Medicare prescription drug benefit, Medicare and Medicaid payment reforms, the FDA’s Critical Path Initiative, and public-private initiatives to develop better information on the quality and cost of care.
Dr. McClellan is the founding chair and a current board member of the Reagan-Udall Foundation for the FDA, is a member of the National Academy of Medicine and chairs the Academy’s Leadership Council for Value and Science-Driven Health care, co-chairs he guiding committee of the Health Care Payment Learning and Action Network, and is a research associate at the National Bureau of Economic Research. He has also previously served as a member of the President’s Council of Economic Advisers and senior director for health care policy at the White House, and as Deputy Assistant Secretary for Economic Policy at the Department of the Treasury. He was previously an associate professor of economics and medicine with tenure at Stanford University, and has twice received the Kenneth Arrow Award for Outstanding Research in Health Economics.
Dr. Fisher is Director of the Dartmouth Institute for Health Policy and Clinical Practice and the John E Wennberg Distinguished Professor of Health Policy, Medicine and Community and Family Medicine at the Geisel School of Medicine at Dartmouth.
Dr. Fisher is recognized for several major contributions to research and policy. He led seminal research on the promise and perils of using large administrative databases for health care research, work that helped to validate the quality of the data and demonstrated how such data could be used to answer important epidemiologic and policy questions. He then built on this work to explore the causes and consequences of the dramatic differences in spending observed across U.S. regions and academic medical centers, demonstrating that the 60% higher intensity of care in high cost U.S. regions and health systems did not result in better health outcomes and was largely due to differences in the use of discretionary and potentially avoidable care. This work was the first to reveal the magnitude of waste in U.S. healthcare and helped to provide the rationale for the transition to value-based payment that is now underway. Third, he led the team that did the empirical research that provided the rationale for Accountable Care Organizations and worked with colleagues to adapt the concept in ways that helped lead to its inclusion in the Affordable Care Act and adoption by many private payers. His current research focuses on evaluating how innovations in payment and care delivery are being implemented within the U.S. health care system and the impact of these changes on health system performance. He now leads one of three federally funded U.S. Centers of Excellence in Health Systems Research that is applying an implementation science framework to exploring the impact of new payment and delivery models and how the effectiveness of different models varies according to different organizational, market and policy contexts.
He has published over 150 research articles and commentaries. He received his undergraduate and medical degrees from Harvard University and completed his internal medicine residency and public health training at the University of Washington. He serves on the boards of the Institute for Healthcare Improvement and the Fannie E. Rippel Foundation and is a member of the National Academy of Medicine (formerly known as the Institute of Medicine of the National Academy of Sciences).
Martin Gaynor is the E.J. Barone University Professor of Economics and Public Policy at Carnegie Mellon University and former Director of the Bureau of Economics at the U.S. Federal Trade Commission. He is one of the founders of the Health Care Cost Institute, an independent non-partisan nonprofit dedicated to advancing knowledge about US health care spending, and served as the first Chair of its governing board. He is also an elected member of the National Academy of Medicine and of the National Academy of Social Insurance, a Research Associate at the National Bureau of Economic Research, an International Research Fellow at the University of Bristol, and a board member of the Jewish Healthcare Foundation. Prior to coming to Carnegie Mellon Dr. Gaynor held faculty appointments at Johns Hopkins and a number of other universities. He has been an invited visitor at the Hungarian Academy of Sciences in Budapest, the Hebrew University of Jerusalem, Northwestern University, and the Toulouse School of Economics.
His research focuses on competition and antitrust policy in health care markets. He has written extensively on this topic, testified before Congress, and advised the governments of the Netherlands, the United Kingdom, and South Africa on competition issues in health care. Gaynor is on the Pennsylvania Governor’s Health Advisory Board and co-chaired the state’s workgroup on shoppable care. He has won a number of awards for his research, including the American Economic Journal: Economic Policy Best Paper Award, the Victor R. Fuchs Research Award, the National Institute for Health Care Management Foundation Health Care Research Award, the Kenneth J. Arrow Award, the Jerry S. Cohen Award for Antitrust Scholarship (finalist), and a Robert Wood Johnson Foundation Investigator Award in Health Policy Research. Dr. Gaynor received his B.A. from the University of California, San Diego in 1977 and his Ph.D. from Northwestern University in 1983.
Hoangmai (Mai) Pham, MD, MPH
Vice President, Provider Alignment Solutions
Mai is responsible for developing and refining Anthem’s provider payment models that reduce the cost of care while rewarding improvements in quality and access. Additionally, she is focused on developing new products and networks built on a foundation of value-based care, and overseeing Anthem’s Enhanced Personal Health Care initiative, a program that focuses on patient-centered care and reimburses doctors for value-based, rather than volume-based, performance.
Prior to joining Anthem in 2017, Mai was a founding official at the Center for Medicare & Medicaid Innovation (CMMI), where she served as Chief Innovation Officer and was responsible for implementation of the alternative payment model provisions of the Medicare Access and CHIP Reauthorization Act (MACRA) and other multi-organizational initiatives for the Center. Mai’s earlier work at CMMI included responsibility as the Director of the Seamless Care Models Groups, overseeing the design and testing of models on accountable care organizations and advanced primary care, including the Pioneer and Next Generation ACO Models and Comprehensive Primary Care Initiative. Previously, she was senior health researcher and co-director of research at the Center for Studying Health System Change and Mathematica, an independent health policy organization.
A general internist, Mai has published extensively on payment policy issues including care fragmentation and coordination, and also practiced for several years at safety net clinics in the Washington D.C. area. Mai received her undergraduate degree from Harvard University, her MD from Temple University, and her MPH degree from Johns Hopkins, where she was also a Robert Wood Johnson Clinical Scholar.
Shelley Lyford is Chief Executive and President of West Health. West Health is a nonprofit, nonpartisan family of organizations, solely founded by pioneering philanthropists, Gary and Mary West, whose mission is to enable seniors to successfully age in place with access to high-quality, affordable health and supportive services that preserve and protect their dignity, quality of life and independence. The organizations use a combination of applied medical research, policy, advocacy and outcomes-based philanthropy to improve healthcare for seniors and lower costs.
Lyford played a critical role in helping establish the Gary and Mary West Foundation in 2006. Under Lyford’s leadership, the Gary and Mary West Foundation has awarded more than 400 grants totaling more than $181 million for applied medical research and community support and social services for seniors and their caregivers. Lyford also leads the Gary and Mary West Health Institute as it conducts applied medical research on a wide range of issues affecting seniors and their families. The research generated is used to provide the evidence needed for healthcare providers, policymakers and communities to make more informed decisions about healthcare delivery models and support services that enable successful aging in America.
Lyford has spearheaded the development of innovative healthcare delivery systems that serve as national care models of excellence, including San Diego’s first Geriatric Emergency Unit; and the new, first of its kind Gary and Mary West Senior Dental Center in downtown San Diego, which provides high-quality, affordable dental care integrated with health and wellness services for lower-income seniors. These and other care models are supported by various research initiatives with collaborators that include the American Geriatrics Society, University of California San Diego Health System, Mount Sinai in New York, Brown University and Northwestern University.
In addition to leading West Health, Lyford is vice-chair of the board of directors for Grantmakers in Aging (GIA) and sits on the San Diego Regional Economic Development Corporation’s Board of Directors focused on promoting San Diego as an epicenter for successful aging research. Lyford holds a master’s degree in international relations and political-economy from the University of San Diego.
Mark Smith is currently a Professor of Clinical Medicine at the University of California at San Francisco
and Visiting Professor at the School of Public Health at the University of California at Berkeley. He co-
chairs the Guiding Committee of the Health Care Payment Learning and Action Network.
From 1996 through 2013 was the Founding President of the California HealthCare Foundation, which he
led from its formation. An independent endowed philanthropy in Oakland, California, the Foundation
began operations with $500 million in assets, made $650 million in charitable grants under his
leadership, and has a current corpus of approximately $720 million. In those 17 years, Smith helped
build the Foundation into a recognized leader in delivery system innovation, public reporting of care
quality, and applications of new technology in health care. Smith spearheaded the launch of California
HealthLine and iHealthBeat, daily electronic publications with a combined circulation of 60,000; the
CHCF Center for Healthcare Reporting at USC, an award-winning initiative which partners with local
publications and broadcast outlets throughout the state in producing original reporting; the CHCF
Innovation Fund, which invests in companies advancing the Foundation’s mission; and the CHCF
Leadership Fellows Program, whose 300 alumni/ae are senior leaders in virtually every clinical
enterprise in the state.
He was a 2014 Menschel Senior Policy Fellow at the Harvard School of Public Health.
Smith is a nationally-recognized health policy expert. He has published over 50 articles in peer-reviewed
journals and 25 book chapters and monographs. He has consulted for the governments of Kuwait,
Denmark, and Singapore, and is a frequent keynote speaker, including for Microsoft, Health 2.0, Kaiser
Permanente, and the Library of Congress.
Before CHCF, Dr. Smith was Executive Vice-President of the Henry J. Kaiser Family Foundation, where he
oversaw programs in HIV, Reproductive Health, and the Health Care Marketplace. Prior to that, he was
on the faculty at the Johns Hopkins Schools of Medicine and of Public Health, and directed the AIDS
Dr. Smith was elected to the Institute of Medicine in 2001. He chaired the IOM’s Committee on the
Learning Healthcare System, which produced the widely-publicized 2012 report Best Care at Lower Cost.
He serves on the Boards of the Institute for Healthcare Improvement, the Commonwealth Fund, the
Archstone Foundation, Concerto Healthcare and the Editorial Board of Health Affairs, and advises
several startup companies and venture funds. He has been honored by the California Legislature, the
California Hospital Association, Grantmakers in Health, the Society of General Internal Medicine, and
Dr. Smith holds a BA from Harvard College, an MD from the University of North Carolina, and an MBA
from the Wharton School at the University of Pennsylvania. A Board-certified internist, he maintains an
active clinical practice in HIV care at Zuckerberg San Francisco General Hospital. He and his wife reside in