Disclaimer: The following information is drawn from materials prepared by candidates for promotion to associate professor in one of the scholarship-requiring tracks (RS and CS). It is intended to illustrate activities and materials that might support promotion. In using these materials, please note the following: *The Provost (and, in some cases, the President) are the University officers authorized to approve promotions. All levels of review below these officers are advisory. *Only Departments are empowered to propose promotions, and the Divisional Dean is charged with transmitting such proposals to the Provost or returning them to the Department. *The judgment of the Department, Dean, and Provost will therefore be critical to assessing qualification for promotion. *Materials considered by the Department, Dean, and Provost will also (and always) include confidential evaluations obtained from outside the University. Materials considered by the Provost will include the confidential evaluations of the Dean and Department, and those considered by the Dean will include the confidential evaluations of the Department. *Thus, the following materials are ONLY PART of a complete proposal for promotion, whereas promotion is based on the ENTIRE proposal. Therefore, it should not be assumed that a record comparable to that below will necessarily result in promotion, or that a record not comparable to that below will fail to result in promotion. The Departmental Chair is likely to be the best source of advice as to whether promotion is feasible and, when it is not, what additional activity may result in qualification for promotion. *This document has been prepared as a tool for use by assistant professors in the Division of the Biological Sciences. Other individuals who may find it informative are Department Chairmen, Section Heads, Committee Chairmen, senior faculty and potential recruits. Its intent is to help guide individuals and their departments as they think about promotion to Professor. This document is not intended to list the elements that every promotion proposal will be expected to address. The following information is presented for information purposes only and is not intended to create any contract or agreement, and its contents are subject to addition, deletion, and change without prior notice.

Name

Lawrence P. Casalino MD, MPH, PhD

Department of Primary Appointment:

Health Studies

Secondary appointments:

None

Proposed rank:

ASSOCIATE PROFESSOR

Proposed track:

RESEARCH SCHOLAR (TENURE)

LAY SUMMARY:

Dr. Casalino has combined 20 years experience as a physician in private practice with Ph.D. training as a sociologist in his approach to studying the organization of physician practice, the effects of varying types of practice organization on the quality and costs of medical care, and the effects of the “institutional environment”—the policies of government, health insurance plans, and large employers who purchase health insurance—on the organization of physician practice. These areas have been poorly studied, in no small part because relevant primary data have not been readily available. Dr. Casalino has led the field in obtaining primary data, including surveys, medical record reviews, and in-depth interviews. Using these data together with concepts from sociology and economics, he has published a series of related articles in major journals, key findings from which include: (1) medical groups use few organized processes to improve the quality of health care, but they are more likely to do so when health plans or government institute financial incentives for quality and/or public reporting programs; (2) paradoxically, these programs may at the same time lead to lower quality in important but unmeasured areas of care, and they may increase racial and socioeconomic disparities in health care; (3) contrary to the expectation of many policy analysts and reformers, the number of large multispecialty medical groups is increasing only very slowly, and under current conditions such groups are created more to gain negotiating leverage with health plans than to improve quality; (4) the Federal Trade Commission’s active (and evolving) anti-trust policy toward physicians strongly impacts the types of medical groups that are created and the extent to which they use organized processes to improve quality. Casalino’s current work focuses on questions such as: Do larger medical groups provide better quality than small practices? Do single specialty groups provide better quality than multispecialty groups? Is there a link between the use of organized processes to improve quality and the quality of care provided?

Dr. Casalino teaches the Social Context of Medicine, a highly-rated required course for all first year medical students. He also created a cross-disciplinary seminar—Topics in U.S. Health Economics, Sociology, and Policy—which is rated highly by the law students, medical fellows, and graduate students in sociology, business, and public policy who enroll in it.

Dr. Casalino chaired the search committee for the founding chairman of the University’s Department of Family Medicine, and he has served on eight other BSD or departmental committees, including the Dean’s Special Committee to Review the Department of Medicine.

PROFESSIONAL SERVICE

Study Sections:

National Institutes of Health 2004

National Institute of Diabetes and Digestive and Kidney Diseases

Special Emphasis Panel

Translational Research for the Prevention and Control of Diabetes

Agency for Healthcare Research and Quality (AHRQ) 2002

"Partnerships for Quality" program

Expert Panels and Work Groups:

Academy Health (this is the academic society for health services research) 2006

Article of the Year Committee

Robert Wood Johnson Foundation 2005

Expert Advisory Council for the Regional Market Pilot Program

Institute of Medicine 2005

External Reviewer for Report #2 – “Medicare’s Quality Improvement

Organization Program: Maximizing Potential” - for the Committee on

Redesigning Health Insurance Performance Measures, Payment

and Performance Improvement Programs.

The Leapfrog Group (national coalition of large employers) 2005-6

Advisory Panel re Expanding Rewards for Quality

Centers for Medicare and Medicaid Services (CMS) 2004

Technical Review Panel: Medicare Fee-for-Service Chronic Care

Improvement Program

Academy Health 2005 Annual Research Meeting 2004-5

Executive Committee Member

Academy Health 2005 Annual Research Meeting 2004-5

Theme Leader: Care of Patients with Chronic Diseases

Center for Value Purchasing Project 2004-5

Park Nicollet Institute Health Research Center

funded by the AHRQ Partnership for Quality Initiative

Center for Health Information Technology Leadership 2004

Expert Panel Member for “The Value of Information Technology

in Chronic Disease Management”

Connecting for Health (Markle Foundation; Robert Wood 2004

Johnson Foundation)

Work Group on Financial, Legal, and Organizational

Sustainability of Electronic Interconnectivity

Academy for Health Services Research and Policy 2003-2005

Dissertation Award Committee (chair, 2004-2005)

Robert Wood Johnson and California HealthCare Foundations 2002

"Rewarding Results" program

National Advisory Committee member

Center for Studying Health System Change 1999

Community Tracking Study

Harvard University Study 1998-1999

"Incentives in California Physician Groups”

Mathematica Policy Research Institute 1998-2000

MedPAC Study of "Health Plans’ Selection

and Payment of Providers"

Robert Wood Johnson Foundation 1997-1998

"Strengthening the Patient-

Provider Relationship"

Editorial Boards:

Medical Care Research and Review 2002-

Peer Review:

Inquiry 2006

Annals of Internal Medicine 2005-

Joint Commission Journal on Quality and Safety 2004-

Milbank Quarterly 2003-

Journal of the American Medical Association 2003-

Medical Care Research and Review 2002-

New England Journal of Medicine 2000-

Journal of Health Politics, Policy and Law 2000-

Health Services Research 1999-

Health Affairs 1996-

Chicago Center of Excellence in Health Promotion Economics 2005-

Robert Wood Johnson Foundation 2003

"Partnerships in Quality" program

Robert Wood Johnson Foundation 2002-

"Health Care Financing and Organization" program

National Endowment for the Humanities 1999

California Healthcare Foundation 1998-

Past Administrative and Committee Activities at the University of Chicago: (ongoing activities

are listed separately under question #51A)

Faculty Grading Working Group, Pritzker School of Medicine 2005-6

Physician In Context Committee, the Pritzker Initiative Curriculum Review 2005-6

Steering Committee, Licensing Committee for Medical Education 2004

Institutional Task Force

Chair, Departmental Health Service Research Search Committee 2003-4

Dean’s Special Committee to Review the Department of Medicine 2003

Dean’s Institutional Task Force to Review the School of Medicine 2003

Chair, Family Medicine Governance/Search Committee 2001-2

Faculty Club 2002-3

board member and chair of membership committee

Other Administrative and Board Responsibilities:

The Leapfrog Group 2005

Advisory Panel re Expanding Rewards for Quality

Aetna Medicare Health Support Disease Management Program 2005-

(funded under a competitive contract with the Center for Medicare

and Medicaid services)

Advisory Board member

Integrated Bay Area Network 1993-1994

Member, board of directors

Serra Medical Group IPA 1985-1992

board member, vice president

Seton Medical Center, Coastside 1984-1986

medical staff president

AWARDS:

Robert Wood Johnson Investigator Award 2000-2004

PRESENTATIONS

Please note: each of these presentations was invited; I have noted the ones where the

Invitation was based on formal peer review.

“Health Care Financing: What You See Depends On Where You Sit.” Blue Cross of California

Annual HMO Executives Meeting. 1994.

“Implications of Managed Care for Family Practice.” Society for Teachers of Family Medicine,

Western Regional Meeting. 1995.

“The Corporate Transformation of California Medicine.” Primary Care Grand Rounds, Stanford University Medical Center. 1995.

“Medicaid Managed Care and Full Risk Capitation of Medical Groups.” Princeton University, Woodrow Wilson School. 1996.

“Medical Groups, IPAs, and the Changing Organization of California Medical Care.” California Department of Corporations, Sacramento, CA. February 1998.

“Physician Organizations Assuming Risk: Market and Policy Implications.” National Health

Policy Forum. Washington, D.C. April, 1998. NHPF is a “participant-driven, nonpartisan

Information exchange program that works to foster more informed government decision making.

It serves primarily senior staff in Congress, the executive branch, and congressional support

agencies.”

“Doctors, Dollars, and Delegation.” Harvard University Sloan Managed Care Industry Research Center. December, 1998.

“The Division of Financial Risk and Care Management Responsibility Between Medical Groups and HMOs.” (invited testimony) California State Senate Hearings. February, 1999.

“Who Will Organize Physician Practice?” Harvard University. Kennedy School of

Management. March, 1999.

“System in Crisis: The Future of Managed Care in California.” California Medical Association,

Third Annual Leadership Conference, November, 1999.

“Risk and Responsibility: Alternative Models of Physician-Health Plan Relationship.” Harvard University Conference: “Understanding the New World of Managed Care.” November, 1999.

“Unintended Consequences of Quality Measurement.” College of Medical Specialty Societies

Spring Symposium. March, 2000.

“Alignment of Payment Incentives for Quality Within and Across Organizations.” Institute of Medicine. April, 2000.

“Organization Out of Chaos: Four Systems in Health Care.” Washington Business Group on

Health. April, 2000. WBGH – now the National Business Group on Health – is “the leading

voice of large employers,” with 200 members – mostly Fortune 500 employers.

“Physician Practice Organization: Why Isn’t There More There There?” Association for Health Service Research Annual Research Meeting. June, 2000. (invited based on competitive peer

review)

“National Trends in Physician and Hospital Organization.” New York Academy of Medicine. December, 2000.

“Do No Harm? The Influence of Public and Private Policies on Physician Groups in California.” Health Policy Roundtable (sponsored by Health Affairs and the California HealthCare

Foundation), Berkeley, California, January, 2001.

“Medicare Plus Choice and Value-Based Purchasing.” National Health Care Purchasing

Institute. October, 2001.

“Is There a Business Case for Quality in U.S. Health Care?” conference on “Quality Health Care: Can We Identify It? Can We Achieve It?” sponsored by the Law School and School of Medicine, University of Chicago. Nov., 2001.

“Problems with the Health Plan-Physician Group Negotiating Model.” (invited testimony)

Joint Hearing of the California Assembly Health and Judiciary Committees, December, 2001.

“Risk Contracting Reconsidered” Center for Studying Health System Change Annual

Conference for Policymakers, December, 2001.

“Regulation of Risk Contracting: A National Perspective.” Presentation for the Financial

Solvency Standards Board, California State Department of Managed Health Care. Glendale, California. February, 2002.

“The Future for Physician Groups.” Annual Health Care Forecasting Conference, Graduate

School of Management, University of California, Irvine. February, 2002.

“Physician Organizations’ Use of Care Management Processes.” University of Minnesota,

Carlson School of Management and Graduate Program in Health Services Research and Policy,

March, 2002.

“Medical Groups, IPAs, and Care Management Processes.” Academy of Health Services

Research and Health Policy Annual Research Meeting. June, 2002. (invited based on

competitive peer review)

“Things Can’t Go On As They Are: Changing Hospital-Physician Relations.” Keynote

presentation to the Strategic Policy Planning Committee of the American Hospital Association. March, 2003.

“Physician Consolidation and Its Effects on Quality.” Presentation to a meeting held by the Agency for Healthcare Research and Quality and the Federal Trade Commission on “Competition and Quality: Latest Findings and Implications for the Next Generation of Research.” Washington, DC, April, 2003.

“Improving Quality in Medical Groups: Providing Incentives for Change.” Plenary Address. California Cooperative Healthcare Reporting Initiative Diabetes CQI Quarterly Meeting. Los Angeles, April 24, 2003.

“Do Physician Organizations Have a Business Case for Improving Quality?” International

Health Economics Association Annual Meeting. June, 2003. (invited based on competitive peer

review)

“Has There Been a Corporate Transformation of American Physician Practice? Effects of

Public and Private Policies.” Academy Health Annual Research Meeting, June 2003. (invited

based on competitive peer review)

“Hospital-Physician Relations Overview.” American Hospital Association Annual Health Care Systems Leadership Retreat. California, October, 2003.

“Independent Practice Association Overview.” Invited Testimony at the Federal Trade

Commission/Dept. of Justice Competition Policy in Health Care hearings, Washington, DC.

Sept. 25, 2003.

“The Best of Times; The Worst of Times: Changing Hospital-Physician Relationships”. Moses

Cone Health System Leadership Retreat. North Carolina. Sept. 19, 2003.

“Physicians and Organized Processes in Long-Term Care.” Consensus Conference: Physician

Practice in Long-Term Care. University of Rochester School of Medicine. April 2, 2004.

"Physician Groups, Clinical Integration, Quality Improvement, and the Federal Trade Commission." Cornell University Department of Policy Analysis and Management. Ithaca, NY November 9, 2004.

"Quality = Incentives + Capabilities. But Do Physicians Have Either?" The Gary F. Krieger, MD Memorial Lecture. American Medical Association Organized Medical Staff Assembly Meeting. Atlanta, Georgia, December 4, 2004.

“Disease Management vs. the Chronic Care Model: Implications for Consumers.” Cornell University conference “Consumers, Information and the Evolving Healthcare Market Place.” Ithaca, NY, April 8, 2005.

“An Organized Process Approach to Reduce Clinical Disparities in Medicare.” Academy

Health Annual Research Meeting, Boston. Jun 28, 2005. (invited based on competitive peer

review)

“Disease Management vs. the Chronic Care Model: Are They Different? Do They Work?”

Medical Grand Rounds, Geisinger Health System. August 4, 2005.

“Physicians’ Role in Ending Health Care Disparities: Incentives and Capabilities.” Commission to End Health Care Disparities (AMA, ACP, and multiple medical specialty societies). Keynote

address. Arlington, VA, Sept. 19, 2005.

“General Internist’s Views of Pay for Performance and Public Reporting: Results of a National Survey.” Department of Health Policy and Management Seminar, University of Michigan, Ann

Arbor, MI. February 9, 2006.

“Physicians’ Failure to Inform Patients of Abnormal Outpatient Test Results: How Common? What Systems Could Make Failure Less Common?” Department of Health Policy and Management Seminar, Columbia University, NY. February 16, 2006.

“National Survey of General Internists’ Views on Pay for Performance and Public Reporting.” Health Services Research and Policy Seminar, Northwestern University. March 2, 2006.

“Who Will Add Value?” Keynote address at the Diabetes and Hypertension Summit, International Diabetes Center, Park Nicollet Clinic, Minneapolis. May 22, 2006

“Have Physicians Been Studying Agency Theory?” Eighth Annual Health Care Organizations Conference. UCLA/RAND. Los Angeles. June 1, 2006. (invited based on competitive peer

review)

“Clinical Integration: Physician Practice and Federal Trade Commission Policy.” Institute for Clinical Quality and Value. Chicago. June 23, 2006.

“Have Physicians Been Studying Agency Theory?” Academy Health Annual Meeting. Seattle.

June 27, 2006. (invited based on competitive peer review)

Major Forthcoming Presentations:

“What Do We Know About Medical Groups? How Should Medicare Pay Them?” Washington, D.C.

D.C., October 5, 2006.