Investigator Awards In Health Policy Research Investigator Awards in Health Policy Research
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Investigators And Their Projects » This Year's Investigator Awards:
Section Info
This section contains information about all of the projects and researchers that have been funded through the Investigator Awards program since the first grants were made in 1993. The indexes in this section can be used to identify investigators by name, area of expertise, or year of award. Throughout the site, you will find that each investigator’s name links to details including contact and project information.
May 2008

The Robert Wood Johnson Foundation (RWJF) has announced the selection of this year’s recipients of its Investigator Awards in Health Policy Research. Fifteen scholars affiliated with major universities across the country will receive a total of $3.5 million to support 11 new research projects. The winning researchers will explore many challenging policy issues facing America today, as well as wide-ranging concerns about the nation’s health and health care system.

This highly competitive funding program attracts investigators from a variety of disciplines, including medicine, nursing, public health, economics, sociology, political science, psychology, history, law, ethics, journalism, and public and social policy. A national advisory committee of distinguished experts from fields similar to those of the investigators reviews applications.

RWJF created the Investigator Awards in Health Policy Research program to support researchers whose cross-cutting and innovative ideas promise to contribute meaningfully to improving health and health care policy. The program provides one of the few funding opportunities in the United States for investigator-initiated projects that are broad in scope, innovative in approach, and have national policy relevance. Since 1992, the Foundation has supported 147 projects involving 186 investigators.

“Through the Investigators’ program, the Foundation invests in ideas and individuals – investments that pay off long after the research grants have ended,” says Lori Melichar, Ph.D., economist and senior program officer in research and evaluation at RWJF. “The books and articles resulting from Investigators’ research contribute to the public discourse in health policy. The program also provides the Investigators with opportunities to join the debate on health policy issues and influence how policymakers think about the challenges of providing and financing health care and improving the health of the nation.”

For details of the 2007 Investigator Awards click "Show Awards" below.

»Show Awards
Carol M. Ashton, M.D., M.P.H.
Nelda P. Wray, M.D., M.P.H.
Improving the Evidence Base for Invasive Therapeutic Procedures
Award Year: 2007

»Show Abstract
Despite the American fascination with high-tech medicine, new treatments don’t always deliver desired cures or improvements. While pharmaceutical products must be rigorously tested and approved by the U.S. Food and Drug Administration before going to market, any surgeon or interventionist can provide a new therapeutic procedure without valid scientific proof of its effectiveness. This can pose real problems for people seeking to make health care decisions – whether it’s a physician considering how to treat a medical problem, a health plan deciding whether to cover a procedure, or a patient considering surgery. Oftentimes, the evidence needed to make those decisions simply doesn’t exist. Carol M. Ashton, M.D., M.P.H., and Nelda P. Wray, M.D., M.P.H. explore how studies that generate evidence of what works best by comparing alternatives could be applied to surgical and other therapeutic procedures. They examine how payment incentives might be used to encourage physicians and patients to help generate the data needed to quantify the risks and benefits of procedures and to create the evidence upon which more informed treatment decisions can be made. Their project, Improving the Evidence Base for Invasive Therapeutic Procedures, should help inform the design of payment policies to promote the use of procedures with scientifically proven benefits and reduce the use of those for which safer, more effective, and less expensive alternatives exist.
Jason Corburn, Ph.D., M.C.P.
Toward the Healthy City: Urban Planning and Policy for Healthy People and Places
Award Year: 2007

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Although the fields of urban planning and public health worked together in the 19th century to improve the health and well-being of poor American city dwellers, today’s urban land-use decisions are no longer driven by public health and social justice concerns. Jason Corburn, Ph.D., is interested in how the two fields might be reconnected to encourage the development of healthier and more just cities. He examines common urban challenges, including health disparities, declines in affordable housing, residential segregation, and unequal access among neighborhoods to transit, open space, and quality food markets. Through case studies of policy innovations in the San Francisco Bay area, where urban planners, public health and community organizations are beginning to work together, Corburn explores how a population health approach might be integrated into land-use decisions through policy processes such as health impact assessment. His project, Toward the Healthy City: Urban Planning and Policy for Healthy People and Places, aims to change views on the connections between public health and urban design, to identify the policy levers that contribute to innovation, and to provide insights for how similar policies can be used in other cities and states.
Thomas H. Gallagher, M.D.
Michelle M. Mello, J.D., Ph.D., M.Phil.
Responding Justly to Patients Harmed by Medical Care: Disclosure, Compensation, and Litigation
Award Year: 2007

»Show Abstract
The Institute of Medicine’s 2000 report, To Err Is Human, and the widespread media attention it received, dramatically increased awareness of the extent of medical mistakes in U.S. hospitals. Since then, a number of states and national quality organizations have adopted policies requiring or encouraging medical professionals to tell patients and families when unanticipated “adverse events” occur. Some organizations and insurers have gone even further by adopting programs through which disclosures of adverse events are accompanied by offers of compensation (known as disclosure and offer or D&O programs). Still, prompt disclosure of medical errors and fair compensation remain the exception rather than the rule. Thomas H. Gallagher, M.D. and Michelle M. Mello, J.D., Ph.D., M.Phil., seek to more fully understand the effects of disclosure initiatives and innovative D&O programs on malpractice costs and patients’ access to compensation. Their project, Responding Justly to Patients Harmed by Medical Care: Disclosure, Compensation, and Litigation, explores how policy levers can be used to make disclosing errors more routine and evaluates the design and effectiveness of D&O programs. Their work should help policymakers better understand the potential of these initiatives and how they might best be integrated into broader medical liability reforms.
David S. Jones, M.D., Ph.D.
The Rise and Fall of Cardiac Revascularization: Therapeutic Evolution and Health Policy in the Late Twentieth Century
Award Year: 2007

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Over the last 15 to 20 years, evidence-based medicine and clinical practice guidelines have been embraced as ways to rationalize medical decisions about how to treat patients. But the results so far have been mixed, as the treatment of coronary artery disease (CAD) demonstrates. Two of the standard treatments for CAD, coronary artery bypass grafting and percutaneous transluminal coronary angioplasty, have been used far more frequently than indicated, with periods of growth and decline not associated with changes in the evidence base on why and when they should be used. David S. Jones, M.D., Ph.D. explores this disconnect between clinical evidence and medical practice. He considers how physicians have responded to competing hypotheses about the causes of CAD, treatment risks and unexpected complications, and evidence of wide disparities in the use of cardiac surgery and angioplasty. His project, The Rise and Fall of Cardiac Revascularization: Therapeutic Evolution and Health Policy in the Late 20th Century, aims to uncover the range of factors that influence clinical decision making in American medicine. Results should increase understanding of the appropriate uses of bypass grafting and angioplasty, as well as newer technologies such as intravascular ultrasound, stents, and possibly even gene therapy.
Shoou-Yih Daniel Lee, Ph.D.
Bryan J. Weiner, Ph.D.
Transformation of Government Health Care: Experience of the New Veterans Health Administration
Award Year: 2007

»Show Abstract
Many Americans strongly oppose the idea of “government-run” health care, preferring market-driven strategies for solving the problems of the U.S. health care system. Yet, over the last decade, the federally financed Veterans Health Administration (VHA) has become one of the great success stories of health care improvement in America. How did the VHA, a massive, government-operated health system, rescue itself from congressional threats of overhaul and privatization? And how did the VHA become a model of high-quality, lower-cost care that now surpasses Medicare and private health plans on many quality measures? Shoou-Yih Daniel Lee, Ph.D. and Bryan Weiner, PhD. probe these questions in their case study of the VHA’s success. Using a framework of “punctuated change,” Lee and Weiner explore how VHA’s leaders and management responded to Congress, overcame organizational inertia, and set a new course. Their project, Transformation of Government Health Care: Experience of the VHA, considers the importance of leadership, the paths and pace of change, internal and external resistance, and the leverage points that help move change along. Their findings should provide a clearer picture of how the VHA became a quality-driven health system and how other public and private health care systems might use the lessons of its success.
Frank Levy, Ph.D.
Curbing the Use of Medical Imaging: Searching for Efficient Technology Utilization in a Fee-for-Service World
Award Year: 2007

»Show Abstract
High-tech diagnostic imaging equipment is now available in hospitals, imaging centers, large multi-specialty group practices, and more types of doctors’ offices than ever before. While this has made things easier for physicians and patients, it has also produced rapid growth in medical expenditures for scans and contributed to the overall rise in U.S. health care spending. Although medical professionals generally agree that imaging’s rapid growth includes significant waste due to overuse, scientific evidence is lacking on which imaging is unnecessary. Frank Levy, Ph.D. seeks to better understand the drivers of the rapid growth in spending for imaging and the ways that waste might be identified. His Investigator Award project, Curbing the Use of Medical Imaging – Searching for Efficient Technology Utilization in a Fee-for-Service World, analyzes spending growth and examines initiatives by health care organizations to define and limit unnecessary imaging and to influence physician behavior. Levy notes that this “soft rationing” – limiting medical expenditures and unnecessary procedures through strategies such as prior authorization requirements and physician profiling – may also become important in other areas of health care. His research findings should help inform efforts to contain the growth and costs of imaging as well as other medical procedures.
Howard Markel, M.D., Ph.D., F.A.A.P.
Alexandra Minna Stern, Ph.D.
History Informing Public Health Preparedness Policy in the 21st Century: A Qualitative Study of Non-Pharmaceutical Interventions and Community Experiences during the 1918-1919 Influenza Pandemic
Award Year: 2007

»Show Abstract
The influenza pandemic of 1918-1919 was the deadliest contagious calamity in human history, killing 650,000 people in the United States and 50 million worldwide. But the pandemic’s effects varied geographically – some communities were devastated while others suffered few if any deaths. To learn why, Howard Markel, M.D., Ph.D., F.A.A.P. and Alexandra Minna Stern, Ph.D., conduct a comprehensive review of the strategies used by 43 U.S. cities during the 1918-1919 flu epidemic. Markel and Stern examine such public health measures as isolation of the ill, quarantines on those suspected of contact with the ill, school closures, and bans on public gatherings. They also analyze the cities’ demographic and housing characteristics, morbidity and mortality patterns, political leadership and coordination among government agencies, supply of health care facilities and medical personnel, and compliance with public health measures. Their project, History Informing Public Health Preparedness Policy in the 21st Century: A Qualitative Study of NonPharmaceutical Interventions and Community Experiences during the 1918-1919 Influenza Pandemic, aims to extract lessons that can inform pubic health policymaking and preparedness planning today.
David Meltzer, M.D., Ph.D.
Hospitalists and American Medicine: A Quantitative History of a New Medical Specialty
Award Year: 2007

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The emergence of hospitalists – physicians who specialize in the medical care of hospitalized patients – represents a major transformation in the practice of modern American medicine. Over the past decade, the field has grown from a few hundred physicians to more than 20,000. David O. Meltzer, M.D., Ph.D. believes that many factors may have contributed to this growth – from shifts in the nature and organization of primary care to Medicare payment incentives that make it more profitable for hospitals to discharge patients quickly. His project, Hospitalists and American Medicine: A Quantitative History of a New Medical Specialty, investigates the rise of the hospitalist movement, its effects on the organization of patient care in hospitals and ambulatory care settings, the potential contributions of hospitalists to improving health care quality, and how their emergence might help inform broader efforts aimed at reorganizing the practice of medicine. His findings should shed light on some of the forces and special interests at play in rethinking the roles of primary care physicians and medical specialists in the United States.
Dorothy E. Roberts, J.D.
Race Consciousness in Biomedicine, Law, and Social Policy
Award Year: 2007

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The validity of race-based medicine remains highly controversial. Some scientists, policymakers, and activists criticize it as flawed given scientific evidence that there is far more genetic variation within racial groupings than between them. Others welcome it for its potential to address health disparities, past discrimination in the provision of medical care, and lack of minority representation in biomedical research. What is the proper role of race in medicine, biomedical and disparities research, and health policy? And how are views about race in medicine related to broader debates in America about racial equality? Dorothy E. Roberts, J.D. explores the development of race-based medicine and its relationship to concepts of social justice. Her project, Race Consciousness in Biomedicine, Law, and Social Policy, uses legal doctrine and theories of racial equality to examine scientific and political debates about race consciousness and colorblindness and to evaluate the ethics of using race in biomedical research and policy development. The results of her study should provide practical guidance to researchers and policymakers concerned with the proper role of race in science and health policy.
Frank J. Thompson, Ph.D.
Medicaid: Political Durability, Democratic Process and Health Care Reform
Award Year: 2007

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In the face of mounting pressures to contain health care costs and strongly held partisan views about entitlement programs, what does the future hold for Medicaid? Will Medicaid, which costs more than $300 billion annually and provides coverage to some 55 million low-income Americans, be subjected to deep budget cuts? Or can it resist erosion and perhaps even expand to cover more of the nation’s 47 million uninsured? Frank J. Thompson, Ph.D. explores these questions in his project, Medicaid: Political Durability, Democratic Process, and Health Care Reform. He examines Medicaid’s structure as a federal grant program; its varied constituents, including the disabled and middle-class elderly as well as low-income mothers and children; characteristics of the American political system, such as federalism and party division, that often make program cuts more difficult; and the use of administrative rather than legislative strategies by the Clinton and Bush administrations to try to transform Medicaid. Thompson considers the possibilities for using Medicaid to expand insurance coverage, to shift more long-term care from institutions to communities, and to achieve other reforms that could promote innovation, transparency, and broader participation in policymaking.
Peter A. Ubel, M.D.
Emotional Adaptation and the Goals of Health Care Policy
Award Year: 2007

»Show Abstract
Researchers have shown that people can adapt emotionally to a wide range of adverse circumstances. But predictions about how fully people will or will not adapt to serious illness and disability, either physical or mental, are often wrong. For example, people with quadriplegia report moods and quality of life that are similar to those reported by people who are healthy, and exceed what healthy people believe their moods and quality of life would be if they were to become quadriplegic. How do these beliefs affect the choices made when patients seek treatments for illnesses, when payers determine coverage policies, and when policymakers weigh programmatic or financing options? What role should well-being play in determining health care priorities, and how should policies that aim to maximize health address conditions where improving physical functioning and well-being do not go hand in hand? Peter A. Ubel, M.D. examines these complicated questions in his project, Emotional Adaptation and the Goals of Health Care Policy. This study attempts to break new ground by introducing insights from well-being research to debates about the cost-effectiveness of medical treatments, coverage decisions by payers, and discussions about health care priorities in the United States.