How Is Healthcare Changing?  How Is the Government Responding?

January 26, 2017 John A. and Cynthia Fry Gunn Building Koret-Taube Conference Center Stanford University

Presented by Cornerstone Research Stanford Institute for Economic Policy Research (SIEPR)

How Is Healthcare Changing?  How Is the Government Responding? An in-depth look at the changing landscape of government enforcement in healthcare coordination, innovation, and reimbursement.

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PROGRAM AGENDA

12:00–12:15 pm

WELCOME

12:15–1:30 pm

LUNCH ADDRESS Deborah L. Feinstein, Director, Bureau of Competition, Federal Trade Commission

1:30–2:45 pm

EVALUATING THE CONSEQUENCES OF NEW TYPES OF HEALTHCARE COORDINATION



Pressure to cut costs while maintaining or improving quality is part of a drive toward increased collaboration among healthcare organizations, including mergers, joint ventures, and alliances. What does this mean from the perspective of patients, providers, payors, and government regulators? Moderator: Ben Handel, University of California, Berkeley Speakers: Gautam Gowrisankaran, University of Arizona Francine Lafontaine, University of Michigan Richard Sankary, Affinity Medical Group; University HealthCare Alliance; University Medical Partners 2:45–3:00 pm

BREAK

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PROGRAM AGENDA

3:00–4:15 pm



HEALTHCARE INNOVATION AND THE ROLE OF GOVERNMENT ENFORCEMENT Innovations bring the promise of better and less expensive healthcare but also concerns about consumer protection and data privacy. How is government enforcement changing in response to these innovations? Moderator: Laurence C. Baker, Stanford University Speakers: Allen Briskin, Pillsbury Winthrop Shaw Pittman Jonathan Kolstad, University of California, Berkeley Andrew Maas, Roam Analytics

4:15–4:30 pm

BREAK

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PROGRAM AGENDA 4:30–5:45 pm

REIMBURSEMENTS ISSUES IN HEALTHCARE The government reimburses insurers and providers for Medicare services. The Affordable Care Act has now increased the level of government oversight of private insurance. What affects the incentives of providers, insurers, and payors? How can these incentives be aligned? What is the role of government enforcement, and how is it likely to change? Moderator: Maria Salgado, Cornerstone Research Speakers: Daniel R. Anderson, U.S. Department of Justice Benjamin B. Wagner, Gibson, Dunn & Crutcher Mark Duggan, Stanford Institute for Economic Policy Research, Stanford University

5:45–6:00 pm

CLOSING

6:00–7:00 pm

COCKTAIL RECEPTION

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SPEAKER BIOGRAPHIES Daniel R. Anderson Deputy Director, Commercial Litigation Branch, Civil Division, U.S. Department of Justice Since joining the Department of Justice in 1996, Daniel Anderson has worked on fraud investigations involving some of the largest healthcare providers in the United States. In 2001, Mr. Anderson was awarded the U.S. Attorney General’s Exceptional Service Award, the Department’s highest honor. In 2011, he received the Stanley D. Rose Memorial Award, the Civil Division’s highest award. Previously, Mr. Anderson was an assistant attorney general for the state of Maryland and was the director of that state’s Medicaid Fraud Control Unit. He has testified before numerous congressional committees, about issues germane to healthcare fraud and elder abuse and neglect. He has written extensively on those topics and on the HIPAA Privacy Rule. In 1995, Mr. Anderson was awarded the John B. Pickett Fellowship at the John F. Kennedy School of Government at Harvard University.

Laurence C. Baker Professor and Chair of Health Research and Policy, Stanford School of Medicine, Stanford University; Senior Advisor, Cornerstone Research Laurence Baker is an economist interested in the organization and economic performance of the U.S. healthcare system. In his research, he has investigated a range of topics, including financial incentives in healthcare, competition in healthcare markets, health insurance and managed care, and the adoption of healthcare technology. Professor Baker has consulted and testified on healthcare systems and financing issues, including hospital mergers, health insurance plan and benefits design, provider payment systems, and contracting and billing matters. Professor Baker was awarded the ASHEcon Medal for his significant contributions to the field of health economics and the Alice S. Hersch Young Investigator Award from AcademyHealth. He is also a fellow at the Stanford Center for Health Policy/Center for Primary Care and Outcomes Research. His recent publications include articles in The Journal of the American Medical Association (JAMA), Health Services Research, and Health Affairs.

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SPEAKER BIOGRAPHIES

Allen E. Briskin Senior Counsel, Pillsbury Winthrop Shaw Pittman Allen Briskin is counsel in the firm’s Health Care & Life Sciences practice. He has twenty-five years of experience representing for-profit, nonprofit, and government healthcare clients in organizational, regulatory, corporate, and business matters. His practice emphasizes health information exchange network development, hospital operations and hospital-physician alignment, managed healthcare, and other health-plan and health-insurance issues. He represents hospitals and healthcare systems, large medical groups, health information exchange organizations, managed-care payors, and other organizations in matters of regulatory compliance, licensing, and contracting. Mr. Briskin is a principal author of the Markle Connecting for Health Common Framework: Model Contract for Health Information Exchange. He was a member of the founding steering committee of the California eHealth Collaborative. He is listed in Best Lawyers in America for Health Care Law practice.

Mark G. Duggan Wayne and Jodi Cooperman Professor of Economics; Trione Director, Stanford Institute for Economic Policy Research, Stanford University Mark Duggan’s research focuses on the healthcare sector and the effects of government expenditure programs such as Medicare and Medicaid on the behavior of individuals and firms. In his most recent research, he has explored the Affordable Care Act’s effect on the labor market and healthcare costs. He is a research associate at the National Bureau of Economic Research and serves on the editorial board of the American Economic Journal: Economic Policy. Professor Duggan served as the senior economist for healthcare policy at the White House Council of Economic Advisers from 2009 to 2010. He has testified before both House and Senate committees. He received the 2010 ASHEcon Medal, awarded by the American Society of Health Economists to the U.S. economist aged forty or under who has made the most significant contributions to the field of health economics. He and his coauthor received the National Institute for Health Care Management’s 2011 Health Care Research Award for their work on Medicare Part D.

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SPEAKER BIOGRAPHIES

Deborah L. Feinstein Director, Bureau of Competition, U.S. Federal Trade Commission Deborah Feinstein was appointed director of the U.S. FTC’s Bureau of Competition by Chair Edith Ramirez on June 17, 2013. She oversees the Commission’s attorneys, investigators, and administrative personnel, who work to enforce antitrust laws for the benefit of consumers. Ms. Feinstein joined the Commission from Arnold & Porter, where she was a partner and chair of the firm’s Antitrust practice. She began her career at Arnold & Porter but then initially joined the FTC in 1989, serving as an assistant to the Bureau of Competition director and as an attorney advisor to a former commissioner before returning to private practice. One of Ms. Feinstein’s many accolades is her naming by Global Competition Review as Global Lawyer of the Year for 2010.

Gautam Gowrisankaran Arizona Public Service Professor of Economics, University of Arizona Gautam Gowrisankaran is an expert on industrial organization and competition, with particular focus on healthcare economics. He has analyzed hospitals, accountable care organizations, health insurance, health information technology, rural healthcare delivery, and wellness incentives. Professor Gowrisankaran has received several research grants from the National Science Foundation, the Agency for Healthcare Research and Quality, and other agencies. His work has been published in leading journals, including the American Economic Review, Econometrica, and Health Affairs, and he serves on the editorial boards of several academic journals. He is also a research associate at the National Bureau of Economic Research. Professor Gowrisankaran has testified in competition matters before the U.S. Federal Trade Commission, U.S. district and state courts, and international bodies. 

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SPEAKER BIOGRAPHIES

Ben Handel Associate Professor of Economics, University of California, Berkeley Ben Handel’s research focuses on the microeconomics of consumer choice and market structure in the healthcare sector, with an emphasis on health insurance markets. His most recent research has emphasized the important role that consumer-choice frictions, such as inertia and limited information, can have in assessing the welfare outcomes of various regulatory policies in health insurance markets. Professor Handel has partnered with many large firms and policy organizations in the healthcare sector to study incentive design and medical providers’ adoption of information technology. Professor Handel also is a research associate at the National Bureau of Economic Research. He received an Alfred P. Sloan Research Fellowship in Economics in 2015 and, with his coauthors, was awarded the Frisch Medal, for an applied article published in Econometrica, by the Econometric Society. In 2016, he received a National Science Foundation CAREER Investigator Award. His research has been published in numerous journals, including Econometrica, the American Economic Review, and the Journal of Econometrics.

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SPEAKER BIOGRAPHIES

Jonathan Kolstad Assistant Professor of Economic Analysis and Policy, Haas School of Business, University of California, Berkeley Jonathan Kolstad is an economist whose research interests lie at the intersection of health economics, industrial organization, and public economics. A unifying theme of his work is how information, market structure, and regulation alter firm organization, individual incentives, and, ultimately, welfare. He has studied, among other topics, the effect of quality information on demand and intrinsic surgeon incentives, the effect of the Massachusetts health insurance expansion on a variety of outcomes, and consumer decision making in insurance markets. Professor Kolstad is a codirector of the Health Initiative at UC Berkeley’s Opportunity Lab. He was awarded the Arrow Award, for the best paper in health economics in 2014, from the International Health Economics Association. Professor Kolstad was a cofounder of Picwell, a company that provides tools that help consumers to select health insurance plans, where he served as chief data scientist. He also is a faculty research fellow at the National Bureau of Economic Research.  

Francine Lafontaine Senior Associate Dean for Faculty and Research, William Davidson Professor of Business Economics and Public Policy, Ross School of Business, Professor of Economics, University of Michigan Francine Lafontaine’s area of interest is industrial organization with a special focus on vertical relationships, franchising and other forms of inter-firm contracting, and related antitrust issues. She also studies the effect of contracting practices on firm performance, business creation, and survival. She served as director of the U.S. Federal Trade Commission Bureau of Economics from fall 2014 to the end of 2015. Professor Lafontaine is a coauthor of the book The Economics of Franchising and the editor of Franchise Contracting and Organization. Her articles have been published in many journals, including the American Economic Journal: Microeconomics, the American Economic Journal: Applied, the Journal of Law, Economics, and Organization, the RAND Journal of Economics, and the Review of Economics and Statistics. 8

SPEAKER BIOGRAPHIES

Andrew L. Maas Co-chief Scientist and Cofounder, Roam Analytics Andrew Maas is a computer scientist whose research focuses on large-scale deep learning to solve problems in natural language processing, speech recognition, and healthcare. In 2013, he cofounded Roam Analytics to develop a machine-learning platform to power life sciences and healthcare companies. Dr. Maas worked as an analytics software engineer for Coursera, where he developed machine-learning systems to quantify student learning and verify student identities. At IBM Research, he built speech-recognition systems capable of learning new languages quickly. Dr. Maas was named to the 2017 Forbes 30 Under 30 list, in the category of enterprise technology. 

Maria Salgado Principal, Cornerstone Research Maria Salgado conducts economic analyses for complex business litigation matters, particularly those involving pharmaceuticals and healthcare, with a focus on intellectual property, antitrust, and marketing matters. She has worked on pharmaceutical matters involving reverse payments, lifecycle management strategies (product hopping), false advertising, breach of contract, and Hatch-Waxman Act issues. In the area of healthcare, Dr. Salgado has experience in class certification, the False Claims Act, and competition matters. Dr. Salgado has published a number of articles in journals such as Health Affairs, The Antitrust Source, Nature Reviews, and the Antitrust Health Care Chronicle. She is currently vice chair of the Antitrust Interface with Intellectual Property Rights Committee of the ABA. Dr. Salgado holds a Ph.D. in economics from Northwestern University.

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SPEAKER BIOGRAPHIES

Richard Sankary Chief Medical Officer of Accountable Care, University HealthCare Alliance/ Stanford Health Care; President, Affinity Medical Group; President, University Medical Partners Richard Sankary is the chief medical officer of Accountable Care at University Healthcare Alliance/Stanford Health Care. He is president of Affinity Medical Group, a 1,200-physician IPA, and president of University Medical Partners, a 150-person medical group in the San Francisco Bay Area. Dr. Sankary is board certified in internal medicine, pulmonology, and sleep medicine. He has led various managed-care organizations since 1990. He trained at Harvard Medical School, University of Texas Southwestern, and University of California, San Francisco.

Benjamin B. Wagner Partner, Gibson, Dunn & Crutcher Benjamin Wagner is a litigation partner and a member of several of Gibson, Dunn & Crutcher’s practices, including FDA and Health Care. He represents corporate clients in internal investigations, compliance reviews, government investigations, and enforcement actions. As a U.S. Attorney for the Eastern District of California, Mr. Wagner oversaw numerous False Claims Act investigations in the healthcare, defense, and education industries. He also served as an Assistant U.S. Attorney and as chief of the Special Prosecutions Unit in the Eastern District, in which role he received the Executive Office of the U.S. Attorneys Director’s Award for Superior Performance three times. Mr. Wagner is an experienced trial and appellate attorney, having tried eighteen felony criminal cases in federal court and argued more than a dozen times before the Ninth Circuit. In 2014, he received a California Lawyer Attorney of the Year (CLAY) award from California Lawyer Magazine. In 2012, the Daily Journal named him one of the top 100 lawyers in California.

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