Staff
Principal Investigator
Emmett B. Keeler (Ph.D., Mathematics, Harvard University), a senior mathematician at RAND, is the principal investigator of the Improving Chronic Illness Care Evaluation (ICICE). He has conducted technical analyses for dozens of studies evaluating quality improvement interventions, insurance design, cost-effectiveness, and quality-of-care statistics. In the RAND Health Insurance Experiment, he assessed the effects of alternative insurance plans on physiological health and developed the episode-of-treatment approach to analyze use. He also led the analysis of physiological outcomes for that study. Dr. Keeler was the lead technical analyst in the Prospective Payment System Quality of Care evaluation, addressing ways to risk-adjust outcomes and investigating the relationship between explicit, implicit, and outcome-based measures of hospital quality. His recent projects include an investigation of how to make the business case for quality improvement as well as studies of hospital competition and Medical Savings Accounts. Three of his 127 published papers were selected as the article of their respective years by the Academy for Health Services Research and Health Policy and won their Distinguished Investigator Award. Dr. Keeler is an elected member of the Institute of Medicine of the National Academy of Sciences.
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ICICE Staff
Steven Asch (M.D., University of California, San Diego; M.P.H., University of California, Los Angeles) is a health policy analyst at RAND and an assistant professor of medicine at the West Los Angeles Veterans Affairs (VA) Medical Center and UCLA. His research interests focus on the application of quality and access measurement systems to the reduction of underuse of necessary medical care. Dr. Asch is a principal investigator for the Quality Assessment Tools (QA Tools), funded by the Health Care Financing Administration, the Agency for Healthcare Research and Quality, the Robert Wood Johnson Foundation, and the VA. These tools form a family of projects to design and test measures of global quality in several managed care plans and in a national population-based sample. He is the principal investigator of a series of projects investigating the barriers that HIV and tuberculosis patients face in obtaining needed medical care. Dr. Asch also directs a national randomized trial of quality improvement in HIV-positive veterans. He has served as a consultant to the National Committee for Quality Assurance, the Foundation for Accountability, the Medicare Payment Advisory Commission, and the Los Angeles County Department of Health Services.
David W. Baker (M.D., University of California, Los Angeles, School of Medicine; M.P.H., University of California, Los Angeles, School of Public Health) is a general internist and a consultant to RAND Health. He serves as the ICICE team leader for congestive heart failure. He is currently serving as Chief of the Division of General Internal Medicine at Northwestern University's Feinberg School of Medicine. Dr. Baker was formerly the associate professor of medicine and epidemiology-biostatistics at Case Western Reserve University and MetroHealth Medical Center in Cleveland, Ohio. Dr. Baker is principal investigator for a study, funded by the Agency for Healthcare Research and Quality (AHRQ), that is analyzing trends in mortality for patients hospitalized with congestive heart failure. He serves on the American College of Cardiology/American Heart Association working group to revise guidelines for the care of patients with heart failure; on the American Board of Internal Medicine committee for the Heart Failure Practice Improvement Module; and on the editorial board of Congestive Heart Failure. At MetroHealth Medical Center, where he practices and teaches, Dr. Baker directs the MetroHealth Heart Failure Disease Management Program to improve the quality of care within the organization. He was the associate project director for the AHRQ-funded guideline Heart Failure: Evaluation and Care of Patients with Left Ventricular Systolic Dysfunction and was lead author for a series of manuscripts in the Journal of the American Medical Association on quality of care for patients with congestive heart failure. Dr. Baker has been an advisor to both the Ohio and the Georgia Peer Review Organizations' heart failure quality improvement projects, and he served on the American Heart Association's working group for measuring quality of care and outcomes for cardiovascular disease.
Julie Brown (B.A., Social Ecology, University of California, Irvine) is the operations manager and a study director for the RAND Survey Research Group (SRG). She directs all SRG activity for ICICE. This includes providing oversight to SRG site liaison and Institutional Review Board application efforts; responsibility for all instrument design and testing for the patient interviews (chronic heart failure, diabetes, asthma, depression); and directing the patient data collection effort. She has extensive experience in health services research, with expertise in health surveys of special populations such as physicians, homeless individuals, the elderly, individuals on public insurance, and individuals with chronic health conditions. Ms. Brown has managed an array of instrument design and data collection efforts, including field abstraction, focus groups, one-on-one interviews, self-administered mail surveys, and telephone surveys.
Shan Cretin (Ph.D., Operations Research, Massachusetts Institute of Technology; M.P.H., Medical Care Organization, Yale University) is the Regional Director of the Pacific Southwest Region for the American Friends Service Committee. Dr. Cretin was formerly a senior scientist at RAND and has more than two decades of experience as a researcher, teacher, and consultant in health services research and health services management. Dr. Cretin has co-authored numerous papers on quality-of-care assessment and improvement methods, the effects of volume on outcomes of care, case-mix adjustment methods, and methods for organizing and financing health care in the United States and in the People's Republic of China. As a private consultant from 1990 to 1998, Dr. Cretin worked with health care organizations to assess and improve the quality of clinical care and business practices.
Rosa-Elena Garcia (M.P.H., Community Health Sciences, University of California, Los Angeles) is a survey coordinator with the RAND Survey Research Group. She is working with ICICE sites on Institutional Review Board approval and to coordinate patient consent and enrollment. Ms. Garcia has worked extensively in the health care sector for more than a decade, gaining experience in program development, implementation, and program evaluation. She has worked with various special populations and implemented projects involving mental health, cancer, AIDS, tobacco education, and asthma. Ms. Garcia has experience conducting research in a variety of organizational and community settings. She has been involved in local, state, national, and bi-national data collection efforts using both qualitative and quantitative methods, including focus groups, one-to-one interviews, self-administered mail surveys, and telephone surveys.
Geoffrey Joyce (Ph.D., Economics, City University of New York) is an economist at RAND. Previously, he held faculty appointments at Cornell University and Hunter College (CUNY). He is leading ICICE efforts to examine the costs of participating in the Collaborative and the impact of care management on utilization and costs. Dr. Joyce is particularly interested in the costs of delivering health care and has conducted research on cost and use issues related to HIV and herpes simplex virus, prenatal services, and managed care. He recently completed work simulating the costs of a Medicare prescription drug benefit. He is also a co-principal investigator of a grant funded by the California HealthCare Foundation to examine the impact of prescription drug benefit designs on costs and utilization. Dr. Joyce is currently working on assessing the cost-effectiveness of various clinical approaches to care for chronically ill patients. He is also evaluating the impact of a smoking cessation demonstration for Medicare beneficiaries.
Joan Keesey (B.A., Mathematics, Pomona College) has managed large claims databases for numerous RAND Health projects. She is a senior programmer/analyst at RAND and the ICICE data manager. For the Health Care Utilization Study, using Medicaid physician claims, Ms. Keesey generated population-based utilization rates for medical and surgical procedures for 13 large geographic sites in the United States. For the New York Hospital Study, she matched New York hospital discharge data to mortality data from the state and the Health Care Financing Administration; she developed files of disease-specific admissions that were appended with data on mortality, prior admissions, and severity of disease. She is currently providing programming and data management support for two RAND Health projects: the Management and Outcomes of Childbirth Study and the HIV Costs and Services Utilization Study.
Thomas A. Louis (Ph.D., Mathematical Statistics, Columbia University) is a professor of biostatistics at Johns Hopkins University School of Public Health. Dr. Louis is coordinating editor of the Journal of the American Statistical Association and is a member of the National Academy of Sciences Committee on National Statistics. He serves on the board of the Institute of Medicine's Medical Follow-up Agency and on the executive committee of the National Institute of Statistical Sciences.
Carol M. Mangione (M.D., University of California, San Francisco; M.S.P.H., Harvard School of Public Health) is a nationally known expert in eye diseases, quality of life, and outcomes of vision care. She is a consultant to RAND and serves as the ICICE team leader for the Diabetes Committee. She co-chaired the writing committee for the first health services research chapter for the National Advisory Eye Council's Vision Research: A National Plan: 1999-2003. This document is used to inform health policy and federal funding decisions on vision research. The first of Dr. Mangione's two primary research areas is the development and application of tools to measure health-related quality of life among visually impaired adults. She recently developed a vision-targeted, health-related, quality-of-life survey that is currently used in more than 20 funded clinical trials and observational studies to define the best treatment approaches for many eye conditions. Her second research area is analyzing the performance of different health care systems, especially managed care systems, in terms of quality and content of care as well as examining the financial incentives and structural elements in those systems that predict quality and outcomes. Her research on vision care services for Medicare beneficiaries in managed care settings is funded by the Agency for Health Care Policy and the Robert Wood Johnson Foundation.
Rita Mangione-Smith (M.D., Wayne State University; M.P.H., University of California, Los Angeles) is an associate professor in the Department of Pediatrics at the University of Washington. Dr. Mangione-Smith was formerly an assistant professor of pediatrics at UCLA and a physician researcher and consultant at RAND. She is the leader of the asthma team for ICICE. Primarily interested in assessing and improving quality of care in pediatrics, she has an active role in several quality-of-care projects at RAND. Dr. Mangione-Smith was recently named a Robert Wood Johnson Foundation Generalist Physician Faculty Scholar, an award that funds her research to develop a communication-based intervention to decrease rates of antibiotic over-prescribing among pediatricians.
Jill Marsteller (M.P.P., College of William and Mary; Ph.D. in Health Services and Policy Analysis, University of California, Berkeley) is currently an assistant professor of health policy and management at the Bloomberg School of Public Health, Johns Hopkins University. Ms. Marstellar was formerly an NCHS/AcademyHealth Fellow at the National Center for Health Statistics, Center for Disease Control (CDC). Prior to returning to school, she worked for six years as a research associate at the Urban Institute in Washington, D.C. Her primary research interests are organizational demographics, hospital ownership patterns, the uninsured population, and state and federal regulation of insurance. Ms. Marsteller is part of the organizational analysis team for ICICE.
Peter Mendel (Ph.D., Sociology, Stanford University) is an associate behavioral scientist at RAND where he is a key investigator on studies of coordinating care for homeless persons with substance addictions and integrating services for HIV+ persons with serious mental illness. He has extensive experience studying the organization of health services, and for ICICE, he is analyzing organizational survey data from management and staff of collaborative providers. Dr. Mendel's earlier work at Stanford on a project funded by the Robert Wood Johnson Foundation resulted in a co-authored book, Institutional Change and Healthcare Organizations (University of Chicago Press, 2000), on the evolution of the healthcare field in the San Francisco Bay Area over the past half century.
Lisa Meredith (Ph.D., Social Psychology, Claremont Graduate School) is a behavioral scientist at RAND, where she conducts health services evaluation research to improve the quality of care for depression in primary care managed care settings. Along with Dr. Unützer, Dr. Meredith serves as a depression expert for the ICICE depression team. Her research has involved examining specialty and payment differences in provider treatment style for depression in the Medical Outcomes Study, including the continuity of the patient-doctor relationship and use of effective treatments. As a co-principal investigator on one large depression trial, she evaluated the effect of alternative team-based quality improvement programs on primary care providers' knowledge about depression treatment. She is also co-principal investigator on another large depression quality improvement project where she is examining the effects of continuity of care on quality. The Robert Wood Johnson Foundation funded her investigation of the quality of patient-provider relationships under different forms of managed care. In two ongoing projects funded by the National Institute of Mental Health , Dr. Meredith is studying the therapeutic content of primary care provider communication with depressed patients and the applicability of decision-making theories to evaluating depression treatment behavior by primary care providers.
Marjorie Pearson (M.S., Health Services, University of California, Los Angeles; Ph.D., Political Science, University of California, Los Angeles) is a social scientist at RAND. She was co-chair of the ICICE organization team. Her research focuses on quality improvement interventions and performance measurement, particularly of nonphysician providers of chronic care. She currently is analyzing the case management performance of nurses in depression care teams. She is also working with researchers, managed care providers, and community agencies to improve systems for delivering and coordinating care to Alzheimer's patients and their caregivers. Dr. Pearson directed an implicit review of the quality of nursing care and has researched physician performance measurement, community-based interventions in preventive health, and communication strategies for increasing awareness and exercise of Medicare rights and protections by the elderly.
Mayde Rosen (B.S.N., Boston University; R.N., State of Massachusetts) is an associate natural scientist at RAND and project director for ICICE. She has worked extensively in the areas of data and information dissemination, data gathering, data cleaning, and system editing for medical and fiscal accuracy. She has chaired and formed interdisciplinary work teams to improve clinical quality, decrease length of stay and ancillary testing, and improve cost-effectiveness and utilization management. She has been the liaison with outside vendors for cost accounting and national benchmarking for data comparisons. Ms. Rosen participated in a combined U.S. Armed Services and Veterans Affairs project to improve the care of patients through the use of guidelines. She is project director for a number of research efforts, including the Cost of Cancer Treatment Study, the National Initiative on Cancer Care Quality, and the evaluation of California Senate Bill 393 on Medicare coverage of prescription drugs.
Matthias Schonlau, (Ph.D., Statistics, University of Waterloo), is a statistician with RAND and heads the RAND statistical consulting service. Prior to joining RAND, he held positions with the National Institute of Statistical Sciences and with AT&T Labs Research, and taught at Rutgers University. Dr. Schonlau's scientific and policy research interests include applications of data mining, data visualization and web surveys. In particular he is interested in how data mining techniques such as boosting can be applied to the health sciences and how graphical methods can be used to communicate more effectively with researchers in the health sciences. Dr. Schonlau has published 34 articles and books, including 15 peer-reviewed publications. In 2001, his team won a second place in the data mining competition at the world's largest conference on data mining "KDD".
Stephen M. Shortell (Ph.D., Behavioral Sciences, University of Chicago) is the Blue Cross of California Distinguished Professor of Health Policy and Management and professor of organization behavior in the School of Public Health at the University of California, Berkeley. He holds appointments in the Haas School of Business and the department of sociology at UC-Berkeley and in the Institute for Health Policy Research at UC-San Francisco. A consultant to RAND, he was chair of the ICICE organization team. Dr. Shortell is currently conducting research on the strategy, structure, and performance of integrated health systems; the performance of community care networks; the relationship between physician group practices and integrated health systems; and the implementation and effect of continuous quality improvement/total quality management on U.S. health care organizations. He is the author or co-author of more than l70 peer-reviewed articles and 11 books, including the recent Remaking Health Care in America: Building Organized Delivery Systems. His many awards include the Baxter Health Services Research Prize for his contributions to health services research; the Gold Medal Award from the American College of Healthcare Executives for his contributions to the health care field; and the Distinguished Investigator Award from the Association for Health Services Research. Dr. Shortell is editor of Health Services Research. He is an elected member of the Institute of Medicine of the National Academy of Sciences; past president of the Association for Health Services Research; and a past chairman of the Accrediting Commission for Graduate Education in Health Services Administration.
Roberto Vargas (M.D. Jefferson Medical College, Philadelphia, PA; M.P.H. Harvard University, Boston, MA) is a natural scientist at RAND and a clinical instructor of medicine in the Division of General Internal Medicine and Health Services Research at the Geffen School of Medicine at UCLA. His research interests examine the role of access to health care and variation in health policies on population level health. As part of the ICICE project he is investigating the impact of the chronic care model breakthrough series on cardiovascular risk in patients with diabetes. He is also a co-principle investigator of a RAND research team examining interventions to reduce racial, ethnic, and poverty driven disparities in breast cancer care. In addition he is is examining the impact of state specific health policies on health outcomes in a national sample of Medicaid enrollees and the role of access to care and health policies on disparities in health in patients in California. Dr. Vargas is also examining the impact of chronic kidney disease on population health and health disparities as part of the NCRR/NIH Comprehensive Center for Health Disparities for Chronic Kidney Disease.
Shin-Yi Wu (Ph.D., Industrial Engineering, University of Wisconsin-Madison) is an associate engineer at RAND specializing in health systems engineering. Her research interests focus on cost-effective quality improvement approaches to improve the care and health outcomes of chronic illness in the elderly. For ICICE, she is characterizing the efforts of organizations to improve delivery and quality of chronic illness care. Other current projects include a Medicare demonstration of smoking cessation programs; evidence reports for elder care; and community-based cancer screening promotion interventions. Dr. Wu's past research included an investigation of the impact of a patient-centered care approach on patient outcomes; a simulation of type 1 diabetes disease progression and a comparison of the cost-effectiveness of alternative treatments; a long-term projection of costs and prevalence of chronic illness; and an evaluation of a medical device to assist patient self-management and monitoring. Dr. Wu has also worked in the Office of Quality Improvement at the University of Wisconsin-Madison and in the Dean's Office, College of Engineering, at Chung-Yuan University in Taiwan.