Peter S. Hussey

Vice President and Director, RAND Health Care; Senior Policy Researcher; Professor, Pardee RAND Graduate School

Boston Office

Education

Ph.D. in health policy and management, Johns Hopkins Bloomberg School of Public Health; B.A. in biology, Johns Hopkins University

One Page Bio

Media Resources

This researcher is available for interviews.

To arrange an interview, contact the RAND Office of Media Relations at (310) 451-6913, or email media@rand.org.

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Overview

Peter Hussey is vice president and director of RAND Health Care, a senior policy researcher at the RAND Corporation, and a professor at the Pardee RAND Graduate School. Previously, he directed the RAND Health Services Delivery Systems program. As director of RAND Health Care, he manages one of the world's largest health policy research organizations, with over 200 experts working on over 200 projects at any point in time. His research career has focused on innovations in health care payment and delivery. Hussey is the author of over 100 publications and has presented widely on health policy topics to practitioners, researchers, and policymakers. Prior to joining RAND, Hussey worked at the Organization for Economic Cooperation and Development in Paris, France. He received his Ph.D. in health policy and management from the Johns Hopkins Bloomberg School of Public Health.

Research Focus

Selected Publications

63.Anderson GF, Hussey PS, Petrosyan V, "It’s Still the Prices, Stupid: Why the U.S. Spends So Much on Health Care, and a Tribute to Uwe Reinhardt," Health Affairs, 38(1), 2019

Price RA, Sloss EM, Cefalu M, Farmer CM, Hussey PS, "Comparing Quality of Care in Veterans Affairs and Non-Veterans Affairs Settings," Journal of General Internal Medicine, 33(10), 2018

Hussey PS, Liu JL, White C, "The Medicare Access and CHIP Reauthorization Act: Effects on Medicare Payment Policy and Spending," Health Affairs, 36(4), 2017

Hussey PS, Friedberg MW, Anhang Price R, Lovejoy SL, Damberg CL, "Episode-Based Approaches to Measuring Health Care Quality," Medical Care Research and Review, 74(2), 2017

Hussey PS, Timbie JW, Burgette LF, Wenger NS, Nyweide DJ, Kahn KL, "Appropriateness of Advanced Diagnostic Imaging Ordering Before and After Implementation of Clinical Decision Support Systems," JAMA, 313(21), 2015

Hussey PS, Wertheimer S, Mehrotra A, "The Association Between Health Care Quality and Cost: A Systematic Review," Annals of Internal Medicine , 158(1), 2013

Hussey PS, Ridgely MS, Rosenthal MB, "The PROMETHEUS Bundled Payment Experiment: Slow Start Shows Problems in Implementing New Payment Models," Health Affairs, 30(11), 2011

Hussey PS, Eibner C, Ridgely MS, McGlynn EA, "Controlling U.S. Health Care Spending — Separating Promising from Unpromising Approaches," New England Journal of Medicine, 361(22), 2009

Commentary

To Reopen Schools Safely, Prepare for New COVID-19 Test Capabilities
Safely reopening K–12 schools for in-person instruction requires complicated protocols ranging from symptom monitoring to physical distancing, as well as containment of transmission in the community. State policymakers and school leaders could begin planning now to draft, pilot, and evaluate protocols for reopening schools that incorporate rapid testing.
Aug 28, 2020 The RAND Blog
Improving MACRA's Chances of Success
Starting in 2019, the Medicare Access and CHIP Reauthorization Act will integrate and potentially simplify performance measurement by combining many measures and programs. Research provides insight into how to avoid pitfalls in MACRA's rollout.
Jan 9, 2017 The Health Care Blog
The Winding Path to Effective Bundled Payment
It's not unusual for a demonstration to fall short of its original objectives. Learning from such cases is part of the innovation process. This is especially worthwhile for bundled payment, which has many potential benefits for patients, providers, and payers.
Aug 29, 2014 Health Affairs Blog
Do You Get What You Pay For? Maybe Not in Health Care
While the current state of the evidence does not provide clear guidance to policymakers seeking to address the twin pillars of health care quality and cost, it is apparent that researchers must produce more detailed data on how to reduce health care spending while improving quality, writes Peter Hussey.
Feb 12, 2013 The RAND Blog

Publications

Report
Measures and Methodology for International Comparisons of Health Care System Performance: Final Report
RAND researchers worked with 15 experts in quality measurement, clinical care, and health economics to generate potential measure constructs that could improve the U.S. ability to learn from international comparisons of health system performance.
Feb 24, 2021
Report
A Comparison of National and International Approaches to COVID-19-Related Measures
The authors evaluate the comparability of commonly used COVID-19 measures within the United States and across countries, and make recommendations for the use and development of measures that would allow for more standardized and valid comparisons.
Jan 29, 2021
Report
Practice Expense Methodology and Data Collection Research and Analysis: Interim Phase II Report
In this report, the authors address how the Centers for Medicare and Medicaid Services can improve the methodology or update data used for setting practice expense payment rates under the Medicare Physician Fee Schedule.
Aug 4, 2020
Journal Article
It's Still The Prices, Stupid: Why The US Spends So Much On Health Care, And A Tribute To Uwe Reinhardt
Prices are the primary reason why the U.S. spends more on health care than any other country.
Oct 17, 2019
Report
Perspectives of Physicians in Small Rural Practices on the Medicare Quality Payment Program
Significant concerns have been raised about the ability of small rural practices to participate in the Centers for Medicare & Medicaid Services' Quality Payment Program. RAND researchers interviewed physicians to investigate these concerns.
Mar 5, 2019
Report
Practice Expenses Associated with Comprehensive Primary Care Capabilities
To help the Centers for Medicare & Medicaid Services (CMS) reimburse primary care practices for investing in "comprehensive primary care" capabilities, the authors developed and piloted a method for estimating related practice expenses.
Nov 15, 2018
Journal Article
Comparing Quality of Care in Veterans Affairs and Non-Veterans Affairs Settings
The VA health system performed as well or better than the non-VA system on most of inpatient and outpatient care quality, but there was high variation in quality across VA facilities.
May 2, 2018
Report
Practice Expense Methodology and Data Collection Research and Analysis
This report proposes alternative methodologies for determining the practice expense (PE) component of the Medicare Physician Fee Schedule in order to avoid misvalued payment rates. A main concern is the allocation of indirect practice costs.
Apr 11, 2018
Journal Article
A Mixed-Methods Evaluation of an Integrated Medication Management Program and Implications for Implementation
Organizational and environmental factors-such as funding mechanisms-were key to the successful implementation and uptake of a Medication Management Therapy program.
Aug 2, 2017
Journal Article
Association Between Patient-Centered Medical Home Capabilities and Outcomes for Medicare Beneficiaries Seeking Care from Federally Qualified Health Centers
The patient-centered medical home (PCMH) may benefit Medicare beneficiaries receiving care at federally qualified health centers; however certain PCMH capabilities, including identifying high-risk patients, effectively using care plans, and supporting self-care, may be particularly difficult for the centers to develop.
Jun 27, 2017
Research Brief
MACRA's Effects on Medicare Payment Policy and Spending
Estimates how sensitive physician behavior is to the design of alternative payment models under the Medicare Access and CHIP Reauthorization Act (MACRA).
May 3, 2017
Journal Article
The Medicare Access and CHIP Reauthorization Act: Effects on Medicare
The Medicare Access and Chip Reauthorization Act (MACRA) will decrease Medicare spending on physician services by an estimated -$35 to -$106 billion and change spending on hospital services by +$32 to -$250 billion between 2015 and 2030.
Apr 5, 2017
Journal Article
Comparing VA and Non-Va Quality of Care: A Systematic Review
The VA often performs better than or similarly to other systems of care with regard to the safety and effectiveness of care.
Sep 14, 2016
Research Brief
Minding the Gaps: Measuring Quality Based on Episodes of Care
An episode-based framework of health care quality measurement could provide a more complete picture of care than current methods. Existing quality measures could be used, but new ones would need to be developed to fill gaps in the framework.
May 6, 2016
Report
The RAND Health Care Payment and Delivery Simulation Model (PADSIM): Concepts, Methods, and Examples
This report describes RAND's Health Care Payment and Delivery Simulation Model (PADSIM), developed to more effectively analyze the impacts of current and future reforms to provider payment policy.
Mar 22, 2016
Journal Article
Episode-based Approaches to Measuring Health Care Quality
Developing an episode-based framework of health care quality measurement would allow for more comprehensive assessments of care quality than currently available methods.
Feb 29, 2016
Journal Article
The Relative Importance of Post-Acute Care and Readmissions for Post-Discharge Spending
This study aims to understand what patterns of health care use are associated with higher post-hospitalization spending.
Feb 19, 2016
Journal Article
How Will Provider-Focused Payment Reform Impact Geographic Variation in Medicare Spending?
The Institute of Medicine has recently argued against a value index as a mechanism to address geographic variation in spending and instead promoted payment reform targeted at individual providers.
2015
Report
Resources and Capabilities of the Department of Veterans Affairs to Provide Timely and Accessible Care to Veterans
The Department of Veterans Affairs health care system, with broad resources and capabilities, provides timely and high-quality care to most, but not all, patients. Meeting veterans' needs over the next five years will require additional capacity.
Dec 31, 2015
Journal Article
Radiologists' Perceptions of Computerized Decision Support: A Focus Group Study from the Medicare Imaging Demonstration Project
The purpose of this study was to discern radiologists' perceptions regarding the implementation of a decision support system intervention as part of the Medicare Imaging Demonstration project.
Nov 6, 2015
Journal Article
Appropriateness of Advanced Diagnostic Imaging Ordering Before and After Implementation of Clinical Decision Support Systems
Computerized clinical decision support (CDS) systems that match patient characteristics against appropriateness criteria to produce algorithmic treatment recommendations are a potential means of improving care.
Jul 13, 2015
Report
Paths to Sustainability for Innovative Delivery System Programs
Innovative health care delivery organizations are developing programs that aim to improve quality and reduce unnecessary use of acute care and costs. Researchers sought to identify paths to sustainability for these innovative care delivery programs.
May 12, 2015
Journal Article
Hospital and Regional Variation in Medicare Payment for Inpatient Episodes of Care
Health care spending varies widely between geographic regions, but there is disagreement regarding the appropriate policy response.
Apr 22, 2015
Journal Article
Including Physicians in Bundled Hospital Care Payments: Time to Revisit an Old Idea?
Given new payment models and the changing relationship between physicians and hospitals, it is time to reconsider bundling physicians into hospital payments.
Apr 21, 2015
Report
Evaluation of CMS' FQHC APCP Demonstration: Final First Annual Report
RAND was asked to evaluate a demonstration of federally qualified health centers becoming advanced primary care practices for Medicare beneficiaries and to assess the effects on care provided. This is the first report in a series of three.
Apr 9, 2015
Report
Specialty Payment Model Opportunities and Assessment: Oncology Model Design Report
This report shares research and analyses of claims data related to the design of a payment model for specialty oncology services for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare & Medicaid Services.
Mar 17, 2015
Report
Specialty Payment Model Opportunities and Assessment: Oncology Simulation Report
This report shares results of a simulation analysis of a payment model for specialty oncology services that is being developed for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare and Medicaid Services.
Mar 17, 2015
Report
Specialty Payment Model Opportunities and Assessment: Gastroenterology and Cardiology Model Design Report
Describes research related to the design of episode-based payment models for ambulatory gastroenterology and cardiology services for possible testing by the Centers for Medicare and Medicaid Services' Center for Medicare and Medicaid Innovation.
Mar 17, 2015
Journal Article
Evaluating the Feasibility and Utility of Translating Choosing Wisely Recommendations Into E-Measures
Few of the low-value services identified by the Choosing Wisely campaign can be translated into e-measures.
Feb 10, 2015
Report
Medicare Imaging Demonstration Final Evaluation: Report to Congress
RAND researchers tested whether exposing ordering clinicians to appropriateness guidelines for advanced imaging procedures would reduce or eliminate inappropriate orders. The study identified many opportunities to refine decision support systems.
Nov 10, 2014
Journal Article
Bundled Payment Fails to Gain a Foothold in California: The Experience of the IHA Bundled Payment Demonstration
To determine whether bundled payment could be an effective payment model for California, the Integrated Healthcare Association convened a group of stakeholders to develop, through a consensus process, the methods and means of implementing bundled payment.
Aug 4, 2014
Research Brief
Continuity of Care and the Cost of Treating Chronic Disease
Modest improvements in continuity of care correlate with sizable reductions in service use, complications, and costs for Medicare patients with congestive heart failure, chronic obstructive pulmonary disease, and type 2 diabetes mellitus.
Jul 16, 2014
Journal Article
Public Reporting of Provider Performance at a Crossroads in the United States: Summary of Current Barriers and Recommendations on How to Move Forward
Twenty-seven years after the first public release by the U.S. government of data on the quality of hospital care, public reporting for consumers has expanded substantially.
Jun 18, 2014
Journal Article
Continuity and the Costs of Care for Chronic Disease
Modest differences in care continuity for Medicare beneficiaries are associated with sizable differences in costs, use, and complications.
Mar 17, 2014
Journal Article
Accountable Care Organization Formation Is Associated with Integrated Systems but Not High Medical Spending
We examined where accountable care organizations (ACOs) have formed and what regional factors are predictive of ACO formation.
Oct 1, 2013
Journal Article
Option Pricing: A Flexible Tool to Disseminate Shared Saving Contracts
Due to volatility in healthcare costs, shared savings contracts can create systematic financial losses for payers, especially when contracting with smaller providers.
Aug 1, 2013
Journal Article
Impact of Socioeconomic Adjustment on Physicians' Relative Cost of Care
Ongoing efforts to profile physicians on their relative cost of care have been criticized because they do not account for differences in patients' socioeconomic status (SES).
Apr 26, 2013
Journal Article
Using a Hospital Quality Improvement Toolkit to Improve Performance on the AHRQ Quality Indicators
A team from RAND and the University HealthSystem Consortium (UHC) developed a toolkit to help hospitals enhance their quality improvement efforts using quality indicators from the Agency for Healthcare Research and Quality.
Apr 1, 2013
Journal Article
Patient Sharing Among Physicians and Costs of Care: A Network Analytic Approach to Care Coordination Using Claims Data
Patients treated by sets of physicians who share high numbers of patients tend to have lower costs.
Mar 1, 2013
Journal Article
The Association Between Health Care Quality and Cost: A Systematic Review
A systematic review found that evidence is mixed and inconsistent regarding both the direction and magnitude of the association between health care costs and quality.
2013
Journal Article
Evaluation of a Center of Excellence Program for Spine Surgery
The objective of our study was to assess whether hospitals designated as spine surgery centers of excellence by a group of over 25 health plans provided higher quality care.
2013
Journal Article
Evaluation of Centers of Excellence Program for Knee and Hip Replacement
The costs of knee and hip replacement in designated centers of excellence do not differ from costs in other hospitals. But hip replacements performed in such centers had lower complication rates. Complication rates for knee replacement did not differ.
2013
Journal Article
Measuring Care Continuity: A Comparison of Claims-Based Methods
Assessing care continuity is important in evaluating the impact of health care reform and changes to health care delivery.
2013
Research Brief
Flattening the Trajectory of Health Care Spending: Facilitate High-Value Innovation
Health information technology has not achieved its full potential, but its benefits should grow over time. Because health care is largely regulated at the state level, the states can play a valuable role as laboratories for innovative policies.
Nov 15, 2012
Research Brief
Flattening the Trajectory of Health Care Spending: Foster Efficient and Accountable Providers
Providers can dramatically improve American health care by focusing on value instead of volume, eliminating wasteful and inappropriate care, applying the best available evidence to their practices, and enhancing patient safety.
Nov 15, 2012
Research Brief
Flattening the Trajectory of Health Care Spending: Engage and Empower Consumers
Cost-sharing leads consumers to reduce both highly beneficial and less beneficial care, so they must be empowered with useful information to make informed decisions. Public cost and quality reports must be accurate, accessible, and understandable.
Nov 15, 2012
Research Brief
Flattening the Trajectory of Health Care Spending: Insights from RAND Health Research
RAND Health research supports four strategies to restrain health care spending growth and maintain quality: foster efficient and accountable providers, engage and empower consumers, promote population health, and facilitate high-value innovation.
Nov 15, 2012
Research Brief
Flattening the Trajectory of Health Care Spending: Promote Population Health
Reversing the rising tide of obesity and further reducing rates of tobacco use could produce substantial long-term dividends in terms of lives saved and disabling illnesses prevented. Communities, employers, and parents all have important roles.
Nov 15, 2012
Journal Article
Physicians with the Least Experience Have Higher Cost Profiles Than Do Physicians with the Most Experience
Health plans and Medicare are using cost profiles to identify which physicians account for more health care spending than others.
Nov 1, 2012
Journal Article
A Comparison of Ambulatory Perioperative Times in Hospitals and Freestanding Centers
Perioperative times were significantly shorter in freestanding ASCs than in hospital-based ASCs. It is unclear how much of the difference was the result of efficiency versus patient selection.
Jul 1, 2012
Research Brief
Which Path Leads to Cost Containment: Selection or Reputation?
Current initiatives to report health care provider costs are unlikely to motivate consumers to select lower-cost providers. Public reports could better engage consumers by focusing on out-of-pocket costs and high-value providers.
May 31, 2012
Research Brief
Helping Hospitals Deliver Better Care: A New Toolkit for Quality Improvement
A team from RAND and the University HealthSystem Consortium developed a toolkit to help hospitals enhance their quality improvement efforts using quality indicators from the Agency for Healthcare Research and Quality.
May 25, 2012
Journal Article
Consumers' and Providers' Responses to Public Cost Reports, and How to Raise the Likelihood of Achieving Desired Results
Public reporting of health care costs is intended to motivate consumers to choose lower cost providers, and motivate providers to lower costs to retain market share. Measures should be chosen based on which pathway policymakers intend to influence.
Apr 1, 2012
Journal Article
The PROMETHEUS Bundled Payment Experiment: Slow Start Shows Problems in Implementing New Payment Models
This project evaluated PROMETHEUS, a pilot project for a bundled payment alternative to fee for service. The pilot faced implementation challenges. Three years into the project, none of the pilot sites had executed contracts or made any bundled payments.
Nov 1, 2011
Report
Policy Options for Addressing Medicare Payment Differentials Across Ambulatory Settings
Building on prior RAND analyses, this report presents options for modifying Medicare payment policies to improve the value of services and to address payment differentials for similar services provided in various ambulatory settings.
Sep 30, 2011
Report
Payment Reform: Analysis of Models and Performance Measurement Implications
This technical report catalogues nearly 100 implemented and proposed health care payment reform programs, classifies each program into one of 11 payment reform models, and identifies the performance measurement needs associated with each model.
Feb 22, 2011
Research Brief
How Will the Affordable Care Act Affect Employee Health Coverage at Small Businesses?
Finds that the Affordable Care Act will increase the percentage of employers that offer health coverage to workers: from 57 percent to 80 percent for firms with 50 or fewer workers, and from 90 percent to 98 percent for firms with 51 to 100 workers.
Sep 8, 2010
Journal Article
The Effects of the Affordable Care Act on Workers' Health Insurance Coverage
The nature of employer-sponsored coverage may change substantially after implementation of the Patient Protection and Affordable Care Act, with an increase in the number of workers offered coverage through the health insurance exchanges.
Sep 1, 2010
Report
Establishing State Health Insurance Exchanges: Implications for Health Insurance Enrollment, Spending, and Small Businesses
The Patient Protection and Affordable Care Act will increase insurance offer rates at small businesses. By 2016, rates would increase from 53 to 77 percent at firms with ten or fewer workers and from 71 to 90 percent at firms with 11 to 25 workers.
Aug 11, 2010
Journal Article
Primary Care: A Critical Review of the Evidence on Quality and Costs of Health Care
Despite contentious debate over the new national health care reform law, there is an emerging consensus that strengthening primary care will improve health outcomes and restrain the growth of health care spending.
May 1, 2010
Report
Feasibility and Design Options for a Potential Entity to Research the Comparative Effectiveness of Medical Treatments
The options available to Massachusetts as it considers establishing a comparative effectiveness center to guide health care purchasing decisions are feasible, but design decisions depend on the prioritization of comparative effectiveness research.
Jan 15, 2010
Journal Article
Selecting Quality and Resource Use Measures: A Decision Guide for Community Quality Collaboratives
Selecting quality of care measures is critical for organizations seeking to improve health care quality in their communities. This Decision Guide identifies the most critical issues to consider when selecting and adopting such performance measures.
2010
Journal Article
A Guide to the Medical Home as a Practice-Level Intervention
Carefully specifying the exact components of medical home interventions-and interpreting their results in the context of these specifications-will help build a coherent body of evidence to guide the revitalization of primary care.
Dec 1, 2009
Draft
How Hospitals Have Implemented the National Quality Forum Safe Practices
Examines in detail how hospitals implemented some of the specific safe practices endorsed by the National Quality Forum.
Nov 11, 2009
Report
Expand the Use of Disease Management Programs
This document explores how increased use of disease management programs would affect health system performance along nine dimensions.
Oct 12, 2009
Report
Increase the Use of Comparative Effectiveness
The RAND Corporation's COMPARE initiative provides information and tools to help policymakers, the media, and others understand, design, and evaluate health care policies.
Oct 12, 2009
Research Brief
Controlling Health Care Spending in Massachusetts
In 2006, Massachusetts passed landmark legislation ensuring near-universal health insurance coverage to its residents, but rising costs threaten the initiative; this policy brief assesses 21 options for controlling health care spending in the state.
Sep 10, 2009
Journal Article
Episode-based Performance Measurement and Payment: Making It a Reality
Proposals to use episodes of care as a basis for payment and performance measurement are largely conceptual at this stage, with little empirical work or experience in applied settings to guide their design.
Sep 1, 2009
Report
Assessing Patient Safety Practices and Outcomes in the U.S. Health Care System
Presents the results of a two-year study that analyzes the extent to which patient safety practices are being adopted by U.S. health care providers, and assesses trends in patient safety outcomes.
Aug 24, 2009
Report
Controlling Health Care Spending in Massachusetts: An Analysis of Options
Presents a comprehensive menu of cost containment strategies and options and determines their potential effect on Massachusetts' health care system.
Aug 17, 2009
Journal Article
A Systematic Review of Health Care Efficiency Measures
Review and characterize existing health care efficiency measures in order to facilitate a common understanding about the adequacy of these methods.
Jun 1, 2009
Journal Article
Controlling U.S. Health Care Spending--Separating Promising from Unpromising Approaches
The reform legislation moving through Congress includes both promising and unpromising approaches to limiting health care spending.
2009
Journal Article
Efficiency and Its Measurement: What Practitioners Need to Know
There are important differences in perspective about the meaning of efficiency in health care and the appropriateness of measures.
2009
Draft
Medicare Payment Differentials across Ambulatory Settings
Analyzes issues related to modifying Medicare payment policy for health care services delivered in various ambulatory settings so that payment rates reflect the costs of delivering the services in each setting.
Aug 19, 2008
Journal Article
Identifying, Categorizing, and Evaluating Health Care Efficiency Measures
Recognizing the importance of improving efficiency measurement of health care quality, the Agency for Healthcare Research and Quality has sponsored this systematic review and analysis of available measures.
Apr 1, 2008
Journal Article
Trends in Socioeconomic Disparities in Health Care Quality in Four Countries
Found socioeconomic disparities in health care quality and status for most of the indicators studied in four countries. These disparities in varied indicators underscore the importance of factors common to the systems or factors outside the system.
Feb 1, 2008
Journal Article
International Migration Patterns of Physicians to the United States: A Cross-National Panel Analysis
Many of the most powerful factors associated with physician migration are difficult or impossible for countries to change through public policy.
2007