Clinical Focus


  • Internal Medicine
  • Gastroenterology

Administrative Appointments


  • Associate CMO, Stanford Health Care -- University Healthcare Alliance (2016 - 2018)
  • Director, Accountable Care, Stanford Health Care -- University Healthcare Alliance (2016 - 2018)
  • Director, Population Health Management and Innovation, Stanford Health Care -- University Healthcare Alliance (2016 - 2018)
  • Service Medical Director, Stanford Health Care -- University Healthcare Alliance (2016 - 2018)
  • Operations Medical Director, Stanford Health Care -- University Healthcare Alliance (2016 - 2018)
  • Clinical Assistant Professor of Medicine, Department of Medicine, Division of Gastroenterology and Hepatology (2016 - 2018)
  • Instructor, SOMGEN 275: Leading Value Improvement in Health Care Delivery, Stanford School of Medicine (2016 - Present)
  • White House Fellow, Special Assistant to the Secretary of Defense, Immediate Office of the Secretary, U.S. Department of Defense (2014 - 2015)
  • Member, Coding and Payment Subcommittee, AGA Institute (2014 - 2014)
  • Course Director, SOMGEN 275: Leadership and Strategies for Health Care Delivery Innovation, Stanford School of Medicine (2013 - 2015)
  • Policy Advisor, Committee on Health, California State Assembly (2013 - 2014)

Honors & Awards


  • Rising Stars: 66 Leaders in Healthcare under 40, Becker's Healthcare (2019)
  • Office of the Secretary of Defense Medal for Exceptional Public Service, Immediate Office of the Secretary, U.S. Department of Defense (2015)
  • Poster of Distinction, Digestive Diseases Week (2015)
  • White House Fellow, President's Commission, White House Fellowships(1 of 15 appointed by President of the United States) (2014-2015)
  • Kaiser Family Foundation Research Fellow, Kaiser Family Foundation (2010-2011)
  • NATMA Foundation Scholarship, North American Taiwanese Medical Association (2009)
  • Center for Public Leadership Zuckerman Fellow, Harvard Kennedy School of Government (2008-2009)
  • AMA Foundation Leadership Award, American Medical Association (2008)
  • Frederick Bronson Cooley Memorial Fellowship, Stanford Graduate School of Business (2006-2007)
  • Isaac and Madeline Stein Fellowship, Stanford Graduate School of Business (2005-2007)
  • Magna cum laude, Brown University (2002)
  • Phi Beta Kappa, Brown University (2002)
  • John Hazen White Fellow, Brown University (2001)
  • Program in Liberal Medical Education (PLME), Brown University (1998-2002)

Professional Education


  • Residency:Stanford University Internal Medicine Residency (2012) CA
  • Internship:Stanford University Internal Medicine Residency (2010) CA
  • Board Certification: Gastroenterology, American Board of Internal Medicine (2016)
  • Subspecialty Fellowship, Stanford University Gastroenterology Fellowship (2016)
  • Board Certification: Internal Medicine, American Board of Internal Medicine (2013)
  • Residency, Stanford University Medical Center (2012)
  • Internship, Stanford University Medical Center (2010)
  • M.P.H., Harvard School of Public Health (2009)
  • M.D., University of California, San Francisco (2008)
  • M.B.A, Stanford Graduate School of Business (2007)
  • Certificate in Public Management, Stanford Graduate School of Business (2007)
  • B.A., Brown University, Public Policy (2002)

Community and International Work


  • Cardinal Free Clinics

    Location

    Bay Area

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

  • Rotacare Free Clinic

    Location

    Bay Area

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

  • Emergency Housing Consortium Lifebuilders

    Location

    Bay Area

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

  • Stanford Medical Youth Science Program

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

  • Conference on Asian Pacific American Leadership

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

  • National Youth Leadership Forum on Medicine

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

Graduate and Fellowship Programs


  • Gastroenterology & Hepatology (Fellowship Program)

Professional Affiliations and Activities


  • Faculty Fellow, Center for Innovation in Global Health, Stanford University (2017 - Present)
  • Member, American Gastroenterological Association (2016 - Present)
  • Board of Directors, White House Fellows Foundation and Association (2015 - Present)
  • Term Member, Council on Foreign Relations (2015 - Present)
  • Member, American College of Gastroenterology (2013 - Present)
  • Board of Trustees, California Medical Association (2006 - 2007)
  • Board of Directors, California Medical Association Foundation (2004 - 2005)

All Publications


  • Lower Gastrointestinal Bleeding In: Pitchumoni C., Dharmarajan T. (eds) Geriatric Gastroenterology Sheen, E., Pan, J., Ho, A., Triadafilopoulos, G. Springer, Cham. 2020; 2nd
  • A Nationwide Study of Inpatient Admissions, Mortality, and Costs for Patients with Cirrhosis from 2005 to 2015 in the USA. Digestive diseases and sciences Zou, B., Yeo, Y. H., Jeong, D., Park, H., Sheen, E., Lee, D. H., Henry, L., Garcia, G., Ingelsson, E., Cheung, R., Nguyen, M. H. 2019

    Abstract

    BACKGROUND AND AIMS: Liver cirrhosis is a substantial health burden in the USA, but population-based data regarding the trend and medical expenditure are limited and outdated. We investigated the trends of inpatient admissions, costs, and inpatient mortality from 2005 to 2015 among cirrhotic patients.METHODS: A retrospective analysis was conducted using the National Inpatient Sample database. We adjusted the costs to 2015 US dollars using a 3% inflation rate. National estimates of admissions were determined using discharge weights.RESULTS: We identified 1,627,348 admissions in cirrhotic patients between 2005 and 2015. From 2005 to 2015, the number of weighted admissions in cirrhotic patients almost doubled (from 505,032 to 961,650) and the total annual hospitalization cost in this population increased three times (from 5.8 to 16.3 billion US dollars). Notably, admission rates varied by liver disease etiology, decreasing from 2005 to 2015 among patients with hepatitis C virus (HCV)-related cirrhosis while increasing (almost tripled) among patients with nonalcoholic fatty liver disease (NAFLD)-related cirrhosis. The annual inpatient mortality rate per 1000 admissions overall decreased from 63.8 to 58.2 between 2005 and 2015 except for NAFLD (27.2 to 35.8) (P<0.001).CONCLUSIONS: Rates and costs of admissions in cirrhotic patients have increased substantially between 2005 and 2015 in the USA, but varied by liver disease etiology, with decreasing rate for HCV-associated cirrhosis and for HBV-associated cirrhosis but increasing for NAFLD-associated cirrhosis. Inpatient mortality also increased by one-third for NAFLD, while it decreased for other diseases. Cost also varied by etiology and lower for HCV-associated cirrhosis.

    View details for DOI 10.1007/s10620-019-05869-z

    View details for PubMedID 31598919

  • National Estimates of Overall and Liver-Related Inpatient Care Cost in Cirrhotic Patients with Diverse Etiologies and Ethnicities in the United States (US) Zou, B., Yeo, Y., Jeong, D., Cheung, R., Sheen, E., Park, H., Lee, D., Garcia, G., Nguyen, M. H. WILEY. 2018: 110A
  • Higher mortality and hospital charges in patients with cirrhosis and acute respiratory illness: a population-based study SCIENTIFIC REPORTS Zou, B., Yeo, Y., Jeong, D., Sheen, E., Park, H., Nguyen, P., Hsu, Y., Garcia, G., Nguyen, M. H. 2018; 8
  • Economic and clinical burden of viral hepatitis in California: A population-based study with longitudinal analysis. PloS one Park, H., Jeong, D., Nguyen, P., Henry, L., Hoang, J., Kim, Y., Sheen, E., Nguyen, M. H. 2018; 13 (4): e0196452

    Abstract

    Economic burden of HBV and HCV infection are trending upwards.Compare hepatitis B virus (HBV) and hepatitis C virus (HCV) related hospital admission rates, charges, mortality rates, causes of death in a US population-based study.Retrospective cohort analysis of HBV and HCV patients from the California Office of Statewide Health Planning and Development (2006-2013) database.A total of 23,891 HBV and 148,229 HCV patients were identified. Across the 8-year period, the mean increase for all-cause ($1,863 vs $1,388) and liver-related hospitalization charges ($1,175 vs $675) were significantly higher for the HBV cohort compared to the HCV cohort. HBV patients had significantly higher liver-related hospital charges per person per year than HCV patients after controlling for covariates ($123,239 vs $111,837; p = 0.002). Compared to HCV patients, adjusted mortality hazard ratio was slightly lower in HBV patients (relative risk = 0.96; 95% CI 0.94-0.99). The major causes and places of death were different. The three major causes of death for HBV were: other malignant neoplasms (35%), cardiovascular disease/other circulatory disorders (17%), and liver-related disease (15%) whereas for HCV patients were: liver-related disease (22%), other malignant neoplasms (20%), and cardiovascular disease (16%). Regarding the place of death, 53% of HBV patients and 44% of HCV patients died in hospital inpatient, respectively.HBV patients incurred higher liver-related hospital charges and higher mean increase for all-cause and liver-related hospitalization charges over the 8-year period compared to HCV patients. HBV patients had slightly lower mortality rate and their major causes and places of death were noticeably different from HCV patients.

    View details for PubMedID 29708985

  • Rising Inpatient Encounters and Economic Burden for Patients with Nonalcoholic Fatty Liver Disease in the USA. Digestive diseases and sciences Nguyen, M. H., Nguyen, A. L., Park, H., Nguyen, P., Sheen, E., Kim, Y. A. 2018

    Abstract

    Nonalcoholic fatty liver disease (NAFLD) is the fastest-growing chronic liver disease. However, little is known about NAFLD inpatient resource utilization and clinical outcomes.The aim of this study was to quantify inpatient NAFLD encounters using patient-level data over time.This was a retrospective analysis of de-identified data for NAFLD patients from the California Patient Discharge Database from 2006 to 2013. NAFLD patients were identified by ICD9 codes 571.40, 571.41, 571.49, 571.8, and 571.9.NAFLD patients (n = 91,558) were predominantly female (60%), 45-65 years old (44%), and white (53%). Inpatient encounters increased from 8153 in 2006 to 16,457 in 2013 and were associated with a 207% increase in charges ($686 million in 2006 to $1.42 billion in 2013) and average increase in charges of 9.8% per year adjusting for inflation. Comorbidities (obesity, diabetes, hyperlipidemia, cardiovascular disease, other cancer, and renal disease) increased significantly over time (all P < 0.05). From 2006 to 2011, there were 11,463 deaths (1849 for liver-related hospitalizations) (mean follow-up 4.00 ± 2.13 years). The most significant predictors of death were age > 75 (aHR 3.9, P < 0.0001), male gender (aHR 1.10, P < 0.0001), white race (aHR 1.2, P < 0.0001), decompensated cirrhosis (aHR 2.1, P < 0.0001), and cancer other than HCC (aHR 3.2, P < 0.0001). Within the liver-related hospitalization cohort, mortality predictors were similar, except for Hispanic race (aHR 0.92, P < 0.0096) and renal disease (aHR 1.50, P < 0.0001).The number of NAFLD inpatient encounters increased significantly from 2006 to 2013, as did the inflation-adjusted inpatient charges. The most significant predictors of death were non-liver cancers (HR 3.11, P < 0.0001, CI 3.06-3.16) and age > 75 years (HR 3.94, P < 0.0001, HR 3.86-4.03).

    View details for PubMedID 30327963

  • Higher mortality and hospital charges in patients with cirrhosis and acute respiratory illness: a population-based study. Scientific reports Zou, B., Yeo, Y. H., Jeong, D., Sheen, E., Park, H., Nguyen, P., Hsu, Y. C., Garcia, G., Nguyen, M. H. 2018; 8 (1): 9969

    Abstract

    Both cirrhosis and acute respiratory illness (ARI) carry substantial disease and financial burden. To compare hospitalized patients with cirrhosis with ARI to cirrhotic patients without ARI, a retrospective cohort study was conducted using the California Office of Statewide Health Planning and Development database. To balance the groups, propensity score matching (PSM) was used. We identified a total of 46,192 cirrhotic patients during the three study periods (14,049, 15,699, and 16,444 patients, respectively). Among patients hospitalized with cirrhosis, the ARI prevalence was higher in older age groups (p < 0.001), the Asian population (p = 0.002), non-Hispanic population (p = 0.001), and among Medicare patients (p < 0.001). Compared to controls, patients with ARI had 53.8% higher adjusted hospital charge ($122,555 vs. $79,685 per patient per admission, p < 0.001) and 35.0% higher adjusted in-hospital mortality (p < 0.001). Older patients, patients with alcoholic liver disease or liver cancer were at particularly higher risk (adjusted hazard ratio = 2.94 (95% CI: 2.26-3.83), 1.22 (95% CI: 1.02-1.45), and 2.17 (95% CI: 1.76-2.68) respectively, p = 0.028 to <0.001). Mortality rates and hospital charges in hospitalized cirrhotic patients with ARI were higher than in cirrhotic controls without ARI. Preventive efforts such as influenza and pneumococcal vaccination, especially in older patients and those with liver cancer, or alcoholic liver disease, would be of value.

    View details for PubMedID 29967363

  • Isoniazid Hepatotoxicity Requiring Liver Transplantation DIGESTIVE DISEASES AND SCIENCES Sheen, E., Huang, R. J., Uribe, L. A., Nguyen, M. H. 2014; 59 (7): 1370-1374

    View details for DOI 10.1007/s10620-014-3072-z

    View details for Web of Science ID 000338344500008

    View details for PubMedID 24573717

  • Isoniazid hepatotoxicity requiring liver transplantation. Digestive diseases and sciences Sheen, E., Huang, R. J., Uribe, L. A., Nguyen, M. H. 2014; 59 (7): 1370-1374

    View details for DOI 10.1007/s10620-014-3072-z

    View details for PubMedID 24573717

  • Two Evils: Gastrocolic Fistula and Heart Failure DIGESTIVE DISEASES AND SCIENCES Sheen, E., Huang, R. J., Triadafilopoulos, G. 2014; 59 (5): 928-932

    View details for DOI 10.1007/s10620-013-2911-7

    View details for Web of Science ID 000334748000009

    View details for PubMedID 24185680

  • Nonresponse to Interferon-alpha Based Treatment for Chronic Hepatitis C Infection Is Associated with Increased Hazard of Cirrhosis PLOS ONE Cozen, M. L., Ryan, J. C., Shen, H., Lerrigo, R., Yee, R. M., Sheen, E., Wu, R., Monto, A. 2013; 8 (4)

    Abstract

    The long-term consequences of unsuccessful interferon-α based hepatitis C treatment on liver disease progression and survival have not been fully explored.We performed retrospective analyses to assess long-term clinical outcomes among treated and untreated patients with hepatitis C virus in two independent cohorts from a United States Veterans Affairs Medical Center and a University Teaching Hospital. Eligible patients underwent liver biopsy during consideration for interferon-α based treatment between 1992 and 2007. They were assessed for the probability of developing cirrhosis and of dying during follow-up using Cox proportional hazards models, stratified by pretreatment liver fibrosis stage and adjusted for known risk factors for cirrhosis and characteristics affecting treatment selection. The major predictor was a time-dependent covariate for treatment outcome among four patient groups: 1) patients with sustained virological response to treatment; 2) treatment relapsers; 3) treatment nonresponders; and 4) never treated patients. Treatment nonresponders in both cohorts had a statistically significantly increased hazard of cirrhosis compared to never treated patients, as stratified by pretreatment liver fibrosis stage and adjusted for clinical and psychosocial risk factors that disproportionately affect patients who were ineligible for treatment (Veterans Affairs HR=2.35, CI 1.18-4.69, mean follow-up 10 years, and University Hospital HR=5.90, CI 1.50-23.24, mean follow-up 7.7 years). Despite their increased risk for liver disease progression, the overall survival of nonresponders in both cohorts was not significantly different from that of never treated patients.These unexpected findings suggest that patients who receive interferon-α based therapies but fail to clear the hepatitis C virus may have an increased hazard of cirrhosis compared to untreated patients.

    View details for DOI 10.1371/journal.pone.0061568

    View details for Web of Science ID 000318341400014

    View details for PubMedID 23637856

  • AdaptAir: Developing and Commercializing an Accessory Versus a Stand-Alone Product Denend, L., Lockwood, A., Sheen, E., Zenios, S. Program in Health Care Innovation, Stanford Graduate School of Business. Stanford, CA. 2013 ; Global Health Innovation Insight Series
  • D.light II: Market Research and Prototyping in Remote Regions Sheen, E., Denend, L., Zenios, S. Program in Health Care Innovation, Stanford Graduate School of Business. Stanford, CA. 2013 ; Global Health Innovation Insight Series
  • D.light III: Building Credibility and Trust Sheen, E., Denend, L., Stefanos, S. Program in Health Care Innovation, Stanford Graduate School of Business. Stanford, CA. 2013 ; Global Health Innovation Insight Series
  • Health Care Reform and the Road Ahead for Gastroenterology CLINICAL GASTROENTEROLOGY AND HEPATOLOGY Sheen, E., Dorn, S. D., Brill, J. V., Allen, J. I. 2012; 10 (10): 1062-1065

    View details for DOI 10.1016/j.cgh.2012.07.022

    View details for Web of Science ID 000309826200006

    View details for PubMedID 22998684

  • How Five Leading Safety-Net Hospitals Are Preparing For The Challenges And Opportunities Of Health Care Reform HEALTH AFFAIRS Coughlin, T. A., Long, S. K., Sheen, E., Tolbert, J. 2012; 31 (8): 1690-1697

    Abstract

    Safety-net hospitals will continue to play a critical role in the US health care system, as they will need to care for the more than twenty-three million people who are estimated to remain uninsured after the Affordable Care Act is implemented. Yet such hospitals will probably have less federal and state support for uncompensated care. At the same time, safety-net hospitals will need to reposition themselves in the marketplace to compete effectively for newly insured people who will have a choice of providers. We examine how five leading safety-net hospitals have begun preparing for reform. Building upon strong organizational attributes such as health information technology and system integration, the study hospitals' preparations include improving the efficiency and quality of care delivery, retaining current and attracting new patients, and expanding the medical home model.

    View details for DOI 10.1377/hlthaff.2012.0258

    View details for Web of Science ID 000307498200006

    View details for PubMedID 22869646

  • Supreme Court Review of the Affordable Care Act: The Future of Health Care Reform and Practice of Gastroenterology DIGESTIVE DISEASES AND SCIENCES Sheen, E. 2012; 57 (7): 1735-1741

    Abstract

    After decades of failed attempts to enact comprehensive health care reform, President Obama signed the Patient Protection and Affordable Care Act into law on March 23, 2010. The Affordable Care Act (ACA) has been regarded as the most significant piece of domestic policy legislation since the establishment of Medicare in 1965. The ACA would cover an estimated 32 of the 50 million uninsured Americans by expanding Medicaid, providing subsidies to lower income individuals, establishing health insurance exchanges, and restricting insurance companies from excluding patients from coverage. The ACA also includes many payment and health care delivery system reforms intended to improve quality of care and control health care spending. Soon after passage of the ACA, numerous states and interest groups filed suits challenging its legality. Supreme Court consideration was requested in five cases and the Supreme Court selected one case, brought by 26 states, for review. Oral arguments were heard this spring, March 26-28. The decision will have far reaching consequences for health care in America and the practice of gastroenterology for decades to come. This article reviews the four major issues before the Supreme Court and implications for health care reform and future practice of gastroenterology. Payment reforms, increased accountability, significant pressures for cost control, and new care delivery models will significantly change the future practice of gastroenterology. With these challenges however is a historic opportunity to improve access to care and help realize a more equitable, sustainable, and innovative health care system.

    View details for DOI 10.1007/s10620-012-2280-7

    View details for Web of Science ID 000305746100001

    View details for PubMedID 22706991

  • Design that Matters: Designing Contextually-Appropriate Products for Low-Resource Environments Sheen, E., Denend, L., Zenios, S. Program in Healthcare Innovation, Stanford Graduate School of Business. Stanford, CA. 2012 ; Global Health Innovation Insight Series
  • KickStart International: Marketing to Hard to Reach Consumers Sheen, E., Denend, L., Zenios, S. Program in Health Care Innovation, Stanford Graduate School of Business. Stanford, CA. 2012 ; Global Health Innovation Insight Series
  • The East Meets West Foundation: Expanding Organizational Capacity Sheen, E., Denend, L., Zenios, S. Program in Health Care Innovation, Stanford Graduate School of Business. Stanford, CA. 2012 ; Global Health Innovation Insight Series
  • KickStart International: Overcoming Manufacturing Challenges Sheen, E., Denend, L., Zenios, S. Program in Health Care Innovation, Stanford Graduate School of Business. Stanford, CA. 2012 ; Global Health Innovation Insight Series
  • PlayPumps International: Building User Acceptance Sheen, E., Denend, L., Zenios, S. Program in Health Care Innovation, Stanford Graduate School of Business. Stanford, CA. 2012 ; Global Health Innovation Insight Series
  • KickStart International: Measuring Impact Sheen, E., Denend, L., Zenios, S. Program in Health Care Innovation, Stanford Graduate School of Business. Stanford, CA. 2012 ; Global Health Innovation Insight Series
  • KickStart International: Delivering Enduring Solutions Sheen, E., Denend, L., Zenios, S. Program in Health Care Innovation, Stanford Graduate School of Business. 2012 ; Global Health Innovation Insight Series
  • D.light: Securing Early Funding Sheen, E., Denend, L., Stefanos, Z. Program in Health Care Innovation, Stanford Graduate School of Business. Stanford, CA. 2012 ; Global Health Innovation Insight Series
  • The efficacy of entecavir therapy in chronic hepatitis B patients with suboptimal response to adevofir ALIMENTARY PHARMACOLOGY & THERAPEUTICS SHEEN, E., Trinh, H. N., Nguyen, T. T., Do, S. T., Tran, P., Nguyen, H. A., Nguyen, K. K., Garcia, R. T., Nguyen, M. H. 2011; 34 (7): 767-774

    Abstract

    An increasing number of patients with chronic hepatitis B (CHB) have experienced treatment failure to adefovir (ADV) and their management poses a growing challenge. Very limited data are available on the efficacy of entecavir (ETV) in patients previously treated with ADV.To examine the effect of ETV monotherapy on HBV DNA and ALT levels in CHB patients previously treated with ADV, but switched to ETV due to suboptimal response.Study candidates were enrolled from five community gastroenterology clinics in the U.S. Each completed at least 12 months of ETV treatment after being previously treated with ADV and experiencing suboptimal response. Primary and secondary outcome measurements were complete viral suppression (CVS, HBV DNA <100 IU/mL) and biochemical response (BR, ALT < 40 U/L), respectively.A total of 60 patients were included in this analysis. Twelve were lamivudine (LAM)-experienced and none were LAM-resistant. At time of switch to ETV, no patients had experienced CVS. The CVS rate was 68% after 12 months of ETV therapy. The BR rate was 67% at switch to ETV and 80% after 12 months. There was no significant difference in response rates between LAM-experienced and naïve patients. Among the eight patients with ADV resistance, each achieved CVS after 12 months of ETV therapy and seven achieved BR.In patients with suboptimal response to adefovir, complete viral suppression and biochemical response can be achieved in the majority by 12 months after switching to entecavir, including patients with prior exposure to lamivudine and those with adefovir resistance.

    View details for DOI 10.1111/j.1365-2036.2011.04785.x

    View details for Web of Science ID 000294571200008

    View details for PubMedID 21806648

  • Adverse Effects of Long-Term Proton Pump Inhibitor Therapy DIGESTIVE DISEASES AND SCIENCES Sheen, E., Triadafilopoulos, G. 2011; 56 (4): 931-950

    Abstract

    Proton pump inhibitors have an excellent safety profile and have become one of the most commonly prescribed class of drugs in primary and specialty care. Long-term, sometimes lifetime, use is becoming increasingly common, often without appropriate indications. This paper is a detailed review of the current evidence on this important topic, focusing on the potential adverse effects of long-term proton pump inhibitor use that have generated the greatest concern: B12 deficiency; iron deficiency; hypomagnesemia; increased susceptibility to pneumonia, enteric infections, and fractures; hypergastrinemia and cancer; drug interactions; and birth defects. We explain the pathophysiological mechanisms that may underlie each of these relationships, review the existing evidence, and discuss implications for clinical management. The benefits of proton pump inhibitor use outweigh its risks in most patients. Elderly, malnourished, immune-compromised, chronically ill, and osteoporotic patients theoretically could be at increased risk from long-term therapy.

    View details for DOI 10.1007/s10620-010-1560-3

    View details for Web of Science ID 000288512300004

    View details for PubMedID 21365243

  • Toward a 21st-Century Health Care System: Recommendations for Health Care Reform ANNALS OF INTERNAL MEDICINE Arrow, K., Auerbach, A., Bertko, J., Brownlee, S., Casalino, L. P., Cooper, J., Crosson, F. J., Enthoven, A., Falcone, E., Feldman, R. C., Fuchs, V. R., Garber, A. M., Gold, M. R., Goldman, D., Hadfield, G. K., Hall, M. A., Horwitz, R. I., Hooven, M., Jacobson, P. D., Jost, T. S., Kotlikoff, L. J., Levin, J., Levine, S., Levy, R., Linscott, K., Luft, H. S., Mashal, R., McFadden, D., Mechanic, D., Meltzer, D., Newhouse, J. P., Noll, R. G., Pietzsch, J. B., Pizzo, P., Reischauer, R. D., Rosenbaum, S., Sage, W., Schaeffer, L. D., Sheen, E., Silber, M., Skinner, J., Shortell, S. M., Thier, S. O., Tunis, S., Wulsin, L., Yock, P., Bin Nun, G., Bryan, S., Luxenburg, O., van de Ven, W. P. 2009; 150 (7): 493-?

    Abstract

    The coverage, cost, and quality problems of the U.S. health care system are evident. Sustainable health care reform must go beyond financing expanded access to care to substantially changing the organization and delivery of care. The FRESH-Thinking Project (www.fresh-thinking.org) held a series of workshops during which physicians, health policy experts, health insurance executives, business leaders, hospital administrators, economists, and others who represent diverse perspectives came together. This group agreed that the following 8 recommendations are fundamental to successful reform: 1. Replace the current fee-for-service payment system with a payment system that encourages and rewards innovation in the efficient delivery of quality care. The new payment system should invest in the development of outcome measures to guide payment. 2. Establish a securely funded, independent agency to sponsor and evaluate research on the comparative effectiveness of drugs, devices, and other medical interventions. 3. Simplify and rationalize federal and state laws and regulations to facilitate organizational innovation, support care coordination, and streamline financial and administrative functions. 4. Develop a health information technology infrastructure with national standards of interoperability to promote data exchange. 5. Create a national health database with the participation of all payers, delivery systems, and others who own health care data. Agree on methods to make de-identified information from this database on clinical interventions, patient outcomes, and costs available to researchers. 6. Identify revenue sources, including a cap on the tax exclusion of employer-based health insurance, to subsidize health care coverage with the goal of insuring all Americans. 7. Create state or regional insurance exchanges to pool risk, so that Americans without access to employer-based or other group insurance could obtain a standard benefits package through these exchanges. Employers should also be allowed to participate in these exchanges for their employees' coverage. 8. Create a health coverage board with broad stakeholder representation to determine and periodically update the affordable standard benefit package available through state or regional insurance exchanges.

    View details for Web of Science ID 000265117600008

    View details for PubMedID 19258550

  • Eliminating Improper Payments: A Review, Framework for Action, and Seven Fundamental Questions Journal of Government Financial Management Sheen , E. 2006; 55 (4): 45-51