Paul M. Ellwood Jr.
Paul M. Ellwood Jr. | |
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Born | neurologist | July 16, 1926
Paul Murdock Ellwood Jr. (July 16, 1926 – June 20, 2022) was an American physician and a controversial figure in
Ellwood began his career as a
Biography
Ellwood was born to Paul and Mary (Logan) Ellwood on July 16, 1926, in
Health maintenance organizations and managed competition
In 1970
In 1971, Ellwood founded the Jackson Hole Group, a "loosely organized but highly regarded" group of politicians, providers, and policymakers who came together in the town of
Controversy over HMOs
Subsequently, when the Clinton administration was grappling with health care reform, the Jackson Hole Group, according to The New York Times, was "one of the most important influences in the shaping of the Clinton plan."[15] The plan was called managed competition, and two of its most prominent advocates from the Jackson Hole Group were Ellwood and Alain Enthoven. In essence, the concept was that groups of health care providers and insurers would compete with each other to get the business of large cooperatives seeking insurance. In the end the Clinton reform plan collapsed. By then, the Jackson Hole Group had distanced itself due to disagreement about the degree of regulation the plan sought to impose, and Ellwood had become a pioneer in outcomes management.[16]
The spread of HMOs and other pre-paid health plans has spawned significant debate about the impact on quality of care. From the beginning, critics argued that pre-paid competitive plans like HMOs provided incentives for doctors and hospitals to "skimp" on care.
Outcomes management
Ellwood's concern about the importance of measuring health outcomes that would hold health providers accountable for quality dated to the mid-1960s. In 1968, as an adviser to the Johnson administration, he devised the plans for the establishment of U.S. Agency for Healthcare Research and Quality (AHRQ). He would become increasingly vocal about the need for evidence-based medicine and outcomes accountability.
In 1988, he was invited by the Massachusetts Medical Society, which publishes The New England Journal of Medicine, to deliver their annual Shattuck Lecture. He called for "a national database containing information and analysis on clinical, financial, and health outcomes that estimate as best we can the relation between medical interventions and health outcomes, as well as the relation between health outcomes and money."[23] He envisioned a sort of health plan "report card" that would allow patients to make informed choices among health plans based on health outcomes for specific conditions and patients’ reports of their satisfaction. He argued that there is extraordinary variation in the quality-performance of different doctors and health institutions, yet patients, insurers, policymakers, and even other doctors have few tools for assessing quality. Similarly, doctors and patients often choose medical interventions with only limited information about the effectiveness of various treatments and how they impact patients' quality of life; a health outcomes database would vastly improve the information available when making such decisions. Finally, a health outcomes database would guide policymakers and large providers in the overall design of health systems. The Mayo Clinic and some health providers have begun to experiment with outcomes management.[24]
Personal life
Ellwood and his former wife, Elizabeth Ann Schwenk,
Publications
1970–1979
- Kottke, Frederic J.; Krusen, Frank H.; Ellwood, Paul M. Jr. (1971). Handbook of Physical Medicine and Rehabilitation. W. B. Saunders.
- Ellwood, Paul M. Jr.; Anderson, Nancy N.; Billings, James E.; Carlson, Rick J; Hoagberg, Earl J.; McClure, Walter (May–June 1971). "Health Maintenance Strategy". Papers from the Workshop on International Studies of Medical Care. Medical Care. 9 (3). Lippincott Williams & Wilkins: 291–298. PMID 5562097.
1980–1989
- Paul M. Ellwood Jr. (January 1988). "Health care delivery update: Part 1. Trends: less and more integration, bundled services, rethinking IPAs". Consultant. 28 (1): 86–8, 91–2, 95. PMID 10312478.
- Paul M. Ellwood Jr. (April 1988). "Health care delivery update: Part 2. Banking on quality: the call for a quality reserve system". Consultant. 28 (4): 92–3, 99–100. PMID 10286733.
- Paul M. Ellwood Jr. (June 9, 1988). "Outcomes Management". New England Journal of Medicine. 318 (23): 1549–1556. PMID 3367968.
- Paul M. Ellwood Jr. (January 13, 1989). "Ellwood explains his theory, terminology on outcomes method of managing care". Modern Healthcare. 19 (2): 30, 32. PMID 10291283.
1990–1999
- Paul M. Ellwood Jr.; A. Enthoven (1996). "Responsible Choices for Achieving Reform of the American Health System". Journal of the Society for Health Systems. 5 (2): 15–28. PMID 8982990.
- Paul M. Ellwood Jr. (May 13, 1996). "How doctors can regain control of health care". Medical Economics. 73 (9): 178–80, 185–8, 191–2. PMID 10157443. Interview by Stephen Murata.
- B. S. Scheur; P. M. Ellwood Jr.; et al. (June 1996). "Empowered patients buy more efficient care ... roundtable of experts". Business and Health. 14 (6): 35, 38–40, 42. PMID 10159022.
- Paul M. Ellwood Jr.; George D. Lundberg (October 1996). "Managed care: a work in progress". JAMA: The Journal of the American Medical Association. 276 (13): 1083–1086. PMID 8847772.
2000–2009
- Paul M. Ellwood Jr. (October 22, 2001). "Does managed care need to be replaced?". MedGenMed. 3 (5): 5. PMID 11698912.
- Berwick, D. M.; DeParle, N. A.; Eddy, D. M.; et al. (November–December 2003). "Paying For Performance: Medicare Should Lead". Health Affairs. 22 (6): 8–10. PMID 14649428.
- Paul M. Ellwood; Alain C. Enthoven; Lynn Etheredge (October 1992). "The Jackson Hole initiatives for a twenty-first century American health care system". Health Economics. 1 (3). Wiley Subscription Services, Inc., A Wiley Company: 149–168. PMID 1341934. Article first published online: September 18, 2006.
- Ellwood, Paul M. Jr. (2005). "Models for organizing health services and implications of legislative proposals" (PDF). The Milbank Quarterly. 83 (4): 1–31. Reprinted from The Milbank Memorial Fund Quarterly, Vol. 50, No. 4, Pt. 2, 1972, pp. 73–101. JSTOR 3349435.
References
- ^ See, for instance, Toner, Robin (February 28, 1993). "Hillary Clinton's Potent Brain Trust on Health Reform". The New York Times. p. Section 3, p. 1. and Michael Booth, "The Latest from the Father of the HMO", Corporate Report Minnesota, cover story, October 1991.
- ^ In "New Optimism from the Father of the HMO, An Interview with Paul Ellwood Jr., MD", Managed Care (November 1997), Ellwood reports he coined the term in May 1970 for the Nixon Administration.
- ISBN 0-465-07935-0.
- ^ "Our Ailing Medical System: It's Time to Operate". Fortune. New York, Harper & Row. January 1970.
- ^ U.S. Congress, Office of Technology Assessment (July 1994). Managed Care and Competitive Health Care Markets: the Twin Cities Experience (PDF) (Report). Washington, DC: U.S. Government Printing Office. OTA-BP-H- 130.
- ^ a b c Kovner, Anthony R. (September 16, 2010). "Paul M. Elwood Jr., M.D. In First Person: An Oral History" (PDF). American Hospital Association Center. Retrieved February 5, 2012.
- ^ ISSN 0362-4331. Retrieved June 21, 2022.
- ^ a b c d e Who's Who in Health Care. Hanover Publications. 1981. p. 136.
- PMID 11698912.
- ^ .
- ^ Frederic J. Kottke; Paul M. Ellwood, eds. (1966). Handbook of physical medicine and rehabilitation. Saunders. Retrieved February 5, 2012.
- OL 4577108M.
- ^ "Gold Key Award Winners". American Congress of Rehabilitation Medicine. Retrieved February 5, 2012.[permanent dead link]
- ^ See for instance "Jackson Hole Revisited: How a Group of Health Policy Thinkers Transformed the Nation's Healthcare System", Health Leaders, June 2001; Richard L. Clarke, "Paul M. Ellwood, MD: Reforming Health Care from Jackson Hole", Healthcare Financial Management, November 1994; and Amy Snow Landa, amednews staff, "Jackson Hole Group Hopes to Spark a Revival", American Medical Association, amednews.com, June 10, 2002.
- ^ Toner, Robin (February 28, 1993). "Hillary Clinton's Potent Brain Trust on Health Reform". The New York Times. pp. section 3, page 1. Retrieved February 5, 2012.
- ^ See Emling. Also Amy Snow Landa, amednews staff, "Jackson Hole Group Hopes to Spark a Revival", American Medical Association, amednews.com, June 10, 2002. For Ellwood’s critique of the Clinton plan, see Paul M. Ellwood, "Balance the Health Budget," The New York Times editorial, December 6, 1993, p. 10.
- Business Week, October 21, 1985.
- ^ Erik Eckholm, "On 'Managed Competition': Primer on Health-Care Idea", The New York Times, May 1, 1993, provides a discussion over managed competition, including critiques from both the left and right.
- ^ Starr, Paul (Winter 1976). "The Undelivered Health System". The Public Interest (42). Retrieved February 5, 2012.
- PMID 3710412.
- ^ American Hospital Association interview, p. 16.
- ^ For a discussion of the debates over HMOs and the evolution of Ellwood's thinking, see Lisa Belkin, "But What About Quality?", The New York Times Magazine, December 8, 1996.
- PMID 3367968.
- PMID 7988991.
- ^ Belkin, Lisa (December 8, 1996). "But What About Quality?". The New York Times. Retrieved February 6, 2012.
- ^ The cover subheading read, "The visionary father transformed the American way of health. The visionary son redefined the American way of welfare. Now both are struggling to rescue their reforms." Lisa Belkin, "But What About Quality?" (on Paul Ellwood), and Jason DeParle, "Mugged by Reality" (on David Ellwood), The New York Times Magazine, December 8, 1996.
External links
- Paul Ellwood and the Genesis of Managed Health Care
- Only Government Has the Clout To Fix Broken Health Care System—Managed Health Care Magazine
- Timeline at Managed Care Museum
- Ellwood, Paul M. at the Encyclopedia of Health Services Research
- Paul M. Ellwood; Walter F. Mondale[dead link] at Life