UVM lab Explores Health Economics
August 2, 2013
BURLINGTON, Vt. -The cost of health care continues to increase every year, but there is work under way at the University of Vermont and Fletcher Allen Healthcare to study so-called health care economics."Health economics is about improving outcomes and reducing costs, saving money, saving lives," said Christopher Jones, a professor of surgery and professor of economics at the University of Vermont. He is also the Director of the Global Health Economics Unit in UVM's College of Medicine.The unit is part of The center for Clinical and Translational Sciences which focuses on bringing better techniques to patient's bedsides."So this is about establishing new ways to treat diseases, field testing those in a lab setting, bringing those swiftly to the patient who needs them and then understanding those patients as populations so we can then go back and work on the next set of research questions," Jones said. And the work takes Jones around the world, because other countries are interested in this topic as well. One example of the center's work happens in UVM's simulation laboratory, where procedures are practiced and streamlined over and over again than transitioned into a real hospital setting.The lab opened in 2011. Medical students, nursing students and medical professionals work together to teach and learn and improve the care that will eventually be given to real patients. This work resulted in a new way to administer what is called a central line -- a catheter that is inserted in the neck to deliver fluids and medicine. The new technique cuts down on infections and complications.Dr. Ted James is the Medical Director of the Clinical Simulation Laboratory. "When we implemented that into our hospital system we actually found that decreased the rate of those complications. We tracked it for 14 months and found we reduced it to zero -- zero central line infections. That is an incredible value for the patient, much higher quality of care and also reduces the cost from treating those complications -- the estimate was 5 to 7 million dollars for that one year," Dr. James said.And while that is one example of health economics, Jones says much more work needs to be done. "There are no silver bullets. Everything comes at a cost and if we are just able to get some efficiency in and placing our money on the most prudent bets, that is where we get real value for our money," he said.And in the process, improve patient outcomes. For more information:
Health Economist Jones Sheds New Light on Treatments, Links Medicine and Business
March 19, 2012
The economy, like the weather, has its ups and downs and prompts daily discussions and even national movements. Health care follows a similar pattern. Bring the two topics together and you have health economics – the examination of health care interventions, the respective cost of these treatments, and the resulting outcomes in populations.Health economist Christopher Jones, Ph.D., assistant professor of surgery and director of the Global Health Economics Unit at the University of Vermont’s Center for Clinical and Translational Science, says the health economist’s point of view can “shine light” on which medical interventions are best from the standpoint of reducing costs while improving patient outcomes. He currently collaborates with surgeons, behavioral psychologists, and obstetrics and gynecology specialists at UVM and Fletcher Allen Health Care to create models that predict the best course of action for treating a specific condition. His current research focuses on using incentives to attain cost-effective and cost-beneficial treatments for chronic disease.This month, the Institute for Clinical and Economic Review (ICER), a leading academic comparative effectiveness research group based at the Massachusetts General Hospital’s Institute for Technology Assessment, announced that Jones was among a group of new members named to the 2012 New England Comparative Effectiveness Public Advisory Council (CEPAC). The 19 members of CEPAC come from all six New England states. The group’s goal is to provide objective, independent guidance on the application of medical evidence to clinical practice and payer policy decisions across the region. Supported by a federal grant from the Agency for Healthcare Research and Quality (AHRQ), and with backing from a consortium of New England state health policy leaders, CEPAC consists of practicing physicians and methodologists with experience in evaluating and using evidence in the practice of healthcare, as well as patient/public members with experience in health policy, patient advocacy and public health.Jones brings unique expertise to CEPAC and UVM. A native of Gilford, N.H., he earned a bachelor’s degree from the University of Michigan, and Master of Science and Doctor of Philosophy degrees from the University of Oxford in England. His doctoral dissertation was the first to examine cost of treatments and cost of outcomes following treatments of in-vitro fertilization, as an interaction and at the population level, an endeavor which eventually led to national policy changes.Prior to joining the UVM faculty in 2011, Jones worked in international finance and in industry, most recently as director of global health economics for a publicly traded pharmaceutical firm specializing in rare diseases. He spent five years collaborating with the National Institute for Health and Clinical Excellence (NICE) in London where he served as health economist for the Royal Institute of Psychiatrists’ National Guideline Development Group on six U.K. mental health initiatives. This experience included evaluating voucher-based incentive programs for treating substance misuse and changing health-related behaviors. Today, Jones relies on that voucher-based incentive program experience in his work with Stephen Higgins, Ph.D., professor of psychiatry, who essentially established the voucher incentive system working with cocaine-dependent individuals more than 25 years ago. They are incentivizing women to lose weight pre-pregnancy and will then examine the impact of this pre-pregnancy weight loss on the caesarean section rate. A 2003 AHRQ study found that the average charge for childbirth-related hospitalizations was $8,300, but varied widely depending on whether the delivery was vaginal or C-section, with C-sections with complications averaging 2.5 times the average charge for vaginal births without complications.For another study, he is collaborating with faculty in obstetrics, gynecology and reproductive sciences, and involving several medical students, to study infertility treatment on several levels. Jones, who created an algorithm that provided the foundation for a fertility prediction tool housed at www.formyodds.com, is mentoring Class of 2013 medical student Olivia Carpinello. She and Jones are looking at the cost-effectiveness of different embryo transfer policies used for in vitro fertilization (IVF) from a national perspective, using Society for Assisted Reproductive Technology data.Working with Andrew Stanley, M.D., UVM associate professor of surgery and a vascular surgeon at Fletcher Allen, Jones is developing predictive cost-effectiveness models related to carotid artery surgery in New England, another project that hopes to incorporate incentives in a study of carotid endarterectomy patients.“Smokers are more likely to need to come back for vascular problems and they consume scarce resources,” says Jones, who hopes to find answers to these questions: “Can incentives help doctors and caregivers get better and better at what they do, which is how bonuses work in the business world? Can the patient be paid to do what’s ultimately right for them, keep a healthy lifestyle, tell us how they’re doing and reduce the need for costly care so that more money and time are available at the end of the day?”“Metaphorically, I’m surgically dissecting the healthcare system,” Jones explains.
New Study Predicts Success of In Vitro Fertilization
July 17, 2008
TimeCHICAGO--(BUSINESS WIRE)--A method that is up to 80 percent accurate in determining whether a woman undergoing in-vitro fertilization (IVF) will take home a baby has been developed by Dr. Christopher Jones, CEO of FORMYODDS.COM. The report will be submitted for publication later this month.“This is an aid to patients considering IVF but not a substitute for a medical diagnosis.”Based on 20 predictive variables, the model was tested using one of the world’s largest IVF datasets comprising over 170,000 treatment cycles. “FORMYODDS.COM is such a breakthrough because it predicts the take-home baby rate using population-based data,” Dr. Jones said.What started as research has led to a website. For women or couples using FORMYODDS.COM, predictions come in the form of a simple report which all parties can discuss with their doctor. “Stated simply, if one hundred women with similar clinical characteristics underwent an IVF cycle using 1, 2 or 3 embryos, a certain number will give birth. Of those who give birth, a certain percentage will give birth to twins. Knowing these percentages can help with many planning aspects such as the timing of treatment,” says Dr. Louis Keith.Dr. Hamisu Salihu, Professor of Epidemiology and Biostatistics at the University of South Florida, who confirmed the findings, said, “This is the pot of gold at the end of the rainbow for women contemplating IVF. The site predicts the take-home baby rate and multiple birth rate – two important rates to know.”What if today is not the right time for IVF? FORMYODDS.COM shows what will happen if the next IVF cycle is completed within one month, compared with next year, five years or after additional cycles of IVF. “Women need to know their chances under real scenarios," says Dr. Timothy R. B. Johnson, Chair of Obstetrics and Gynecology at the University of Michigan, and “FORMYODDS.COM pools all the variables together in a manner that is meaningful for the fertility doctor, cost-effective and immediately useful for counseling.”Dr. Jones cautions, “This is an aid to patients considering IVF but not a substitute for a medical diagnosis.” Further information is available atwww.formyodds.com.
VT gov. denies rising health-care costs
Feb. 4, 2014
BURLINGTON, Vt. – Vermont Gov. Peter Shumlin denies health insurance costs are rising, despite contrary evidence.The cheapest monthly health insurance premium under the Obamacare state exchange in Vermont — Vermont Health Connect — will be $413, says PricewaterhouseCoopers, an international consulting firm headquartered in London.PwC’s findings are comparable to other studies, which Vermont Watchdog has reported. The Manhattan Institute, a New York-based free-market think tank, suggested health insurance premiums would increase by a whopping 157 percent under the new system.Vermont Watchdog asked Shumlin about that report, but he denied its credibility.“If it were true, we wouldn’t be doing it,” Shumlin responded.Vermont Watchdog asked Shumlin’s office to respond to PwC’s report, released just last week, but, so far, no response is forthcoming.According to a summary of its findings, PwC’s “(Health Research Institute) examined unsubsidized monthly exchange premiums for a 27-year-old and a 50-year-old in metropolitan areas across the US … The second-lowest-cost silver plans — which are used to determine an individual’s tax credit — were mapped from state-based exchanges and HealthCare.gov to capture a full 50-state snapshot.”A 27-year old living in Chittenden County, Vermont’s most populous county, would be expected to pay anywhere from $395-$429 per month for one of the so-called silver plans, PwC says. A 50-year old living in the same area would pay the same amount for monthly.coverage.Government subsidies are likely to ease the burden of higher costs, but the subsidies are limited and not available for everyone.The amount in health insurance cost subsides one can receive depends on annual income, according to the Washington-D.C. based economic think tank Center on Budget Policies and Priorities. For example, a person making $11,490 to $15,282 annually will receive a 94 percent reduction in the price of their health coverage; a person making 40,215 to $45,960 will receive only a 70 percent reduction.While PwC said it predicts generally higher costs in the Northeast, health insurance prices in the Green Mountain State are expected to climb even higher. Weaker competition and high-cost providers are partly to blame, but so are the generous benefit mandates, the levels of management needed to run the exchange and the uncertainty among health insurers’ regarding who they will need to cover.“(Insurance companies) have to build in what is an older, sicker group of people signing up for health care for the first time,” Darcie Johnston, president of Vermonters for Health Care Freedom, said about the increased costs.Johnston said the shortage of providers dates back to the early 1990’s, when she said other health-care providers were “driven out” because of community ratings. Johnston said the report’s numbers are only based on what insurers expect will happen.“Yet they might not be high enough. The costs might go up even more,” she said.In Vermont, only two health insurers are participating in the exchange: MVP andBlue Cross Blue Shield of Vermont. Between the two providers, consumers can choose from a total of six bronze and silver plans. Because bronze plans are the cheapest available and silver plans are the only plans eligible for cost-sharing subsidies, it’s predicted the plans will be the most popular in the exchange.Chris Jones, an assistant professor of surgery at the University of Vermont Global Health Economics Unit, said the absence of more health insurance providers in Vermont is understandable, based on its size.“It’s a small state so by definition there’s weaker competition,” said Jones.”There’s no real money in it for them, aside from name recognition. Jones also acknowledged that reform efforts will cause “sticker shock” for some residents, particularly young people.That doesn’t surprise Massachusetts Institute of Technology economics professorJon Gruber, who said, ”Vermont has always had high medical costs, as have most Northeastern states. On top of that you don’t have a very competitive insurance market, which further raises premiums.”Contact Jon Street at and find him on Twitter @JonStreet.