Miriam Laugesen

Miriam Laugesen

Miriam Laugesen

A problem well stated is a problem half-solved. (Charles Kettering)
Associate Professor
Health Policy and Management
Director, Faculty Lead, Certificates in Health Policy (Policy Analysis and Policy Analysis and Practice)

Office/Address:

Department of Health Policy and Management, Columbia University Mailman School of Public Health, 722 West 168th Street, Fourth Floor, MSPH Box 14
New York NY USA 10032
Phone:
212-304-5264
Fax:
212-305-3405
Website address: Email: Twitter: CV:

Biography

Miriam Laugesen is a political scientist and health policy researcher who studies healthcare prices and cost containment in the United States and other countries, medical interest groups' role in health policy, the regulatory process in agencies, and social and healthcare service integration.

She is the author of Fixing Medical Prices: How Physicians are Paid (Harvard University Press, 2016). The book goes to the heart of the U.S. medical pricing process, "lifting the hood" (Health Affairs) on a largely unknown, yet highly influential committee of medical organizations. Because changes in Medicare fees influence fees paid by (among others) private insurers and many state programs, or almost 20 percent of U.S. healthcare expenditure, the committee has an outsized influence on U.S. healthcare. Described as "a superb book" (Bulletin of the History of Medicine), and "a beautiful book" (Harold Pollack, University of Chicago), Fixing Medical Prices extended and solidified Laugesen's research agenda around Medicare physician payment policy and the contemporary role of medical organizations in health policy.

Currently, Laugesen is a Tow Foundation Faculty Scholar, an award for mid-career faculty that recognizes outstanding and innovative research and thought leadership. As part of a body of growing health policy and health economics research on the importance of pricing as a contributor to higher U.S. health expenditure, her work on physician fees has helped raise awareness among other scholars, the medical profession, policymakers, journalists, and the public, that U.S. physician fees are substantially higher that elsewhere, although notably, most procedural and surgical services show larger price differentials than primary care services. In other papers she has addressed a wide range of health policy topics, including state and local public health policies in the U.S. and New Zealand, public opinion, children's health insurance coverage expansions, and state health insurance benefit regulation.

At the Mailman School, she is the faculty lead for two certificates, the Certificate in Health Policy Analysis (HPM students), and the Certificate in Health Policy and Practice (students in other departments). She is the current President of the American Political Science Association's Health Politics and Policy Section, and she serves on the AcademyHealth Education Council, which advises the AcademyHealth Board on training and health services research workforce issues. She is the Book Review Editor for the Journal of Health Politics, Policy and Law and a member of several editorial boards.

Laugesen completed postdoctoral training at RAND/University of California, Los Angeles in health services research, and received her PhD from the University of Melbourne (Australia) in political science. Her doctoral level training incorporated coursework in the Government Department and at the John F. Kennedy School at Harvard University. She received a Master of Arts in political science from Washington University in St Louis, where she was a Fulbright Scholar, and completed her undergraduate training at Victoria University (New Zealand) where she was awarded a first-class honours degree in public administration and politics.

Topics

Education

PhD, 2000, University of Melbourne, Australia
MA, 1993, Washington University in St. Louis
BA, 1992, (First Class Honors) Victoria University of Wellington, New Zealand
Other, 1997, Harvard University Health Policy PhD Program (non-degree program)

Mailman Affiliations

Faculty , Obesity Prevention Initiative
Certificate Lead for Health Policy Certificates, Department of Health Policy and Management

Editorial Boards

Health Economics, Policy and Law
Journal of Health Politics, Policy and Law
Journal of Health Services Research and Policy

Columbia Affiliations

Other Affiliations

Honors & Awards

Gold Award, Legislative/Government Article, Association of American Society of Healthcare Publication Editors, with Kim Isett and David Cloud
Leonard S. Robins Best Paper Award 2014, American Political Science Association, Section on Health Politics and Policy. For best health politics paper presented at the 2013 Annual Meeting
Robert Wood Johnson Investigator Award in Health Policy Research, 2009
Fulbright Graduate Scholar, 1992

Areas of Expertise

Health Systems Strengthening, Healthcare Financing, Healthcare Policy, Healthcare Providers, Healthcare Reform, Healthcare Regulation, Healthcare Workers

Select Urban Health Activities

Mainstreaming Public Health in the Bloomberg Administration: A Model for Reform?: Dr. Laugesen was a co-investigator on a project led by Professor Kim Isett on the expansion of public health policies under Mayor Bloomberg. The study was funded by the Robert Wood Johnson Foundation. The project addressed three key questions (1) how were widespread reforms passed and implemented, (2) have these policies been effective, and will they be sustained, and, (3) what lessons, if any, can other cities learn from Mayor Bloomberg's approaches in New York?

Select Global Activities

Democratic Governance and Health [book] (Completed 2012): Governments in many countries are interested in increasing public participation in health care policy decision-making. One option is to create elected health boards of citizen representatives serving specific geographic areas. New Zealand is the only country in the world where elected health boards have been a core and enduring feature of the governance of its health system since the 19th Century. Elected boards have survived health system reform attempts by governments on the left and right. Much like Social Security in the US, this 'third rail' issue is one that generally receives strong public support. One attempt in the 1990s did succeed; hospitals were depoliticized and required to operate as profitable businesses. That effort ran aground, due to voter resistance (see Laugesen, "Why Some Market Reforms Lack Legitimacy" 2005). Democratic Governance in Health, coauthored by Miriam J. Laugesen and Robin Gauld was published by Otago University Press in 2012. It critically surveys the origins and endurance of elected boards in New Zealand, drawing on original archival research as well as recent survey data. The authors dispassionately consider the boards in the context of changing priorities of a regionalized, quality-oriented health care system in New Zealand.
Insurance coverage and health care across borders (Completed): Previously, most analyses of insurance coverage and healthcare across borders explored specific countries or regions. European analyses often focused on treatment for specialty or high-cost services. In contrast, the high cost of US healthcare and the lack of basic coverage motivates some people to travel to Mexico for routine health care services. With Professor Arturo Vargas-Bustamante (UCLA), Dr. Laugesen sought to develop a more universal conceptual framework that would "travel" across a variety of health care system types, and reflect differences in insurance coverage and health care costs. The authors presented the framework at a European Consortium for Political Research workshop in 2009, and the paper was published in Health Policy in 2010. Next, with colleagues from the University of Texas, Dr. Laugesen and Dr. Vargas Bustamante researched how Medicare could potentially cover US retirees living in Mexico at a lower cost than in the US, and how uninsured Mexican nationals in the US could receive coverage through public programs sponsored by Mexico, or through private insurance plans operating in California. This analysis was published in Revista Panamericana de Salud/Pan American Journal of Public Health (with M. Caban, & P. Rosenau) in 2012.
Fixing Medical Prices: International Evidence from Better Health Systems (2016-): Accurate healthcare pricing of physician services is fundamental for creating the right incentives in a healthcare system. We are studying fee-for-service reimbursement, alternative payment models, and the use of incentive payments in a selected number of high-income countries to evaluate the advantages and disadvantages of different payment methods. The project also aims to identify strategies countries use to balance prices, utilization and expenditure suitable for adoption in the US by private and public payers. PI: Miriam Laugesen with Michael Gusmano (Rutgers), Lawrence Brown (Columbia), Victor Rodwin (NYU)

Select Publications

Laugesen, Miriam J. 2019. How the American Medical Association's Rent-Seeking Strategy Compensated for Its Loss of Members. Journal of Health Politics Policy and Law 44 (1): 67-85.
L Gross, Tal and Miriam J. Laugesen. 2018. "The Price of Health Care: Why Is the United States an Outlier?" Journal of Health Politics Policy and Law October 43 (5): 771-791.
Laugesen, Miriam J. 2018. Regarding "Committee Representation and Medicare Reimbursements: An Examination of the Resource-Based Relative Value Scale" Health Services Research 53(6): 4123-4131.
Laugesen, Miriam J. 2018. Do Other Countries Have a Better Mix of Generalists and Specialists? Journal of Health Politics Policy and Law 43 (5): 853-872.
Spivack, Steven B., Miriam J. Laugesen, Jonathan Oberlander. 2018. No Permanent Fix: MACRA, MIPS, and the Politics of Physician Payment Reform. Journal of Health Politics Policy and Law 43 (6): 1025-1040.
Laugesen, M.J. (2016) Fixing Medical Prices: How Physicians are Paid. Cambridge: Harvard University Press. http://www.hup.harvard.edu/catalog.php?isbn=9780674545168
Oberlander, J. and M.J. Laugesen. 2015. Leap of Faith: New Physician Payment System. New England Journal of Medicine 373 (13) September 24, 1185-1187.
Laugesen, M.J. and R. Gauld. 2012. Democratic Governance and Health: Hospitals, Politics and Health Policy in New Zealand. Dunedin: Otago University Press Dunedin.
Laugesen, M.J., R. Wada and E. Chen. 2012. In Setting Doctors' Medicare Fees, CMS Almost Always Accepts The Relative Value Update Committee Panel's Advice on Work Values Health Affairs 31 965-972.
Laugesen, M.J. and S.A. Glied 2011. Higher Fees Paid to US Physicians Drive Higher Spending for Physician Services Compared to Other Countries Health Affairs 30 1647-1656 2011

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