2014 Healthcare Report

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INNOVATIONS IN HEALTHMarch 27 - 28, 2014 | Cambridge, MA

EXECUTIVE SUMMARYA synthesis o ideas rom the Harvard University

Advanced Leadership Initiative Think Tank


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Innovations in Health: Executive Summa

7 Advanced Leadership Initiative

Innovations in Health:Executive Summary

March - , | Cambridge, MA

INNOVATIONS IN HEALTH CHAIRS

Barry R. Bloom

Harvard University Distinguished Service Proessor

Joan L. and Julius H. Jacobson Proessor o Public Health

Harvard School o Public Health

Co-Chair, Advanced Leadership Initiative

Michael Chu

Senior Lecturer

Harvard Business Schoo

ADVANCED LEADERSHIP INITIATIVECHAIR AND DIRECTOR

Rosabeth Moss Kanter

Ernest L. Arbuckle Proessor o Business Administration

Harvard Business Schoo


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EXECUTIVE SUMMARY CREDITS

Valerie L. Denomy

Managing Director, Advanced Leadership Initiative

[email protected]

Michael Perry

Communications Manager, Advanced Leadership Initiative

[email protected]

2014 President and Fellows o Harvard College


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Advanced Leadership Initiative

TABLE OF CONTENTS

Executive Summary

Background: Health Care is a System

The Consensus: Americas Health Care System is Broken

Health Care Reorm

Bringing About Policy Changes

Health System Transormation in Turkey

Other Health System Innovations

Designing the Ideal U.S. Health Care System

APPENDICES

Appendix : Think Tank Agenda

Appendix : Think Tank Speakers

Appendix : Advanced Leadership Faculty

Appendix : Advanced Leadership Fellows


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Executive SummaryUnlike ALIs previous our Think Tanks on Health, this Think Tank was an experiment. First, Think

Tank participants heard rom speakers who provided background on the health care system in the

United States, the issues associated with this system, how the U.S. health care system compares with

that o other developed countries, and how the Affordable Care Act was implemented to bring about

change. Think Tank participants then learned about systemic innovations taking place in Turkey and

other countries around the world that are improving access to health care, the delivery o health care

services, and the quality o care that is being delivered.

Equipped with this background inormation, Think Tank

participants then divided into seven smaller groups to answer

the question, What do you want in a health care system?

Groups were tasked with determining where the U.S.

health care system should go, what values should guide this

transormation, what major obstacles would impede progress,

and what could be done to overcome these obstacles. In

envisioning Americas uture health care system, Think Tank

participants shared many common values and ideas.

KEY THEMES

Throughout the course o the Innovations in Health Think Tank, several major themes emerged.

Among them were:

The generally recognized goals of a health system are undamentally to improve the health opopulations, to provide health security and prevent impoverishment, and to provide patient orconsumer satisaction.

The significance of health care.Health care represents % o the global economy and .% o

U.S. GDP. As the population in developed countries ages, spending on healthcare will continue togrow. But behind the economic significance, health care affects peoples quality o lie and theirpersonal and financial security.

Health care is delivered through a health system. A health system is all o the activities in asociety to promote, restore, or maintain health. Systems deliver the results that they are designedto deliver. Thereore, achieving different results requires changing the system.

The health system in the United States is broken.While political leaders oten proclaim, TheU.S. has the best health care system in the world, this is not supported by the data. The U.Shas significant issuesand perorms below other countriesin terms o access, quality, cost,and equity. As the prevalence o chronic diseases grows, these issues will be exacerbated. Theseissues are systemic in nature and thereore require systemic solutions.

Transformation is necessary in the United States. Isolated delivery systems in the UnitedStates work well, such as those o Kaiser and Mayo Clinic. While these systems deliver care inan integrated, team-based environment, the U.S. must bring about broad change throughoutthe entire national health system. The U.S. health system requires transormational change,not incremental repairs. The participants generally supported the Affordable Care Act (ACA)especially its goals o expanding coverage and changing reimbursement to be more value-basedbut it was only seen as a starting point. The ACA has addressed the problem o access,but not the challenge posed by cost. Political paralysis has hindered continual improvement tothis legislation. Additional steps are required to bring about transormation.

Health care

is systemic. Tosolve systemicissues is what itsall about . . . itsabout trying tosolve problemsthat really mat-ter and problemsthat really matterrequire systemicchallenges.

Michael Chu, Professor,

Harvard Business School Barry Bloom and Michael Chu


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Health system innovations are taking place around the world.Countries are transorming theirhealth systems. Turkey has achieved universal coverage and improved outcomes in a remarkablyshort period, based on strong government support or and leadership o transormation.The United Kingdom has transormed its health system, and transormative innovations aretaking place in countries such as France, Germany, the Netherlands, Brazil, and China. Thesetransormations oten involve financial support, changes in the reimbursement model (to global

or bundled payment), use o technology, a community health ocus, and appropriate, well-trainedlabor. While the health systems o virtually all nations continue to ace difficult issues o long-term economic viability, no OECD country seems as stalled as the U.S. The U.S. can learn rom,and reapply, best practices rom around the world.

A vision for Americas future health system is grounded in values of health equity, access,and shared responsibility.In imagining Americas uture health system, Think Tank participantssee not just a transormed system ocused on delivering care when individuals are sick, but asystem that promotes and spreads health and emphasizes wellness and prevention. Key valuesinclude viewing health care as a human right, implementing universal coverage and equitableaccess to care, and ensuring provider choice. Participants envision a health care system that isefficient, transparent, accountable, and effective. They also see a system grounded in real-worldeconomics, that is financially sustainable, and that deals with realities related to significant levelso spending at the end o a persons lie. They see shared responsibility between individuals and

society.

Obstacles to bringing about this transormation include lack o societal and institutionalreadiness to embrace change, encumbrances o the current system, including entrenched specialinterests that resist change, and a dysunctional political environment.

Keys to overcoming these barriers include educating society on the need or transormationand activating society to bring about transormation. Other important areas o ocus includeemphasizing primary care, equipping providers with enabling technologies, experimenting withnew ways o doing things, using more data and inormation to make decisions, and creating a newworkorce o community health care workers who can coordinate care.

CONCLUSION

Americas health care system is broken. Fixing this system requires innovative, transormational,systemic changes. While special interests, political dysunction, and other obstacles to bringingabout transormational change are enormous, the good news is that examples o transormationalchange exist in countries around the world. Countries, such as Turkey, have made transormation otheir health care system a priority, demonstrated leadership, and brought about remarkable changein an incredibly short period o time, showing that transormational change on a large scale is indeedpossible.


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Background:

Health Care is a SystemIn opening this Think Tank, Harvard School o Public Health proessor, ALI Co-Chair, and Think TankChair Barry Bloom emphasized the importance o health care, which represents % o the globaleconomy and .% o U.S. GDP.

Bloom stressed that health care is delivered by a health system. He defined health systems as theinstitutional arrangements by which societies provide or health needs o their people, and cited theWorld Health Report , which said that health systems include all the activities whose primarypurpose is to promote, restore, or maintain health. The overarching goals o health systems are toimprove the populations health, provide health security, and provide patient satisaction.

Health systems are complex and consist o many components, including the health workorce andhuman capacity, finance and resource allocation, management, governance, access to and delivery o

quality health services, the public and private sectors, metrics and evaluation, and much more.

Oten overlooked is that health systems have a moral premise, which varies rom country to country.The basic premises are that:

Health is an individual responsibility.

Health is a shared responsibility.

Health is some combination of individual and shared responsibility.

Not all health systems are equal; some perorm well, while others do not. Robin Osborn, the vicepresident and director o International Health Policy and Practice Innovations at the CommonwealthFund, said that political leaders may disagree about the attributes o high-perorming health systems,but patients have no problem identiying such attributes. She listed the ollowing as goals o high-

perorming health systems:

Best possible health outcomes or everyone.

Accessto care or all.

Excellent patient experiences: patient-centered, coordinated, high quality, sae care or all.

Lower cost: accountable or use o resources and elimination o waste.

Innovation.

Learninghealth care system.

Changing a complex health system to make it high perorming is extremely difficult. Proessor Bloom

invoked Donald Berwick, ounder o the Institute or Healthcare Improvement, ormer Administratoro Medicare and Medicaid Services, and ALI ounding board member. Berwick has said that a basicprinciple o systems is that they are perectly designed to produce the results they achieve. Thereoreto change a systems level o achievement it is necessary to change the system.

There is aundamentaltruth that is soobvious that it isnot understood.I you want agreater level oachievemento a complex

system you canttinker with themarginsyouhave to changethe system.

Barry Bloom, Professor,

Harvard School of Public

Health


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The Consensus:

Americas Health CareSystem is BrokenEquipped with a clear understanding that health care is deliv-ered via systems, several presenters examined how well Ameri-cas system is perorming. The overwhelming conclusion is thatthe U.S. health care system is underperorming along multipledimensions. Specifically:

Costs.The U.S. currently spends two and a hal times theOrganisation or Economic Co-operation and Development(OECD) average, at more than $, per person per year. As a

percentage o the economy, health care represents more than% o U.S. GDP, up rom around % in . Other developedcountries, such as Japan, Germany, France, and the U.K. were all in the % range in , buttoday, spending on health care has grown to represent just % to % o the economy. Per capitagovernment spending on health care in the U.S. exceeds that o other countries, but many othercountries cover everyone in the country and the U.S. government covers only about % o thepopulation. Higher costs are driven by higher prices. For example, a hip replacement in the U.S.costs more than $,, while costing around $, in England, France, and the Netherlands.

Currently, % o all spending is on % o patients, % is on % o patients, and % is on % opatients. These tend to be older, sicker patients with chronic diseases. Also, about % o all spend-ing is on individuals who will die within one year. In contrast, just % o spending is on the % othe population that is healthiest.

Coverage.As o , % o U.S. residents had private health insurance and % had insurancethrough a government program (mainly Medicare or Medicaid). About million people (% o thepopulation) lacked coverage. Among those with insurance, million were deemed underinsuredand vulnerable to high out-o-pocket expenses relative to their income. For example, Harvard pro-essor David Cutler shared data indicating that the typical American amily has a health insurancepolicy with a deductible o $,, yet has only $ o cash in their bank account.

Access. The lack o insurance coverage and the high costs o the U.S. health system affect access tocare. In , % o Americans had cost-related barriers to accessing health care, compared to %in the U.K.; % o all Americans reported having serious problems or being unable to pay medicalbills, compared to just % in Canada and % in the U.K. Americans also report difficulty in sched-uling appointments with doctors and accessing non-emergency care ater hours. As a result, %o Americans went to the ER in the past two years, which is ar higher than any other developedcountry.

Outcomes. High spending might be satisactory i the quality o and outcomes rom the U.S. healthcare system were better, but that is not the case. In , the U.S. ranked th among industrialized

countries in lie expectancy. In the U.S. ranked th among countries. Health outcomes arepoor compared to other countries along several other important measures.

The U.S. also has issues related to equity and lags behind other countries in the adoption o tech-nologies such as electronic medical records and the use o email by clinicians to communicate withpatients. However, where email is being used, it is postively affecting care and costs. For example, atKaiser Permanente, use o email has reduced office visits by about %.

Excessive costs, low rates o coverage, limited access, inequity, and lagging outcomes indicate anincredibly poor value. As a result, % o Americans believe the health system should be completelyrebuilt, which is a dramatically higher rate than any other OECD country.

The U.S. isclearly an outlierwhen it comes tospending.

Robin Osborn, Vice

President and Director of

International Health Policyand Practice Innovations,

Commonwealth Fund

Robin Osborn


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Health Care ReformOn March , , President Obama signed the Patient Protectionand Affordable Care Act (ACA) into law. Several Think Tank presentersdiscussed the goals o health care reorm, key elements o this legislation,and progress thus ar. Proessor Bloom said the priorities or health reormare broad and include increasing access, quality, value, and equity, whileimproving the health o the population.

Proessor Cutler stated that Obamacare ocuses mainly on coveringpeople, regulating insurance, and paying or this through various attemptsto reduce costs. John McDonough, previously a Massachusetts statelegislator, a ormer health care policy advisor to Senator Ted Kennedy,integral player in health reorm in Massachusetts and nationally, and nowa proessor at the Harvard School o Public Health, said that the ACA is acomplex bill with sections, only one o which deals with private healthinsurance coverage.

Key strategies o ACA include:

Expanding insuranceto the uninsured.

Improving the integrationo health care services.

Providing incentivesor improved perormance.

Routinely collecting dataon outcomes and costs.

Delivering care through teamsthat are responsible or improved value.

Implementing new toolsto improve care, such as comparative effectiveness.

ACA innovations include accountable care organizations (ACOs), patient-centered medical homes(PCMHs), health exchanges, bundled payments, global budgets, comparative effectiveness research,telemedicine, and much more. Concepts such as ACOs, bundled payments, and global budgets all aimto shit rom the volume-based ee-or-service system to a system ocused on quality and improvingthe health o the population.

ACA is still early in the implementation process, and there have been bumps along the way, but morethan six million individuals have signed up or health insurance, which is in line with expectations,and the costs o implementing ACA have, thus ar, been ar lower than predicted. Also, aspects o ACAare driving significant changes in care delivery. For example, payment reductions to hospitals basedon excessive readmission rates have gotten the attention o all hospital executives. Every hospitalnow aims to reduce their readmissions with initiatives underway to do so. As a result, in a relativelyshort period o time, or the first time in history, the rate o hospital readmission has declined nation-

ally. But that means that patients must be discharged to continuing care in the community which isoten lacking.

While many Think Tank participants agree the ACA has helped to initiate change and serves as agood start, they also believe it is not a undamental enough transormation o the U.S. health caresystem.

I the U.S.

health caresystem looks adecade rom nowapproximatelywhat it lookslike now, then allefforts at healthreorm wouldhave ailed.

David Cutler, Professor,

Harvard School of PublicHealth; Harvard Kennedy

School; Faculty of Arts

and Sciences

David Cutler


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Bringing About Policy ChangesUsing health reorm in Massachusetts and nationwide as exam-ples, Proessor McDonough provided a real-world perspective onhow policy change actually comes about. He shared three ideas:

Past dependence. Policy is not linear or necessarily stream-lined. Policy undergoes an evolutionary process where eachpolicy action is dependent on all previous policy actions.For example, the passage o health care reorm in Massa-chusetts in came ater much effort and work. Under-standing this policy requires understanding the history andcontext surrounding it, which goes back to at least .Policies arent developed out o thin air; they are dependent on their context.

Punctuated equilibrium. The general perception is that policy is developed and evolves in alinear, incremental manner. But this isnt always the case. At times the status quo is rapidly dis-rupted and a new order is created; new government institutions are created and existing ones are

abandoned or transormed. Two criteria are necessary or punctuated equilibrium to occur:

Development of a robust replacement idea. A new, different and contextually appropriatepolicy must be created.

Dissolution of the existing policy monopoly.Once established, a policy is supported bya group o invested stakeholders. For punctuated equilibrium to occur, the supporters ora policy need to lose aith in it, creating the opportunity or transormational change.

Continuous policy improvement. Don Berwick, who studied the quality movement and com-panies such as Toyota, brought concepts o continuous improvement to health care. No matterhow good an organization, opportunities to improve quality, efficiency, and systems are alwaysavailable.

The same idea applies to policy, legislation, and regulation. New legislation creates a oundation

and initiates a continuous improvement cycle. Typically, even when ederal legislation is passed, itis prone to regular updates, oten annually - both big and little changes all contribute to ongoingimprovement. However, because o the political dissension that currently exists, no such eed-back and improvement process exists or the ACA. For example, with a ew years o experience,much has been learned about the specific readmissions penalties enacted. Typically, this learningwould be reflected in new and improved rules. But the current toxic environment is hinderingthat improvement.

You cant just go

rom the NorthPole to theSouth Pole; youactually haveto go througha process inwhere you wantto go has tobe understoodwithin thecontext o whereyou are, notwhere you wishto be.

John McDonough,

Professor, Harvard School

of Public Health

John McDonough


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Health System

Transformation in TurkeyWhile the Affordable Care Act is not seen as transormational in the United States, reorm activitiesin Turkey have been transormational.

As a country, Turkey has a relatively young population and over the pastdecade has enjoyed strong economic growth. Even as global economicgrowth has slowed, Turkeys economy grew more than % in and, and is currently growing in the % range.

However, Turkey had lacked a robust health care system. Even thoughthe countrys constitution articulated health care as a undamental right,the country had not delivered on this right. The journey to universalhealth coverage began in , but little progress was made or many

years. Throughout the s and s there was economic and politi-cal instability. There was inadequate allocation o resources, inequitableoutcomes, lack o political leadership, and a dysunctional governmentthat was unable to respond to catastrophic events. There were significantregional disparities and little growth in the health care labor orce. Duringthis time, the expectations o citizens rose, as did their dissatisaction withthe current health system.

Finally, in the early s, the Turkish government decided that transorming the health care systemwas a national priority. There was strong leadership support or a rapid transormation in achievinguniversal coverage within three years. Several policy changes ensued, including:

Changes in governance in redefining the role o the Ministry o Health to be a policymaker andregulator; not a provider.

Changes in financing, with significant increases in health expenditures, a consolidation o in-surance schemes, and rapid expansion o coverage. From to , spending per capita onhealth care virtually doubled.

Expansion o staff and o provider contracting to add human resources. From to , thetotal number o staff employed or contracted by the Ministry o Health almost doubled.

Expansion o health care services, with a ocus on community-based services and services orchildren.

Specific elements o the health transormation program in Turkey were:

A comprehensive strategy inormed by evidence and global experience.

Continuous monitoring, learning, and improvement.

Flexible implementation.

Focus on user satisaction (measured through surveys) and receptivity about the context orchange.

Implementation that was led by a pragmatic and responsive transormation team.

As a result o these policy changes and government ocus, universal coverage was achieved in a three-year period. Mortality has improved and out-o-pocket health expenditures as a share o householdexpenditures have declined. Public satisaction with health services has increased.

The key toTurkeys successhas been thegovernmentswillingness toinvest in health.

Rifat Atun, Professor of

Global Health Systems,


Health

Rifat Atun


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Key lessons rom Turkeys transormational experience include:

Creating a receptive context is essential.In Turkey, this context resulted rom political stability,economic growth and stability, and strong and sustained leadership support. The context orchange was supported by the belie that health is a undamental right and by the prioritization ohealth by the government.

Executing change requires a focused transformation team.The success in Turkey was driven bya dedicated transormation team that was solely ocused on executing this transormation.

Allowing for implementation to be flexible. Turkey allowed or flexibility in execution o chang-es, with ongoing learning.

Combining demand-side and supply-side changes.Universal coverage increased the demand orhealth care services, but just increasing demand was not enough to transorm the health caresystem. Turkey also increased the supply o services and the health care labor orce, including en-gaging private sector companies and contracting or services. Turkey invested in service deliveryinnovations rather than hospitals, especially to serve the poor in remote areas.

Thinking of health, not health care. Most health care systems ocus on, and pay or, the treat-ment o diseases. A transormative mindset is to ocus on health.

Going orward, challenges in Turkey include continuing health investment, sustaining insurance cov-erage, improving the equity o the health care system, and managing public expectations. In addition,Turkey must prepare or and better manage chronic diseases, cultivate a health workorce, improve inthe areas o quality and saety, and oster even greater innovation.

The main lesson rom Turkey is that an entire system can be transormed when made a governmentpriority that is strongly supported by leaders, provided adequate unding, and staffed with appropriateresources.

Dont investin health care;invest in healthand innovation.

Rifat Atun, Professor of

Global Health Systems,


Health


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Other Health SystemInnovationsInnovative ideas implemented around the world were also highlighted at this Think Tank on Innova-tions in Health. Among the innovations discussed, the transormation o the Turkish health systemreceived the most attention, but several other innovative initiatives rom around the world were alsomentioned, including innovations in both developed and developing countries. These included:

Virtual wards (U.K.). The aim o this program is to enable patients with multiple chronic condi-tions and other complex needs to be managed in their homes. The program uses predictive riskmodeling to identiy patients at the greatest risk o uture hospitalization, and provides a nursecase manager and a single point o contact or use by patients, to improve care and reduce hospi-tal costs. The program uses a shared EMR, and every night, all virtual ward patients are sharedwith local hospitals and ater-hours services.

Value-based care (France and Germany). In France, a patients drug copayments are adjustedbased on a drugs therapeutic value, but treatments or chronic diseases have no copayments,encouraging patients to use the appropriate treatment. In Germany, assessments determine cov-erage and prices.

Support network for mental health (U.K.). This is a community o coaches, clinicians, and peersto help patients sel-manage their care. The U.K.s National Health Service (NHS) has desig-nated this a high-impact innovation and it has produced great success, with % o memberssel-managing their psychological issues, % reporting an improvement in mental health, a %adherence rate, and significant savings.

Disease and device registries (Sweden). Nearly government-supported registries allow orthe collection o longitudinal health outcome data that is used to establish best practices andimprove the value o the health care system.

After-hours care (Netherlands). Large-scale ater-hours primary care cooperatives have been

developed in the Netherlands, with nurse phone triage and physician backup. Some allow orwalk-in visits and have house calls. This service uses evidence-based protocols and guidelines. Ithas increased primary care contact by % while reducing ER visits by % and use o ambulanc-es by %.

Family Health Program (Brazil). This program provides primary care to % o the population inBrazil at a cost o $$ per year, ree to patients at the point o care. Each site has a multidis-ciplinary team and community health workers who are each responsible or up to amilies;over , community health workers have been recruited in the past years. Inant mortali-ty has been reduced by %.

Medicall (Mexico). This service in Mexico provides / phone-based access to individualsto provide advice with health problems. This call center, which serves the entire country, usesprotocols developed by the Cleveland Clinic. Over million people pay $ per month or the ser-vice, and two thirds o calls are treated on the phone immediately. When callers cant be treatedover the phone, they are reerred to appropriate providers. This provides a high-value, low-costsolution.

Narayana Hrudayalay Hospital (India). This hospital in India perorms more than , openheart surgeries per year, with outcomes that are comparable to the best hospitals in the world, ata breakeven cost o $, per surgery. The ocus and scale allow or purchasing supplies at lowcost and continuous improvement o operations.

These innovations prove that much can be learned rom studying the best practices and innovativeprograms rom other countries, and that learnings rom around the world can be applied to improvethe U.S. health care system.


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Designing the Ideal U.S.

Health Care SystemALI Think Tank participants divided into seven groups, witheach group asked to determine: what they wanted the healthcare system to do, the underlying values o the health system,the obstacles in achieving this vision, and how barriers could beovercome. Groups were also asked to come up with unique, novelideas. There were many similarities in the vision, values, obsta-cles, and suggestions o these groups.

SITUATION

Think Tank participants concur that the current U.S. health care system is broken and must undergoundamental transormation o the system through a transormation agenda. The ACA can serve as astarting point, but ACA is not transormational enough.

VISION

Participants envision a healthy society that promotes and en-courages good health, based on the belie that healthy peoplemake a stronger society. This idea is transormative compared totodays health care system that ocuses on treating sickness anddisease.

VALUES

Values that support this vision include the belies that:

Everyone should have universal and equal access to health, as it is a human right.

The health system must include wellness and prevention, and not just treatment o diseases.

The health system must be able to be paid or by the country within its means.

Individuals should have reedom o provider choice.

The health system should be efficient, transparent, and effective.

There should be individual accountability and responsibility.

OBSTACLES

Bringing about this vision wont be easy. Major obstacles include:

Recognition that transormation must start with the current system.

Entrenched special interests will be resistant to change.

Lack o social readiness, as about % o the population is satisfied with the current system andwill be averse to change. Also, there is huge distrust and lack o cultural readiness or change.


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Lack o societal ocus and investment or prevention and wellness. We dont penalize unhealthychoices or reward healthy ones, and we incentivize intensive treatment o diseases.

Reusal to deal with end-o-lie issues.

Reducing waste means cutting someones income.

Political dysunction and a divided Congress.

OVERCOMING BARRIERS

Among the ideas shared or overcoming these barriers were:

Create new types of community-based health care services and workers. In particular, as othercountries have done, the United States needs more community-based health workers to provideand coordinate care. This includes nurses and individuals who serve as advocates and guides.Examples include programs in Brazil and Turkey, as well as programs such as Teach or America.

Use technology to enable these community-based workers. This includes smart phones withhealth apps, along with appropriate training on the use o technology.

Engage in societal activation. Society needs to be educated and engaged to create readiness or

transormative change. This includes showcasing successes, ostering more local experimenta-tion, and having greater transparency about outcomes and costs.

Have a more enlightened approach to regulation.There is unnecessary regulation intended toprotect citizens. But it goes too ar and adds cost and complexity.

Aggregate high-quality data.This data can be used to help make better judgments.

UNIQUE IDEAS

Several groups came up with unique ideas to try to improve health and the health care system.Among them:

Deliver care through schools. This can include primary care and preventive care. By delivering

care through schools, children can be diagnosed and treated, when otherwise various ailmentsmight have gone undiagnosed.

Make the use o data and quality part o the accreditation process.

Create a national health care commission. Analogies include the Federal Reserve and the FCC.Such a commission could have members representing diverse stakeholder groups. Non-po-litical appointees would have a term o perhaps years.

Provide more incentives or good behavior, wellness, and prevention.

Freeze health spending as a percentage o GDP.

Engage in partial means testing or health care benefits.

Collect taxes rom non-profit hospitals.

Pursue tort reorm.

Change medical education and training.


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AgendaThursday, March 27, 2014

:a Welcome Remarks

Speaker: Proessor Barry Bloom


:p Lunch Keynote

Speaker: Proessor David Cutler

Harvard School o Public Health; Harvard Kennedy School;

Faculty o Arts and Sciences

:p Speaker Session I

Speaker: Proessor Riat Atun


Health care reorm in Turkey

:p Speaker Session II

Speaker: Robin Osborn

Commonwealth Fund

Health care in the OECD Countries

:p Group Discussion: How To Bring About Change in Health Care

Discussant: Proessor John E. McDonough


Moderator: Proessor Barry Bloom


Friday, March 28, 2014

:a Welcome and Debrief

:a Discussion Session I

:a Discussion Session II

:p Closing Remarks

Speakers: Proessor Barry Bloom


Proessor Michael Chu

Harvard Business School


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2014 Think TankSpeaker BiographiesBarry R. Bloom

Harvard School of Public Health

Advanced Leadership Initiative

Barry R. Bloom, ormerly Dean o the Harvard School o Public Health, is a Harvard University Dis-

tinguished Service Proessor and Joan L. and Julius H. Jacobson II Proessor o Public Health, and

Co-Chair o the Advanced Leadership Initiative. He received a BA and an honorary ScD rom Amherst

College, and a PhD rom Rockeeller University.

Bloom has been engaged in global health or his entire career and made undamental contributions

to immunology and to the pathogenesis o tuberculosis and leprosy. He served as a consultant to theWhite House on International Health Policy rom to , was elected President o the American

Association o Immunologists in , and served as President o the Federation o American Societies

or Experimental Biology in . He served on WHO Committees on Leprosy, Tuberculosis, Tropical

Diseases and the Advisory Committee or Health Research. Bloom was an Investigator at the How-

ard Hughes Medical Institute. He received the first Bristol-Myers Squibb Award or Distinguished

Research in Inectious Diseases, the John Enders Award o the Inectious Diseases Society o America

in , and shared the Novartis Award in Immunology in . He received the Robert Koch Gold

Medal or lietime research in inectious diseases in , and Cyprus Order o the Grand Cross o

Makarios III, in , and the USA-India Chamber o Commerce Award or contributions to health in

India.

Bloom is Chair o the Technical Research Advisory Committee to the Global Programme on Malaria

o the World Health Organization, and has served on the National Advisory Councils o the NationalInstitute o Allergy and Inectious Diseases, NIH, and the Center or Inectious Diseases, o the CDC.

He is a member o the Scientific Advisory boards o the Doris Duke Charitable Foundation, the Well-

come Trust Center or Human Genetics, and the Pathogens, Immunology and Population Health Strat-

egy Committee. He is a member o the U.S. National Academy o Sciences, the Institute o Medicine,

the American Academy o Arts and Sciences, and the American Philosophical Society.


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Michael Chu

Harvard Business School

Michael Chu was appointed a Senior Lecturer in the Social Enterprise Initiative o the General

Management Group o the Harvard Business School in July . He is also Managing Director o the

IGNIA Fund, a venture capital firm dedicated to investing in commercial enterprises delivering highimpact goods and services to low-income populations in Mexico, which he co-ounded in . He

continues to serve as Senior Advisor o Grupo Pegasus, a private equity firm headquartered in Buenos

Aires, which he co-ounded in .

Chu teaches the second year elective Business at the Base o the Pyramid, a course introduced jointly

with Proessor V. Kasturi Rangan. He is Faculty Co-Chair o two Executive Education programs,

Strategic Leadership or Inclusive Finance and Business Innovations in Global Healthcare. In the past,

he has taught the course Investing and Managing in Emerging Markets, and Effective Leadership o

Social Enterprises. Chu is co-head o Project Antares, a collaboration between HBS and the Harvard

School o Public Health ocusing on commercial platorms to deliver high-impact health care interven-

tions to low-income populations.

Beore Pegasus, as President & CEO o ACCION International, Chu participated in the ounding oseveral regulated microfinance banks throughout Latin America, including Banco Solidario, which

under his chairmanship has been the most profitable bank in Bolivia, Mibanco in Peru and Compar-

tamos Banco, which ollowing its IPO in the Mexican Stock Exchange in has been incorporated

into that exchanges index.

From to , as an executive and limited partner in the New York office o Kohlberg Kravis

Roberts & Co, Chu was one o sixteen proessionals deploying KKRs $. billion private equity und

and managing an investment portolio with aggregate annual revenues in excess o $ billion. He

joined the private equity firm rom PACE Industries, a KKR-sponsored leveraged buyout, where he

served as Senior Vice President & CFO, and listed by Forbes as one o the twenty largest private com-

panies in the United States. Previously, he held senior management positions in U.S. corporations and

was a management consultant with the Boston Consulting Group. Chu currently serves on the boards

o Arcos Dorados (NYSE-ARCO), Sealed Air Corporation (NYSE-SEE), on the Economic AdvisoryBoard o the International Finance Corporation in The World Bank Group) and is a Trustee Emeritus

o Dartmouth College.

Chu graduated with an AB (Honors) rom Dartmouth College and received a MBA with highest dis-

tinction (Baker Scholar) rom Harvard Business School.

Chu was born in Kunming, China and grew up in Montevideo, Uruguay. He and his wie Victoria

Cowling Chu reside in West Newton, MA.


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Rifat Atun, MDHarvard School of Public Health

Dr Riat Atun is Proessor o Global Health Systems at Harvard School o Public Health, and Directoro the Global Health Systems Cluster. In - he was a member o the Executive ManagementTeam o the Global Fund to Fight AIDS, Tuberculosis and Malaria.

His research ocuses on health systems reorm, diffusion o innovations in health systems and globalhealth financing.

He was a member o the Advisory Committee or the WHO Research Centre or Health Developmentin Japan and chaired the WHO Task Force on Health Systems and TB control. He is a member o thePEPFAR Scientific Advisory Board, the UK Medical Research Council Global Health Group, Norwe-gian Research Council Global Health and Vaccination Research Advisory Board, the US NationalAcademies Institute o Medicine Standing Committee on Health Systems.

Pro Atun studied medicine at University o London as a Commonwealth Scholar and undertook hispostgraduate medical studies and Masters in business administration at University o London andImperial College London. He is a Fellow o the Faculty o Public Health, the Royal College o GeneralPractitioners, and the Royal College o Physicians (UK)

David CutlerHarvard School of Public Health; Harvard Kennedy School;Faculty of Arts and Sciences

David Cutler has developed an impressive record o achievement in both academia and the publicsector. He served as Assistant Proessor o Economics rom to , was named John L. LoebAssociate Proessor o Social Sciences in , and received tenure in . He is currently the OttoEckstein Proessor o Applied Economics in the Department o Economics and holds secondary ap-pointments at the Kennedy School o Government and the School o Public Health. Proessor Cutlerwas associate dean o the Faculty o Arts and Sciences or Social Sciences rom -.

Honored or his scholarly work and singled out or outstanding mentorship o graduate students, Pro-essor Cutlers work in health economics and public economics has earned him significant academicand public acclaim. Proessor Cutler served on the Council o Economic Advisers and the NationalEconomic Council during the Clinton Administration and has advised the Presidential campaigns oBill Bradley, John Kerry, and Barack Obama as well as being Senior Health Care Advisor or the ObamaPresidential Campaign. Among other affiliations, Proessor Cutler has held positions with the NationaInstitutes o Health and the National Academy o Sciences. Currently, Proessor Cutler is a ResearchAssociate at the National Bureau o Economic Research, a member o the Institute o Medicine, and aFellow o the Employee Benefit Research Institute. He advises many companies and groups on healthcare.

Proessor Cutler was a key advisor in the ormulation o the recent cost control legislation in Massa-chusetts, and is one o the members o the Health Policy Commission created to help reduce medical

spending in that state.

Proessor Cutler is author o two books, several chapters in edited books, and many o publishedpapers on the topics o health care and other public policy topics. Author o Your Money Or Your LieStrong Medicine or Americas Health Care System, published by Oxord University Press, this book,and Proessor Cutlers ideas, were the subject o a eature article in the New York Times Magazine,The Quality Cure, by Roger Lowenstein. Cutler was recently named one o the people who couldhave a powerul impact on healthcare by Modern Healthcare magazine and one o the most influ-ential men aged and younger by Details magazine.

Proessor Cutler received an AB rom Harvard University () and a PhD in Economics rom MIT().


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John E. McDonough

Harvard School of Public Health

John E. McDonough, DrPH, MPA is a proessor o practice at the Harvard School o Public Health.

Between and , he served as a Senior Advisor on National Health Reorm to the U.S. Senate

Committee on Health, Education, Labor and Pensions. Between and , he was ExecutiveDirector o Health Care For All, Massachusetts consumer health advocacy organization. From

through , he was an associate proessor at the Heller School at Brandeis University. From

to , he was a member o the Massachusetts House o Representatives where he co-chaired the

Joint Committee on Health Care. His articles have appeared in the New England Journal o Medicine

Health Affairs and other journals. He has written: Inside National Health Reorm in and Experi-

encing Politics: A Legislators Stories o Government and Health Care in , both by the University

o Caliornia Press and the Milbank Fund, and Interests, Ideas, and Deregulation: The Fate o Hospital

Rate Setting in by the University o Michigan Press. He holds a doctorate in public health rom

the University o Michigan and a masters in public administration rom the Kennedy School o Gov-

ernment at Harvard.

Robin OsbornCommonwealth Fund Health Care in the OECD Countries

Robin Osborn, vice president and director o The Commonwealth Funds International Health Policy

and Practice Innovations program, has responsibility or the Funds annual International Symposium

on Health Policy, annual international health policy surveys and comparisons o health systems data,

The Commonwealth Fund-Nuffield Trust international conerences on quality, the Harkness Fellow-

ships in Health Care Policy and Practice, the Australian-American Health Policy Fellowships, and

international partnerships with Health Ministries, research organizations, and health oundations. In

addition, she serves on the editorial board o the Health Systems in Transitionseries o the European

Observatory. Prior to joining the Fund in , Osborn was director o ellowship programs at theAssociation or Health Services Research, where she directed the Picker/Commonwealth Scholars

Program and served as deputy director o the Robert Wood Johnson Foundation Investigator Awards

in Health Policy Research Program. While living in London rom -, she held management

positions at BUPA, with responsibility or developing managed care programs. Her previous positions

include managing director o the Miller Institute or Perorming Artists at St. Lukes-Roosevelt Hospi-

tal Center; executive director o Blue Cross and Blue Shield o Greater New Yorks corporate ounda-

tion; special assistant to the vice president o Blue Cross and Blue Shield; and assistant director o

Jacobi Hospital Center, a ,- bed, public saety net hospital. She earned a BS with honors at Tuts

University and an MBA rom Columbia University.


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2014 Advanced LeadershipFaculty Biographies

Rosabeth Moss Kanter, Chair and Director

Rosabeth Moss Kanter holds the Ernest L. Arbuckle Proessorship at Harvard Business School, where

she specializes in strategy, innovation, and leadership or change. Her strategic and practical insights

have guided leaders o large and small organizations worldwide or over years, through teaching,

writing, and direct consultation to major corporations and governments. The ormer Editor o Harvard

Business Review (-), Proessor Kanter has been repeatedly named to lists o the most

powerul women in the world (Times o London), and the most influential business thinkers in

the world (Thinkers ). In , she received the Academy o Managements Distinguished Career

Award or her scholarly contributions to management knowledge; and in was named Intelligent

Community Visionary o the Year by the World Teleport Association; and in received theInternational Leadership Award rom the Association o Leadership Proessionals. She is the author

or co-author o books. Her latest book, SuperCorp: How Vanguard Companies Create Innovation,

Profits, Growth, and Social Good, a maniesto or leadership o sustainable enterprises, was named

one o the ten best business books o by Amazon.com. A ollow-up article, How Great

Companies Think Differently, received Harvard Business Reviews McKinsey Award or the

years two best articles.

James P. Honan, Co-Chair and Senior Associate Director

James P. Honan has served on the aculty at the Harvard Graduate School o Education since .

He is also a aculty member at the Harvard Kennedy School and a principal o the Hauser Center or

Nonprofit Organizations. He is Educational Co-Chair o the Institute or Educational Managementand has also been a aculty member in a number o Harvards other executive education programs

and proessional development institutes or educational leaders and nonprofit administrators,

including the Harvard Seminar or New Presidents, the Management Development Program, the

ACRL/Harvard Leadership Institute, the Principals Center, and the Harvard Institute or School

Leadership; Governing or Nonprofit Excellence, Strategic Perspectives in Nonprofit Management,

NAACP Board Retreat, and Habitat or Humanity Leadership Conerence (Faculty Section Chair); and

Strategic Management or Charter School Leaders, Achieving Excellence in Community Development,

American Red Cross Partners in Organizational Leadership Program and US/Japan Workshops on

Accountability and International NGOs.

Barry R. Bloom, Co-Chair

Barry R. Bloom, ormerly Dean o the Harvard School o Public Health, is Harvard University

Distinguished Service Proessor and Joan L. and Julius H. Jacobson Proessor o Public Health.

Bloom has been engaged in global health or his entire career and made undamental contributions

to immunology and to the pathogenesis o tuberculosis and leprosy. He served as a consultant

to the White House on International Health Policy rom to , was elected President o

the American Association o Immunologists in , and served as President o the Federation o

American Societies or Experimental Biology in .


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David R. Gergen, Co-Chair

David R. Gergen is a proessor o public service and co-director o the Center or Public Leadership

at the Harvard Kennedy School, positions he has held or the past decade. In addition, he serves as

a senior political analyst or CNN and works actively with a rising generation o new leaders. In the

past, he has served as a White House adviser to our U.S. presidents o both parties: Nixon, Ford,

Reagan and Clinton. In the s, he began a career in journalism with the McNeil-Lehrer NewsHourand he has remained a regular commentator on public affairs or some years. Among his current

non-profit boards are Teach or America, City Year, Schwab Foundation, the Aspen Institute, and the

Mission Continues. He is an honors graduate o Yale and the Harvard Law School, a veteran o the

U.S. Navy, and has been awarded honorary degrees.

Rakesh Khurana, Co-Chair

Rakesh Khurana is the Marvin Bower Proessor o Leadership Development at the Harvard Business

School. He teaches a doctoral seminar on Management and Markets and The Board o Directors and

Corporate Governance in the MBA program. Khurana received his BS rom Cornell University in

Ithaca, New York and his AM (Sociology) and PhD in Organization Behavior rom Harvard University.

Prior to attending graduate school, he worked as a ounding member o Cambridge TechnologyPartners in Sales and Marketing.

William C. Kirby, Co-Chair

William C. Kirby is T. M. Chang Proessor o China Studies at Harvard University and Spangler Family

Proessor o Business Administration at the Harvard Business School. He is a Harvard University

Distinguished Service Proessor. He serves as Chairman o the Harvard China Fund and was Director

o the Fairbank Center or Chinese Studies rom -. A historian o modern China, Proessor

Kirbys work examines Chinas business, economic, and political development in an international

context. He has written on the evolution o modern Chinese business (state-owned and private);

Chinese corporate law and company structure; the history o reedom in China; the international

socialist economy o the s; relations across the Taiwan Strait; and Chinas relations with Europeand America.

Charles J. Ogletree, Jr., Co-Chair

Charles Ogletree is the Harvard Law School Jesse Climenko Proessor o Law, and Founding

and Executive Director o the Charles Hamilton Houston Institute or Race and Justice (www.

charleshamiltonhouston.org) named in honor o the visionary lawyer who spearheaded the litigation

in Brown v. Board o Education. Proessor Ogletree is a prominent legal theorist who has made an

international reputation by taking a hard look at complex issues o law and by working to secure the

rights guaranteed by the Constitution or everyone equally under the law. Ogletree has examined

these issues not only in the classroom, on the Internet, and in the pages o prestigious law journals,

but also in the everyday world o the public deender in the courtroom and in public television orumswhere these issues can be dramatically revealed.


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Fernando M. Reimers, Co-Chair

Fernando Reimers is the Ford Foundation Proessor o International Education and Director o the

Global Education and International Education Policy Program at the Harvard Graduate School o

Education. Proessor Reimers ocuses his research and teaching on identiying education policies

that support teachers in helping low-income and marginalized children succeed academically. His

courses ocus on the core education challenges in the development field and on the role o socialentrepreneurs in creating solutions o value to improve the quality and relevance o education. His

current research in Brazil and Mexico ocuses on the impact o education policy, education leadership

and teacher proessional development on literacy competencies and civic skills. He is currently

serving on the Global Learning Leadership Council o the American Association o Colleges and

Universities Project General Education or a Global Century ocusing on some o the pressing issues

related to global learning and undergraduate education.

Peter Brown Zimmerman, Co-Chair

Peter Brown Zimmerman is Lecturer in Public Policy and Senior Associate Dean or Strategic Program

Development at the Harvard Kennedy School. He also serves as aculty Chair o the Senior Executive

Fellows Program and is Co-Chair o the Advanced Leadership Initiative. He is a graduate o theKennedy Schools Public Policy program. Beore coming to Harvard, he worked or the U.S. Navy, on

the National Security Council staff and on the staff o the Senate Intelligence Committee. He has

consulted with and advised a wide range o public and nonprofit organizations.

David E. Bloom, Executive Board

David E. Bloom is Clarence James Gamble Proessor o Economics and Demography in the Department

o Global Health and Population, Harvard School o Public Health. Dr. Bloom also serves as Director

o Harvards Program on the Global Demography o Aging. He is an economist whose work ocuses

on health, demography, education, and labor. In recent years, he has written extensively on primary,

secondary, and tertiary education in developing countries and on the links among health status,

population dynamics, and economic growth. Dr. Bloom has published over articles, book chaptersand books in the fields o economics and demography.

Amy C. Edmondson, Executive Board

Amy C. Edmondson is the Novartis Proessor o Leadership and Management at the Harvard Business

School. The Novartis Chair was established to enable the study o human interactions that lead to the

creation o successul business enterprises or the betterment o society. Edmondson is the author

o Teaming: How Organizations Learn, Innovate and Compete in the Knowledge Economy (Jossey-

Bass, ), Teaming to Innovate (Jossey-Bass, ), and more than seventy articles on leadership,

teams, innovation, and organizational learning. Number on the Thinkers list o the worlds

most influential management thinkers, Edmondson teaches on topics including leadership, teamwork,

and innovation at HBS and around the world.

William W. George, Executive Board

Bill George is a proessor o management practice at Harvard Business School, where he has taught

leadership since , and the ormer chairman and chie executive officer o Medtronic. He is the

author o our best-selling books: Authentic Leadership, True North: Discover Your AuthenticLeadership; Finding Your True North: A Personal Guide; and Lessons or Leading in Crisis. True

North Groups: A Powerul Path to Personal and Leadership Development, his most recent book,

was published in September . Proessor George is currently the aculty chair o HBSs Executive

Education program Authentic Leadership Development.


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Monica C. Higgins, Executive Board

Monica Higgins joined the Harvard aculty in and is currently a proessor at Harvard Graduate

School o Education (HGSE) where her research and teaching ocus on the areas o leadershipdevelopment and organizational change. Prior to joining HGSE, she spent eleven years as a member o

the aculty at Harvard Business School in the Organizational Behavior Unit. Her recent book, Career

Imprints: Creating Leaders Across an Industry (), ocuses on the leadership development o

executives in the biotechnology industry. In education, her research interests ocus on both highereducation and K- public education. Specifically, she has a multimedia project underway on the

careers and social networks o the Harvard Business School Class o . In addition, Proessor

Higgins is studying senior leadership teams and organizational learning in urban school districts as

well as how entrepreneurial firms achieve impact at scale. Proessor Higgins teaches in the areas oleadership and organizational behavior, entrepreneurship, sel-assessment and career development,

and strategic human resources management.

Robert H. Mnookin, Executive Board

Robert H. Mnookin is the Samuel Williston Proessor o Law at Harvard Law School, the Chair o

the Program on Negotiation at Harvard Law School, and the Director o the Harvard Negotiation

Research Project. A leading scholar in the field o conflict resolution, Proessor Mnookin hasapplied his interdisciplinary approach to negotiation and conflict resolution to a remarkable range

o problems; both public and private. Proessor Mnookin has taught numerous workshops or

corporations, governmental agencies and law firms throughout the world and trained many executives

and proessionals in negotiation and mediation skills. In his most recent book, Bargaining with theDevil: When to Negotiate, When to Fight, Mnookin explores the challenge o making such critical

decisions.

Roger B. Porter, Executive Board

Roger B. Porter is IBM Proessor o Business and Government. Joining the Kennedy School aculty in

, he has served or more than a decade in senior economic policy positions in the White House,

most recently as Assistant to the President or Economic and Domestic Policy rom to . Heserved as Director o the White House Office o Policy Development in the Reagan Administration

and as Executive Secretary o the Presidents Economic Policy Board during the Ford Administration.

He is the author o several books on economic policy, including Presidential Decision Making and

Efficiency, Equity and Legitimacy: The Multilateral Trading System at the Millennium. An alumnus oBrigham Young University, Porter was a Rhodes Scholar at Oxord University, where he received his

BPhil degree. He was a White House Fellow rom to and received his MA and PhD degrees

rom Harvard University.

Forest L. Reinhardt, Executive Board

Forest L. Reinhardt is the John D. Black Proessor o Business Administration at Harvard Business

School. Reinhardt is co-chair o the Harvard Business Schools Global Energy Seminar, a newexecutive education course or the leaders o firms that produce oil and gas, generate and distribute

electricity, or play other important roles in the delivery o energy services. He also teaches regularly

in the HBS Agribusiness Seminar. In the HBS Owner/President Management Program, Reinhardtteaches a core course on Global Markets. Drawing on microeconomics, macroeconomics, political

science, and history, the course helps business leaders understand the economic and political

environment in which business is conducted, and the strategic opportunities and risks to which

globalization gives rise. Reinhardt recently served as course head or the required MBA course,Strategy, which covers topics in industry analysis, competitive advantage, and corporate strategy.

Reinhardt currently serves as the aculty chair o Harvard Business Schools Asia-Pacific Research

Center and the chair o the HBS Executive Education Asia-Pacific Region.


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Guhan Subramanian, Executive Board

Guhan Subramanian is the Joseph Flom Proessor o Law and Business at the Harvard Law School and

the Douglas Weaver Proessor o Business Law at the Harvard Business School. He is the first person

in the history o Harvard University to hold tenured appointments at both HLS and HBS. At HLS he

teaches courses in negotiations and corporate law. At HBS he teaches in several executive education

programs, such as Strategic Negotiations, Changing the Game, Making Corporate Boards MoreEffective, and the Advanced Management Program. He is the aculty chair or the JD/MBA program

at Harvard University and the Co-Chair o the Harvard Program on Negotiation. Prior to joining the

Harvard aculty he spent three years at McKinsey & Company.

Ronald S. Sullivan, Jr., Executive Board

Proessor Ronald S. Sullivan, Jr. joined Harvards law aculty in July . His areas o interest include

criminal law, criminal procedure, legal ethics, and race theory. Prior to teaching at Harvard, Proessor

Sullivan served on the aculty o the Yale Law School, where, ater his first year teaching, he won the

law schools award or outstanding teaching. Proessor Sullivan is the Faculty Director o the Harvard

Criminal Justice Institute. He also is a ounding ellow o The Jamestown Project. Proessor Sullivan

is a Phi Beta Kappa graduate o Morehouse College, and the Harvard Law School, where he served as

president o the Black Law Students Association and as a General Editor o the Harvard BlackLetter

Law Review. Ater graduating rom Harvard, Proessor Sullivan spent a year in Nairobi, Kenya as a

Visiting Attorney or the Law Society o Kenya.


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2014 AdvancedLeadership Fellows

Lezli BaskervilleLezli Baskerville has been President, CEO, National Association or Equal Opportunity in HigherEducation, the advocacy association o the nations Historically Black Colleges and Universities andPredominately Black Institutions, in Washington D.C.

Elizabeth BruceElizabeth Bruce has been Executive Vice President and Member o the Executive Committee, Ca-blevisions Madison Square Garden Division in New York.

Bruce CohenBruce Cohen has been Chie Counsel and Staff Director, and Minority Chie Counsel, United StatesSenate Judiciary Committee in Washington D.C.

Mary Louise CohenMary Louise Cohen has been Founding Partner, Phillips & Cohen, a law firm in Washington, D.C. Shehas also been Counsel, United States Senate Judiciary Committee in Washington D.C.

John ConleyJohn Conley has been Partner and Co-Founder, Gilliam Capital, a lie science investment firm in Mas-

sachusetts.


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Patricia CossoPatricia Cosso has been Director o Portolio Strategy and Business Development, AstraZeneca Mex-ico, in Mexico.

Carlos Guzmn joins Patricia Cosso as an Advanced Leadership Partner.

John DubinskyJohn Dubinsky has been Chairman, President and Chie Executive, Mercantile Bank. He has also beenPresident Emeritus (Midwest), US Bank, Missouri.

Yvette Dubinsky joins John Dubinsky as an Advanced Leadership Partner.

Jeffrey DunnJeffrey Dunn has been President and CEO, HIT Entertainment, a kids entertainment company, in Lon-

don and New York. He has also been President, Nickelodeon Film & Enterprises in New York.

Juan Carlos L. FernandezJuan Carlos L. Fernandez has been President, Inmobiliaria y Constructora INCO Ltd., a real estatedevelopment firm in Chile.

Susan McManama GianinnoSusan McManama Gianinno has been Chairman and CEO, Publicis Worldwide USA in New York, aglobal advertising and communications company.

Lawrence Gianinno joins Susan McManama Gianinno as an Advanced Leadership Partner.

Martin N. Gilbert, M.D.Martin N. Gilbert has been External Consultant, National Health Service, United Kingdom; and Exec-utive Advisor, Kaiser Permanente Medical Care Program in Caliornia.


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Jeffrey T. GillingJeffrey T. Gilling has been Chairman, Diamond Antenna and Microwave Corporation, an aerospacecomponents manuacturer in Massachusetts.

Carol GossCarol Goss has been President and CEO, The Skillman Foundation, whose mission is to improve thelives o children in metropolitan Detroit, Michigan by strengthening their schools and neighborhoods

Ronald B. GraisRonald B. Grais has been Partner, Jenner & Block LLP, in the law firms Illinois office.

Marilynn Grais joins Ronald B. Grais as an Advanced Leadership Partner.

Arjun GuptaArjun Gupta has been Founder and Managing Partner, TeleSot Partners, a special situations venturecapital firm ocused on high-tech and energy value chain companies, in Caliornia and Colorado.

Andrs HidalgoAndrs Hidalgo has been President and Associate Publisher, Grupo El Comercio, a newspaper in Ecua-dor.

Robin HowlingsRobin Howlings has been Owner & CEO, Danamark WaterCare Ltd., a provider o innovative waterfiltration solutions in Canada.


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Margaret HuberMargaret Huber has been Chie o Protocol or Canada. She has also served as Canadas Ambassadorto the Czech Republic, Slovak Republic, Jordan and Iraq.

Kathy HurleyKathy Hurley has been Executive Vice President, Pearson Foundation, a nonprofit organization whosemission is to make a difference by promoting literacy, learning, and great teaching nationwide.

Carol JohnsonCarol Johnson has been Superintendent, Boston Public Schools, Memphis City Schools, and Minneap-olis Public Schools.

James J. KozlowskiJames J. Kozlowski has been President and Co-Founder, TGF Management Corp, a private equity firmwhich invests in and manages various middle market companies

in Texas.

Mary Kozlowski joins James J. Kozlowski as an Advanced Leadership Partner.

Peter H. McNerneyPeter H. McNerney has been Co-Founder and Partner, Thomas, McNerney & Partners, a venture capi-tal firm ocused on medical technology and lie sciences in Minnesota.

Alberto MoraAlberto Mora has been Secretary and General Counsel, Mars, Incorporated in Virginia; General Coun-sel, Department o the Navy; and Winner, JFK Library Foundation Profile in Courage Award.


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Jorge MoranJorge Moran has been CEO & President, Sovereign Bank. He has also been Global Executive VicePresident, Santander Bank in the U.S.

Carrin PatmanCarrin Patman has been Partner, Bracewell & Giuliani, in the law firms Texas office.

Patricia RamsayPatricia Ramsay has been Cultural and Development Director, University o Technology, Jamaica. She

has also been a television host in Jamaica.

Arthur J. ReimersArthur J. Reimers has been Partner and Managing Director, Goldman, Sachs & Co., New York andLondon.

Lindsay Reimers joins Arthur J. Reimers as an Advanced Leadership Partner.

Luis Rodriguez-OvejeroLuis Rodriguez-Ovejero has been Founder, CEO & President, Grupo Satec, a Spanish IT systems inte-grator in Spain.

Guy RolnikGuy Rolnick has been Deputy Publisher, Haaretz-Group, a news media company in Israel; and Found-er and Editor-in-Chie, TheMarker, a financial news media company in Israel.


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Michael RubensteinMichael Rubenstein has been Founder and Director, CambridgeSot, a Massachusetts-based companythat develops scientific sotware or pharmaceutical, chemical, and biotech R&D.

Inge SkjelfjordInge Skjelford has been Managing Director, Rabobank International, a global banking businessserving agri-clients. He has also been a member o the International Finance Corporation, World BankGroup.

Gillian SorensenGillian Sorenson has been Assistant Secretary-General o the United Nations. She has also served as

Senior Advisor to the United Nations Foundation.

Mark SterlingMark Sterling has been Partner, Hogan Lovells, in the law firms Florida and Washington, D.C. offices.

Wendy Sterling joins Mark Sterling as an Advanced Leadership Partner.

Mary Green SwigMary Green Swig has been President and CEO, Mary Green Enterprises, an internationally recognizeddesign firm in Caliornia.

Steven L. SwigSteven L. Swig has been Co-Founder and President Emeritus o Presidio Graduate School, awarding an

MBA/MPA in Sustainable Management in Caliornia.


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Torsten ThieleTorsten Thiele has been Head o Telecom Project Finance, Investec Bank plc., an international bankand asset manager, serving the United Kingdom, South Arica and Australia based in the United King-dom.

Waide WarnerWaide Warner has been Partner, Davis Polk & Wardwell LLP, in the law firms New York and Londonoffices.

Cecilia Tso Warner joins Waide Warner as an Advanced Leadership Partner.

Marissa C. WeselyMarissa C. Wesely has been Partner, Simpson Thacher & Bartlett LLP, in the law firms New York and

London offices.

2014 SENIOR ADVANCED LEADERSHIP FELLOWS

Howard Fischer (2014 Senior AL Fellow)Howard Fischer has been ounder and CEO, Basso Capital Management, with a core ocus on invest-ing in convertible securities and SPACs, in New York.

Randee Fischer joined Howard Fischer as an Advanced Leadership Partner.

Nina Lahoud (2014 Senior AL Fellow)Nina Lahoud has been Principal Officer in the Asia and Middle East Division at the United NationsDepartment o Peacekeeping Operations, in New York.


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Paul W. Lee (2014 Senior AL Fellow)Paul W. Lee has been Partner, Goodwin Procter LLP, at the law firms Boston office. He has also beenpast president o the National Asian Pacific American Bar Association.

William A. Plapinger (2014 Senior AL Fellow)William A. Plapinger has been a partner o Sullivan & Cromwell LLP, most recently in the firms Londonoffice.

Cassie Murray joined William A. Plapinger as an Advanced Leadership Partner.

2014 Healthcare Report

Documents