Dr. Dudley received in his M.D. degree from the Duke University in 1991 and his M.B.A. from Stanford in 1990. After an internal medicine residency at the Massachusetts General Hospital, he did his pulmonary and critical care fellowship at UCSF. For his research, he was a Pew Charitable Trusts Fellow in Health Policy at UCSF, then joined the faculties of the Pulmonary Division and the Institute for Health Policy Studies at UCSF in 1997. His major academic activities include several health services research and health policy projects, various advisory committees, and teaching in the Pulmonary Clinic and the ICU. Community service activities include consulting on health policy issues with the Institute of Medicine (the National Roundtable on Quality of Care, the Committee on Quality of Health Care in America, and the National Cancer Policy Board), the Pacific Business Group on Health, General Motors, the Leapfrog Group and other large employers, the American Thoracic Society, and other medical societies
R. Adams Dudley, MD, MBA, is Associate Professor of Medicine and Health Policy at the University of California, San Francisco.
His major research interests include developing measures of quality and efficiency of care, assessing the impact of quality-based or value-based purchasing by employers and health plans, the consumer role in value-based purchasing, and financial risk adjustment (adjusting premiums and capitation rates to reflect the severity of illness of enrollees). He has three primary projects currently. The California Intensive Care Outcomes (CALICO) project involves developing reports of hospital-specific ICU quality of care and efficiency for all hospitals with ICUs in California. The California Hospital Assessment and Reporting Task Force (CHART), which he leads, has convened representatives of consumers, purchasers, health plans, and hospitals in California to establish a consensus, universal, robust hospital performance reporting system. He also is working with public and private purchasers to summarize the research on quality-based purchasing and consumer-driven health care strategies to identify optimal approaches to health care purchasing.
He has served as a consultant on health policy issues to the Institute of Medicine's National Roundtable on Quality of Care, Committee on Quality of Health Care in America, and National Cancer Policy Board, to the Joint Commission on Accreditation of Healthcare Organizations, to the World Health Organization, to the Pacific Business Group on Health, General Motors, the Leapfrog Group and other large employers, and to the American Thoracic Society and other medical societies. He recently was named a recipient of the prestigious Robert Wood Johnson Foundation Investigator Award.
The second area of research involves improving the techniques available to adjust for the financial risk health plans and providers face based on the prevalence and severity of illness among their enrollees. We are attempting to expand on current claims-based risk adjustment models (which essentially assign a single estimated cost to all patients with a particular diagnosis) to include clinical information about the severity of the illness (e.g., pulmonary function measurements in patients with cystic fibrosis). Products of this line of investigation include primarily papers about methods, addressing issues from model selection to the utility of different types of databases to the applicability of models built in one population to risk assessment in other populations.
The final area includes assessment of the feasibility of changing the relative weights put on quality versus price by participants in the health care market. Projects have ranged from identifying proxies for quality that purchasers can measure easily and assessing the potential for purchasers to reduce hospital mortality by using these proxies as a basis for hospital referral to evaluating medical group responses to specific incentive structures (e.g., capitation in various forms with or without quality withholds or bonuses).
Goldman, LE, Henderson, S, Dohan, DP, Talavera, JA, Dudley, RA. Public Reporting and Pay-for-performance: Safety Net Hospital Executives' Concerns and Policy Suggestions. Inquiry, 2007; in press.
Rosenthal MB, Dudley RA. Pay-for-Performance: Will the Latest Payment Trend Improve Care? Journal of the American Medical Association, 2007; in press.
Goldman, LE, Vittinghoff, E, Dudley, RA. Quality of Care in Hospitals with a High Percent of Medicaid Patients. Medical Care, 2007; in press.
Lin, GA, Dudley, RA, Redberg, RF.† Cardiologists' Use of Percutaneous Coronary Interventions for Stable Coronary Artery Disease. Archives of Internal Medicine, 2007; in press.
Frolich, A, Talavera, JA, Broadhead, P, Dudley, RA. A Behavioral Model of Clinician Responses to Incentives to Improve Quality. Health Policy, 2007 Jan;80(1):179-93.
Mehrotra, A, Grier, SA, Dudley, RA. The Relationship Between Health Plan Advertising and Market Incentives: Evidence of Risk Selective Behavior. Health Affairs, 2006;25(3):759-65. Nominated for Article-of-the-Year Award from AcademyHealth.
Mangione CM, Gerzoff RB, Williamson DF, Steers WN, Kerr EA, Brown AF, Waitzfelder BE, Marrero DG, Dudley RA, Kim C, Herman W, Thompson TJ, Safford MM, Selby JV.† Influence of diabetes disease management on quality of care:† the Translating Research into Action for Diabetes (TRIAD) Study. Annals of Internal Medicine, 2006;145(2):107-16.
Hayward, RA, Heisler, M, Adams, J, Dudley RA, Hofer, TP. Over-estimating Outcomes Rates: Statistical Estimation When Reliability Is Suboptimal. Health Services Research, in press.
Robinowitz, DL, Dudley, RA. Public Reporting of Provider Performance: Can it Improve Quality? Can Its Impact Be Made Greater? Annual Review of Public Health, 2006;27:517-536.
Covinsky KH, Hilton J, Lindquist K, Dudley RA. Development and validation of an index to predict ADL dependence and other adverse outcomes in community-living elders.† Medical Care, 2006;44(2):149-57.
Dudley RA, Rosenthal MB. Pay for Performance: A Decision Guide for Purchasers.† AHRQ Publication No. 06-0047. Rockville, MD: Agency for Healthcare Research and Quality, 2006.† Available online at www.ahrq.gov/qual/p4pguide.htm.
Dudley, RA, Kuzniewicz, M, Dean, M, Lane, RK, Rennie, D, Bacchetti, P, Clay, T, Crane, S, Luft, HS.† The California Intensive Care Outcomes (CALICO) Project: Final Report.† Sacramento: California Office of Statewide Health Planning and Development, 2005.
Dudley RA. Pay-for-performance research: how to learn what clinicians and policy makers need to know. Journal of the American Medical Association. 2005;294(14):1821-3.
Lipton, HL, Agnew, JD, Stebbins, M, Kuo, A, Dudley, RA.† Managing the Unmanageable: The Nature and Impact of Drug Risk in Physician Groups. Journal of Health Politics, Policy and Law, 2005;30(4):719-50.
Dudley RA, Frolich A, Robinowitz DL, Talavera JA, Broadhead P, Luft HS. Strategies to Support Quality-based Purchasing: A Review of the Evidence (Technical Review No. 10).† AHRQ Publication No. 04-0057. Rockville, MD: Agency for Healthcare Research and Quality, 2004.
Dudley RA, Frolich A, Robinowitz DL, Talavera JA, Broadhead P, Luft HS. Executive Summary: Strategies to Support Quality-based Purchasing: A Review of the Evidence.† AHRQ Publication No. 04-P024. Rockville, MD: Agency for Healthcare Research and Quality, 2004.
Chuang, KH, Luft, HS, Dudley, RA. The Clinical and Economic Performance of Prepaid Group Practices.† In: Enthoven, AC, ed. Toward a 21st Century Health System: The Contributions and Promise of Prepaid Group Practice, San Francisco: Jossey-Bass, 2004.
Dudley, RA, Luft, HS, Kuzniewicz, M, Dean, M, Lane, RK, Rennie, D, Clay, T, Bacchetti, P, Crane, S.† The California Intensive Care Outcomes (CALICO) Project: First Year Report.† Sacramento: California Office of Statewide Health Planning and Development, 2004.
Luft, HS, Dudley, RA.† Assessing Risk Adjustment Approaches under Non-random Selection. Inquiry, 2004; 41(2):203-17.
Chuang, KH, Aubry, W, Dudley, RA. Independent Medical Review of Health Plan Coverage Denials: Early Trends. Health Affairs, 2004; 23(6):163-9.
Jha, AK, Perlin, JB, Kizer, KW, Dudley, RA. Effect of the Transformation of the Veterans Affairs Health Care System on the Quality of Care. New England Journal of Medicine, 2003; 348(22):2218-27.
Mehrotra, A, Bodenheimer, T, Dudley, RA.† Employers' Efforts To Measure And Improve Hospital Quality:† Determinants of Success. Health Affairs, 2003; 22(2):60-71.
Luft, HS, Dudley, RA.† Measuring Quality in Modern Managed Care.† Health Services Research, 2003; 38(6):1373-1379.
Brindis, RG, Weintraub, WS, Dudley, RA.† Volume as a Surrogate for PCI Quality: Is This the Right Measuring Stick?† American Heart Journal, 2003;146(6):932-4.
Havrenek, EP, Krumholz, HM, Dudley, RA, Adams, K, Gregory, D, Lampert, S, Lindenfeld, J, Massie, B, Pina, I, Rich, MW, Konstam, MA.† Aligning Quality and Payment for Heart Failure Care: Defining the Challenges.† Journal of Cardiac Failure, 2003; 9(4):251-4.
Mehrotra, A, Dudley, RA, Luft, HS.† What's Behind Health Expenditure Trends? Annual Review of Public Health, 2003; 24:385-412.
O'Hare, AM, Dudley, RA, Hines, D, McCulloch, C, Navarro, D, Colin, P, Stroup, K, Rapp, J, Johansen, KL. Impact of Surgeon and Surgical Center Characteristics on Choice of Permanent Vascular Access. Kidney International, 2003; 4(2):681-9.
Dudley, RA, Medlin, CA, Hammann, LB, Cisternas, MG, Brand, R, Rennie, DJ, Luft, HS. The Best of Both Worlds? The Potential of Hybrid Prospective/Concurrent Risk Adjustment. Medical Care, 2003; 41(1):56-69. Nominated for AcademyHealth Impact Award.
Johansen, KL, Sakkas, G, Doyle, J, Shubert. T, Dudley, RA.† Exercise Counseling Practices among Nephrologists Caring for Patients Receiving Maintenance Dialysis.† American Journal of Kidney Disease, 2003; 41(1):171-8.
Luft, HS, Dudley, RA, and the Improving Quality of Care By Restructuring Provider Payments Team. Improving Health Care by Linking Risk Adjustment and Condition-Specific Quality Measurement. Public Finance and Management, 2002; 2(4): Available online at www.spaef.com/PFM_PUB/index.html.
Gupta, N, Kotler, PK, Dudley, RA. A Report Card Approach to ICUs.† Journal of Intensive Care Medicine, 2002; 17(5):211-218.
The TRIAD Study Group. The Translating Research into Action for Diabetes (TRIAD) Study: A Multi-Center Study of Diabetes in Managed Care. Diabetes Care, 2002 February; 25(2):386-9.
Dudley, RA, Rittenhouse, D, Bae, R. Creating a Statewide Hospital Quality Reporting System. Oakland, CA: California Health Care Foundation; 2002.
Luft, HS, Dudley, RA, Bowers, LV. Condition-Specific Patterns of Costly Illness: Implications for Risk Adjustment and Quality Monitoring. In Chinitz, D, ed., The Changing Face of Health Systems, Jerusalem: Gefen Publishing. 2002; 110-118.
Hlatky, MA, Dudley, RA. Operator Volume and Clinical Outcomes of Primary Coronary Angioplasty for Patients with Acute Myocardial Infarction.† Circulation, 2001; 104(18):2155-2157.
Dudley, RA, Mangione, CM. Physician Responses to Evidence-Based Hospital Referral Programs. American Journal of Medicine, 2001; 111(9):731-733.
Dudley, RA, Hricak, H, Scheidler, J, Yu, K, Kahlben, C, Powell, CB, Schwartz, L, Yetter, EM, O'Malley, CM, Warren, R. Shared Patient Analysis: A Method to Assess the Clinical Benefits of Patient Referrals.† Medical Care, 2001; 39(11):1182-1187.
Dudley, RA, Johansen, KL. Physician Responses to Purchaser Quality Initiatives for Surgical Procedures.† Surgery, 2001; 130(3):425-428.
Dudley, RA, Luft, HS. Managed Care in Transition. The New England Journal of Medicine, 2001; 344(14):1087-1092.
Dudley, RA, Bae, RY, Johansen, KL, Milstein, A. When and How Should Purchasers Seek to Selectively Refer Patients to High Quality Hospitals? In: Hewitt, M, ed (for the Committee on Quality of Health Care in America and the National Cancer Policy Board). Interpreting the Volume-Outcome Relationship in the Context of Health Care Quality, Washington, DC: National Academy Press; 2000; 79-94.
Korenbrot, CC, Dudley, RA, Greene, JD. Changes in Births to Foreign-Born Women after Welfare and Immigration Policy Reforms in California. Maternal and Child Health Journal, 2000; 4(4):241-50.
Dudley, RA, Landon, BE, Rubin, HR, Keating, NL, Medlin, CA, Luft, HS. Assessing the Relationship between Quality of Care and the Characteristics of Health Care Organizations. Medical Care Research and Review, 2000; 57 Supplement 2:115-134.
Dudley, RA, Johansen, KL, Brand, R, Rennie, DJ, Milstein, A. Selective Referral to High Volume Hospitals: Estimating Potentially Avoidable Deaths. The Journal of the American Medical Association, 2000; 283(9):1159-1166.
Kuerer, HM, Hwang, ES, Anthony, JP, Dudley, RA, Crawford, B, Aubry, WM, Esserman, LJ. Current national health insurance coverage policies for breast and ovarian cancer prophylactic surgery. Annals of Surgical Oncology, 2000; 7(5):325-332.
Dudley, RA, Bowers, LV, Luft, HS. Reconciling Quality Measurement with Financial Risk Adjustment in Health Plans. The Joint Commission Journal on Quality Improvement, 2000; 26(3):137-146.
Dudley, RA. Comparing the Quality of Care Provided by Health Plans: Are the Data There? Value in Health, 1999; 2(4):255-257.
Dudley, RA, Luft, HS. Goals, Targets, and Tactics: Making Health Care Policy Decisions Explicit. Journal of Health Politics, Policy and Law, 1999; 24(4):705-713.
Dudley, RA, Rennie, DJ, Luft, HS. Population Choice and Variable Selection in the Estimation and Application of Risk Models. Inquiry, 1999; 36(2):200-211.
Showstack, JA, Katz, PP, Lake, JR, Brown, RS, Dudley, RA, Belle, S, Everhart, J, Wiesner, RH, Zetterman, RK. Resource Use in Liver Transplantation: The Effects of Patient Characteristics and Clinical Practice. The Journal of the American Medical Association, 1999; 281(15):1381-1386.
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