J.B. Silvers, Ph.D. – John R. Mannix Medical Mutual of Ohio Professor and Associate Dean of Finance, Weatherhead School of Management

Dear Colleagues:

Greetings, and I hope that you and yours are healthy and safe – and can stay that way.

As part of being careful to stay safe, the “Friday Lunch,” a CWRU tradition since 1989, continues on Zoom. We work to present experts from campus and sometimes beyond to discuss important issues for the university, local community, nation or the international stage.

This Week’s Program

Health care is a business, a source of incomes and profits and wealth, in any country. But it is more of a business, less constrained by other values and offering many more opportunities for income, in the United States than anywhere else.

That means that in order to understand the U.S. health care non-system, it’s important to follow the classic advice from the Watergate investigations: “follow the money.”

The health care business is humongously complicated. Pricing, incomes and investment are determined by a weird combination of payers (federal government, state governments, and in the private sector employers), purposes (payment not just for treatment but for research and education), intermediaries (mostly health insurers but for pharmaceuticals the Pharmacy Benefit Managers, PBMs), regulations (such as federal government quality reporting) and market forces (such as the degree of competition and concentration in the market for hospital services, or the ability to vertically integrate in order to induce referrals from physicians to hospitals).

It also is an arena of continual change driven either by government policies or market innovations – such as new Medicare payment rules, or private equity firms buying up hospitals, nursing homes, and physician groups, especially groups of emergency physicians.

So it is useful even for someone like me, who is supposed to be an expert on health care policy, to occasionally check in on developments in the health care biz and especially the hospital business, as hospitals are still by far the largest component of care and costs. What’s most visible right now is a mix of new construction, such as the Metrohealth rebuilding and Ahuja expansion; hospitals under financial stress especially in rural areas; and further consolidation with larger systems gobbling up smaller. But why is any of this happening, and what might be its effects?

These are questions that it makes a lot of sense to ask J.B. Silvers. He is one of the nation’s leading experts in hospital and health care finance, including many years as a member and treasurer of the Joint Commission on Accreditation of Health Care Organizations. And from his term as CEO of the QualChoice insurer to his current position as Vice Chairman of the Metrohealth Board of Directors, he has for decades been a close observer of and participant in the health care business in our region.

So he will join us to offer some brief remarks about what seem to him to be the most interesting and important current trends and developments. I’ll pose a few questions about what’s puzzling me most. And then we’ll open it up so other participants can take advantage of this opportunity to shed light on the confusing health care world – or perhaps get even more astonished by what people manage to invent in pursuit of either better health or profit.

Signing In

This semester’s discussions will begin at 12:30 p.m., the usual time. The meeting will be set up as from Noon to 2:00 p.m., so people are not all signing in at the same time and to allow for the discussion to run a bit long. Each week we will send out this newsletter with information about the topic. It will also include a link to register (for free) for the discussion. Every Monday the same information will be posted on our website: fridaylunch.case.edu.

If you register, you will automatically receive from the Zoom system the link to join the meeting. This week’s link for registration is:

https://cwru.zoom.us/meeting/register/tJMud-6upzsqH91Aaq5mlgZ2KbtkK_PitvLK

After registering, you will receive a confirmation email containing information about joining the meeting.

Please e-mail padg@case.edu if you have questions about how the Zoom version of the Friday Lunch will work or any other suggestions. Or call at 216 368-2426 and we’ll try to get back to you. We are very pleased to be partnering this semester with the Siegal Lifelong Learning Program to share information about the discussions.

Best wishes for safety and security for you and yours,

Joe White
Luxenberg Family Professor of Public Policy and Director, Center for Policy Studies

About Our Guest

J.B. Silvers, Ph.D., is the John R. Mannix Medical Mutual of Ohio Professor of Health Care Finance and professor of banking and finance at Weatherhead School of Management with a joint appointment in the Case Western Reserve University School of Medicine. His research in the areas of financial management and health services has been published in numerous journals including the Journal of Finance, Financial Management, Journal of the American Medical, Association, Medical Care, Annals of Family Medicine, and the Journal of Business Research, among others. Silvers contributes commentary to public radio’s Marketplace frequently and other national & local print and broadcast media including the New York Times, Business Insider and MarketWatch.

Professionally, Silvers has testified to Congress, several state legislatures, federal and state courts. He has also served on committees at the National Academies and several national and state commissions. Until recently, he was a board member (12 years) and treasurer of the Joint Committee on Accreditation of Healthcare Organizations (TJC/JCAHO) and a board member of SummaCare Insurance Company (14 years). For seven years Silvers was a commissioner on the Prospective Payment Assessment Commission (now MedPAC) advising Congress on Medicare payment. From 1997 to 2000, while on leave, he served as President and CEO of QualChoice Health Plan and Insurance Company, a subsidiary of University Hospitals of Cleveland. He currently is vice chair of the board at MetroHealth Medical Center. At Weatherhead, he has served as Department Chair, Senior Associate Dean and Interim Dean.

Silvers earned a Ph.D. in finance from Stanford University, a MS in Industrial Management and a BS in Engineering Science from Purdue University. He has been a faculty member at Case Western Reserve University since 1979 after prior appointments at Stanford, Harvard, and Indiana.

Schedule of Friday Lunch Upcoming Topics and Speakers:

December 3: President Biden’s Trade Policy: Continuity and Change. With Juscelino Colares, J.D., Schott-van den Eynden Professor of Business Law.