J.B. Silvers, Ph.D. – John R. Mannix Medical Mutual of Ohio Professor of Health Care Finance

Dear Colleagues:

Greetings, and I hope that you and yours are healthy and safe in this socially-distanced time.

As part of that distancing, we’re continuing the “Friday Lunch” as an online event. After over thirty-years of in-person discussions it’s a bit of an adjustment; but it has been good to see colleagues who have moved away and now can take advantage of the new format.

This week we welcome back to the now-virtual table our university’s eminent scholar of health care finance, J.B. Silvers. As a leading scholar of the business of healthcare, as well as how that is affected by public policy, Professor Silvers has regularly shared his thoughts about the strange and wondrous developments in the biz. He brings to that task a lifetime of scholarship and practice. Yet I guess that even he has not seen as bizarre a set of events as the last eight months have brought us.

Covid-19 created new needs for care, some for people without insurance. It also forced adjustments within hospitals and other sites of care that greatly reduced volumes of non-Covid-related care, thereby potentially radically reducing revenues. The federal government, however, responded with a large and not necessarily well-targeted set of subsidies. These seem to have favored some providers over others. Insurers, meanwhile, in many cases saw the volume of care for which they were paying decline steeply – potentially leading to big profits. Yet most employers self-insure, so the employers, not the health plan companies, may have been the real beneficiaries of the slowdown.

The first financial question, then, is what the heck happened? Who has lost or won, and how much? Yet there is a second level, the long-term effects. For instance:

• * in order to respond to the crisis, care providers have expanded some activities (like e-health) which required investment but might yield savings later if continued. Or not! How will they be paid for, and will they continue?

• * The economic fallout has severely affected revenues for the Medicare Part A trust fund; what might the consequences of that be, especially if the recession continues?

* Policy-makers and some private payers have been trying to get hospitals and doctors to accept versions of payment-by-patient, rather than fees-per-service. Will the sudden decline in volume of services make providers more willing to go along?

I can think of lots of other questions and I’m eager to hear from Professor Silvers both about what has happened so far and implications for the future.

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/tJIkc–pqjsrH9Abgzg4uyBlqjzhmzJeXqY1

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, PhD, 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:

October 23: COVID-19: Rapid Research and Rapid Revelations. With Mark Cameron, Ph.D., Associate Professor, Department of Population and Quantitative Health Sciences.

October 30: Election Forecast Discussion. With Karen Beckwith, Ph.D., Flora Stone Mather Professor of Political Science, and other faculty.

November 6: “Banning the Box”: The Substance and Politics of Legislation to Reduce Obstacles to Hiring Felons. With Daniel Shoag, Ph.D., Associate Professor of Economics.

November 13: Targeted Assassinations and Other Red and Not-So-Red Lines. With Shannon E. French, Ph.D., Professor of Philosophy, Inamori Professor of Ethics, and Director, Inamori International Center for Ethics and Excellence

November 20: What’s the Beef? The Controversy Over the Health Effects of Red Meat. With Hope Barkoukis, Ph.D., Jack, Joseph and Morton Mandel Professor in Wellness and Preventive Care and Chair, Department of Nutrition.

December 4: The Economics of Sports After (?) COVID-19. With Jonathan Ernest, Ph.D., Assistant Professor of Economics.