Placement: Harvard T.H. Chan School of Public Health and Harvard Business School
Mentor: Meredith Rosenthal, Ph.D., C. Boyden Gray Professor of Health Economics and Policy, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health
Co-mentor: Thomas H. Lee, M.D., M.Sc., Chief Medical Officer, Press Ganey Associates
Project: From Volume to Value in Spinal Surgery: What Promotes Successful Uptake of Value-Based Health Care?
Christer Mjåset, M.D., is a 2019–20 Harkness/Norwegian Institute of Public Health Fellow in Health Care Policy and Practice. Mjåset is a specialist in neurosurgery at Oslo University Hospital and is enrolled in the Ph.D. program at Oslo University Hospital, where he conducts research on the Norwegian Spine Registry and population outcomes related to neck surgery. His previous research agenda spans medical ethics, narrative medicine, and neurological diseases. Mjåset has been vice president of the Norwegian Medical Association (2017–2019), leader of the Norwegian Junior Doctors (2015–2019), and leader of the steering committee of the Norwegian Choosing Wisely Campaign (2017–2019). With Choosing Wisely, he was responsible for launching the campaign nationwide, and delivered a TED talk about overtreatment (“Why Your Doctor Needs Your Help to Battle Overtreatment”) in May 2018. Since 2016, Mjåset has been a faculty member of the Healthcare Leadership Academy in London, where he coaches and mentors young health care workers in leadership theory and practice. He is also a lecturer in the Department of Health Management and Health Economics at the Institute of Health and Medicine, University of Oslo, where he teaches in the health care leadership program for young Norwegian doctors. Mjåset is the author of five published works of fiction and several short stories. He won the Oslo City Cultural Scholarship for writers in 2006. He earned his M.D. and B.A. in literature and philosophy from the University of Oslo.
Project Overview: Doctors and health delivery systems have, traditionally, been paid according to the volume of care. The weaknesses here are well-known; fee-for-service payment drives up patient volumes and creates not only variations in treatment, but also overtreatment. At the same time, an aging population, a rise in chronic conditions, and medical innovation have increased demand for treatment in many countries. As a result, governments are in search of more sustainable health care models. In the U.S., unlike in Norway, some organizations have transitioned to value-based health care models, becoming more cost-efficient and providing better care for patients. Some of these have primary care physicians as part of the clinical staff. As hospitals and primary health care are organized independently in Norway, integrated delivery systems are of interest to the Norwegian health care sector.
This project will study factors that are associated with successful transition from fee-for-service to value-based models of health care in selected hospitals in the U.S. The project will include site visits to organizations that have transitioned to value-based health care plans and become more cost-efficient with better care for patients. A special focus will be on how institutions handle outcomes data and quality metrics in clinical and strategic management. Also, the study will attempt to collect outcomes data that correlate with data available in the Norwegian Health Atlas and the Norwegian Registry for Spine Surgery, with the goal of producing a survey that is relevant to the health policy landscape in both the U.S. and in Norway.
Current Position:
- Deputy CEO, Helseplattformen (The Health Platform)
Harkness-Related Publications:
C. Mjåset, U. Ikram, N. Nagra , T. Feeley. "Value-Based Health Care in Four Different Health Care Systems." NEJM Catalyst. 2020.
C. Mjåset, K. Lawrence, T. Lee. "Hybrid Physicians Create ‘Social Capital’ for Health Care." NEJM Catalyst. 2020.
C. Mjåset, H. Byrkjeflot, F. Hanssen, W. Wynn-Jones. En introduksjon til forløpsbasert finansiering [An introduction to course-based financing]. Journal of the Norwegian Medical Association. 2020.
