Placement: Harvard Medical School
Mentor: Michael Chernew, Ph.D. (Leonard D. Schaeffer Professor of Health Care Policy; Director of the Healthcare Markets and Regulation Lab, Harvard Medical School)
Co-mentor: J. Michael McWilliams, M.D., Ph.D. (Warren Alpert Foundation Professor of Health Care Policy and Professor of Medicine, Harvard Medical School)
Project: Risk Adjustment on Socioeconomic Status in Value-based Models: France and the U.S.
Grégoire Mercier, M.D., Ph.D., M.Sc., is a 2018–19 French Harkness Fellow in Health Care Policy and Practice. He is the founder and current head of the Economic Evaluation Unit at Montpellier University Hospital, a multidisciplinary team in charge of producing real world and experimental evidence on the efficiency and organizational impact of innovative health care strategies. He is also a researcher at the CEPEL (UMR CNRS/Montpellier University), a social sciences team primarily focused on public policy. Mercier’s research focuses on equity in healthcare and on the assessment of healthcare coordination using real world data. He served as principal investigator on a research project supported by the French Ministry of Health looking at potentially avoidable hospitalizations and has developed a new indicator that is now part of the national guidelines on healthcare coordination. At the inter-regional level, Mercier is leading the first health services research program aimed at bridging the gap between research and policy. His publications include 60 peer-reviewed articles in journals such as Health Affairs, BMC Health Services Research, and Plos One. He completed his medical degree (Public Health) and Ph.D. in Management from Montpellier University and holds a M.Sc. in Health Economics, Policy and Management from the London School of Economics.
Project Abstract: A broad-spectrum strategy to improve the quality, coordination, and cost-effectiveness of health care is the move away from fee-for-service payments and towards value-based payments. Indeed, value-based programs foster care coordination, incentivize care redesign, reward high quality, and transfer the economic risk from payers to providers. The implementation of value-based programs requires sound risk adjustment on demographic and clinical factors, however, the feasibility and impact of adjustment on socioeconomic factors within value-based payment initiatives remains unclear. Little is known about the circumstances under which risk adjustment on socioeconomic status is most relevant, and what data should be included in the adjustment model. Using U.S. hospital and ambulatory care databases, this project aims to investigate what has been done to date to include socioeconomic factors within the U.S. bundled payments and population-based payments, and how various risk adjustment methods compare in terms of feasibility and impact. In addition, it aims to examine the extent to which these methods are transferable to the French context.
Career Activity Since Fellowship
- Head of the Economic Evaluation Unit, Montpellier University Hospital
Current Position:
- Head of Data Science Unit, Montpellier University Hospital