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George Mason University

Len Nichols, PhD

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Biography

Len M. Nichols has been the Director of the Center for Health Policy Research and Ethics (CHPRE) and a Professor of Health Policy at George Mason University since March 2010. He has been intimately involved in health reform debates, policy development, and communication with the media and policy makers for 25+ years, after he was Senior Advisor for Health Policy at the Office of Management and Budget (OMB) in the Clinton Administration. Since that time he has testified frequently before Congress and state legislatures, published extensively and spoken to a wide range of hospital associations, hospital systems, physician groups, boards of directors, and health policy leadership forums around the country. After OMB, Len was a Principle Research Associate at the Urban Institute, Vice President of the Center for Studying Health System Change, and Director of the Health Policy Program at the New America Foundation. In addition to his positions at GMU Len is on the Board of Directors of the National Committee for Quality Assurance and in 2016 was appointed by the Comptroller General to serve on the Physician-Focused Payment Model Technical Advisory Committee (PTAC), which advises the Secretary of HHS on Medicare payment policies. Len was an advisor to the Virginia Health Reform Initiative and is now the payment reform advisor to the Virginia Center for Health Innovation. Len was an Innovation Advisor to the Center for Medicare and Medicaid Innovation at CMS in 2012, and has recently been the Principal Investigator on PCMH evaluation studies as well as in more general studies of how to use payment and delivery reform to achieve triple aim and health equity goals. Recently he has become focused on how payment models may be used to incentivize sustainable investments in social determinants of health. Len’s first job was teaching economics at Wellesley College from 1980-1991, where he became Associate Professor and Economics Department Chair, after receiving his Ph.D. in Economics from the University of Illinois in 1980. Len got his B.A. from Hendrix College in Conway, Arkansas, and his M.A. in Economics from the University of Arkansas in Fayetteville. He lives in Arlington, Virginia, with his wife Nora Super of the Milken Institute.

University Service

  • Member, CHHS Dean Search Committee, 2016-2017

Community Service

  • Member, Physician Focused Payment Model Technical Advisory Committee, HHS
  • Member, Fairfax County Health Care Integration Working Group

Degrees

PhD, Economics, University of Illinois at Urbana-Champaign (1980)

MS, Economics, University of Illinois at Urbana-Champaign (1978)

MA, Economics, University of Arkansas (1976)

BA, Economics and Business, Hendrix College (1975)

Research

Research Interests

  • Health care reform 
  • Payment reform
  • Insurance Market reform
  • Health Disparities 
  • Social Determinants of Health

Publications

"What Should We Conclude From "Mixed" Results in Payment Reform Evaluations?" Health Affairs Blog, August 14, 2017. With Alison E. Cuellar, Lorens Helmchen, Gilbert Gimm, and Jay Want.

"Medical Home Implementation in Small Primary Care Practices: Provider Experiences and Perspectives," Journal of the American Board of Family Medicine. 29:6 (Nov-Dec. 2106), pp. 767-774. With Gilbert Gimm (first author), Dan Hough, Jay Want, Treniese Polk, Margaret Rodan, and Len M. Nichols.

"The Care First Patient Centered Medical Home Program: Cost and Utilization Effects in the First Three Years," Journal of General Internal Medicine https://doi.org/10.1007/s11606-016-3814-z (published online 29 July 2016), with Alison Cuellar (first author), Lorens A. Helmchen, Gilbert Gimm, Jay Want, Sriteja Burla, Bradley J. Kells, Iwona Kicinger, and Len M. Nichols.

"Ebola Crisis of 2014: Are Current Strategies Enough to Meet the Long-Run Challenges Ahead?" American Journal of Public Health. Published online ahead of print March 19, 2015: e1–e3. https://doi.org/10.2105/AJPH.2015.302576 with Gilbert Gimm.

"Health Reform in Virginia: The Commonwealth's Way," Journal of Health Politics, Policy, and Law 37(6) (December 2012) pp. 1133-39.

"Justice Roberts' Health Care Stewardship" Hasting Center Report 42(5) Sept-Oct 2012, pp. 17-18.

"ACO Pathways: Diverse but Ultimately Parellel," Mayo Clinic Proceedings, 87(8) 2012.

"Government Intervention in Health Care Markets is Practical, Necessary, and Morally Sound," Journal of Law, Medicine, and Ethics, 40(3) 2012 pp. 547-57.

"Making Health Markets Work Better Through Targeted Doses of Competition, Regulation, and Collaboration," St. Louis University Journal of Health Law and Policy, 5(1) (2011) pp. 7:25.

"Obesity and Health System Reform: Private vs. Public Responsibility," Journal of Law, Medicine, and Ethics v. 39 #3 (Fall 2011) pp. 380-86, with Y. Tony Yang.

"Implementing Insurance Market Reforms Under the Federal Health Law," Health Affairs (June 2010) v. 29 # 6.

"Be Not Afraid," New England Journal of Medicine (February 24, 2010), v. 362:e30.

"Stewardship: What Kind of Society Do We Want?", in Connecting American Values with Health Reform, Hastings Center, July 2009.

"The Long Road to Health Reform Requires Bi-Partisan Leadership," Health Affairs (May/June 2008), with Christine Ferguson and Elizabeth Fowler.

"Crossroads in Quality," Health Affairs (May/June 2008), with Margaret O'Kane, Janet Corrigan, Sandra M. Foote, Sean R. Tunis, George J. Isham, Elliott S. Fisher, Jack C. Ebeler, James A. Block, Bruce E. Bradley, Christine K. Cassel, Debra L. Ness and John Tooker.

"Why Do Latinos Have So Little Employer-Sponsored Insurance," Inquiry (November, 2007) with James D. Reschovsky and Jack Hadley.

"The Moral Case for Covering Children (and Everyone Else)," Health Affairs 26:2 (March/April 2007) pp. 405-07.

"Hospital Payment Systems: Will Payers Like the Future Better than the Past?" Health Affairs v. 25(1):81-93 (January/February 2006), with Ann O'Leary.

"State Health Insurance Market Reforms and Access to Insurance for High Risk Employees," Journal of Health Economics v. 24 (2005), pp. 725-50, with Amy Davidoff and Linda J. Blumberg.

"The Effects of Medicaid Reimbursement on Access to Care of Medicaid Enrollees: A Community Perspective," Medical Care Research and Review v. 62 # 6 (2005) with Peter Cunningham.

"Changes in Medicaid Physician Fees, 1998-2003: Implications for Physician Participation," Health Affairs Web Exclusive (June 23, 2004), with Stephen Zuckerman, Joshua McFeeters, and Peter Cunningham.

"Ten Myths About the Uninsured," Healthplan (May/June 2004), with Mark Pauly.

"Improving State Insurance Market Reform: What's Left to Try?" in State Health Insurance Market Reform: Toward Inclusive and Sustainable Health Insurance Markets. Alan C. Monheit and Joel C. Cantor, eds. (Routledge Press: New York). 2004.

"Are Market Forces Strong Enough to Deliver Efficient Health Care Systems? Confidence is Waning in 12 Communities," Health Affairs (March/April 2004), with Paul B. Ginsburg, Robert A. Berenson, Jon Christianson, and Robert E. Hurley. (7th - most downloaded article from Health Affairs website in calendar 2004).

"Why Are So Many Americans Uninsured?" in Health Policy and the Uninsured. Catherine McLaughlin edited. Urban Institute Press: Washington, DC. February 2004 (with Linda J. Blumberg).

"A New Approach to Risk Spreading via Coverage-Expansion Subsidies," American Economic Review v. 93, #2 (May 2003) with John Holahan, Linda J. Blumberg, and Yu-Chu Shen.

"The Non-Group Insurance Market: Short on Fact, Long on Opinions and Policy Disputes," Health Affairs web exclusive (October 23, 2002), with Mark V. Pauly.

"Health Insurance Expansions of Working Families: A Comparison of Targeting Strategies," Health Affairs v. 21 # 4 (July/August 2002), with Danielle Ferry, Sherry Glied, and Bowen Garrett.

"Can Defined Contribution Health Insurance Reduce Cost Growth?" Employee Benefit Research Institute Issue Brief # 246 (June 2002).

"Worker Decisions to Purchase Health Insurance," International Journal of Health Care Finance and Economics, v. 1 # 3/4, with Linda J. Blumberg and Jessica Banthin. September/December 2001.

"Premium Rebates and the New Consensus on Medicare Reform," Health Care Financing Review v. 23 # 2, with Roger Feldman, Bryan Dowd, Robert Coulam, and Ann Mutti (Winter 2001).

"Policy Options for Filling Gaps in the Health Insurance Coverage of Older Workers and Early Retirees," in Ensuring Health and Income Security for an Aging Workforce. P. Budetti, R. Burkhauser, J. Gregory, and H. Hunt, eds. Upjohn Institute: Kalamazoo, MI 2001.

"Health Care Quality: At What Cost?" Future of the Public Sector Issue Brief # 13, (May 1998).

"The Health Status of Workers Who Decline Employer-Sponsored Insurance," Health Affairs 20(6):180-87, with Linda J. Blumberg, 2001.

"The Not-So-Simple Economics (and Politics) of Medicare Reform," in The Political Economy of Health Care Reforms, Huizhong Zhou, ed. Upjohn Institute: Kalamazoo, MI. 2001.

"Who Really Wants Price Competition Among Medicare's Managed Care Plans?", with Robert D. Reischauer. Health Affairs, v. 19 # 5 (September/October 2000).

"Competitive Pricing by Medicare's Private Health Plans: Be Careful What You Wish For," in M. Moon, editor, Competition with Constraints: Challenges Facing Medicare Reform. Urban Institute Press (2000).

"Regulating Non-Group Health Insurance Markets: What Have We Learned So Far?" Journal of Health Politics, Policy and Law v. 25 # 1 (February 2000).

"Health System Reform Debates and Medical Expenditure Surveys," in A. Monheit and R. Wilson, eds., Informing American Health Care Policy. Josey-Bass (1999).

"Managing the Medicare Health Insurance Market for Beneficiaries and Taxpayers," in Robert Helms, ed., Medicare in the 21st Century: Seeking Fair and Efficient Reform. AEI Press (1999).

"State Policy Options for Nonprofit Conversion," with Jill Marsteller and Randall R. Bovbjerg, Health Services Research v. 33 # 5 (December 1998, Part II).

"Building a Marketplace for Elderly Consumers," Generations v. 22 # 2 (Summer 1998).

"The Health Care Labor Force and National Health Care Spending: Tracing the Health Care Dollar to Health Professionals," (with C. Eugene Steuerle), in Health Benefits and the Workforce Volume 2. US Department of Labor, Pension and Welfare Benefits Administration. (Washington, DC). 1998.

"A Different Kind of New Federalism? The Health Insurance Portability and Accountability Act," (with Linda J. Blumberg), Health Affairs v. 17 # 3 (May/June 1998).

"The Health Insurance Portability and Accountability Act of 1996: Summary of Provisions and Anticipated Effects," (with Linda J. Blumberg) Journal of Medical Practice Management v. 14 # 1 (July/August) 1998.

"Managed Competition as a Route to Markets That Serve Public Needs: A View From Near the White House," in Health Policy: Understanding Our Choices from National Reform to Market Force, edited by Marilynn M. Rosenthal and Max Heirich. Westview Press: Boulder, Colorado (1998).

"Beyond National Health Reform: A View from the States," with John Holahan, National Tax Association Proceedings of the 89th Annual Conference, National Tax Association, 1997.

"Managed Care and the Resurgence of Any Willing Provider and Freedom of Choice State Legislation," with Jill A. Marsteller, Diana K. Verrilli, and Randall R. Bovbjerg, Journal of Health Politics, Policy, and Law v. 22 # 5 (October 1997) pp. 1133-1189.

"Medical Savings Accounts for Developing Countries," with Kai Hong Phua and Nicholas Prescott, in G. Schieber, ed. Innovations in Health Care Financing, World Bank: Washington D.C. (1997).

"Who Will Jump Into the MSA Pond?" Business and Health, October 1996.

"State Health Policy in the 1990s," with John Holahan, in Health Policy, Federalism, and the American States, Robert F. Rich and William D. White, eds., Urban Institute Press, Washington, DC, 1996.

"First, Do No Harm: Developing Health Insurance Market Reform Packages," with Linda J. Blumberg, Health Affairs v. 15 # 3 (Fall 1996).

"The Effects of Health Insurance and Physician Characteristics on Patient Choice of Physician," with Philip F. Cooper and Amy K. Taylor, Inquiry v. 33 # 3 ( Fall 1996).

"Winners and Losers in the Employment-Related Health Insurance Market: How Are Net Health Benefits Distributed?" with Alan C. Monheit and Thomas M. Selden, Inquiry v. 32 # 4 (Winter 1995/1996).

"Nonphysician Health Care Providers: Use of Ambulatory Services, Expenditures, and Sources of Payment," National Medical Expenditure Survey Research Findings No. 27, 1996.

"Medical Savings Accounts," Business and Health (September 1995).

"MSAs and Risk Segmentation," Health Affairs v. 14 #2 (Summer 1995).

"Thoughts on Saving Medicare with the Market," Internist: Health Policy and Practice (July/August 1995)

"Numerical Estimates and the Policy Debate," Health Affairs, v. 14 #1 (Spring 1995), and in H. Aaron, ed., The Problem That Won't Go Away: Reforming U.S. Health Care Financing. Brookings Press (Washington, DC) 1996.

"The Clinton Health Plan: Financing, Estimation, and Economic Effects," (with Alice M. Rivlin and David M. Cutler), Health Affairs, Spring (I) 1994.

"Establishing the Real Investment Costs of Inflation: Some Results from Cointegration, Causation, and Sign Tests," (with Katherine T. McClain), Journal of Post-Keynesian Economics, winter 1993.

"Estimating Costs of Underutilizing Advanced Practice Nurses," Nursing Economics v. 10 #5 (Sept-Oct. 1992).

"Consistent Comparisons Between Monopoly and Perfect Competition," (with Susan Skeath, Ann Velenchik, and Karl Case), Journal of Economic Education v. 23 #3 (Summer 1992).

"Overhead Workers and Political Economy Macro Models," (with Bruce Norton) Review of Radical Political Economics v. 22 #4 (September 1991).

"On the Sources of Scope Economies in US Manufacturing Firms," Review of Industrial Organization v. 4 #1 (Spring 1989).

"Contributions of Diversification, Promotion, and R & D to the Value of Multiproduct Firms: A Tobin's q Approach," Financial Management, v 15, #4 (Winter 1986, with Mannuel Jose and Jerry L. Stevens).

"On the Existence of a Market for Second Hand Physical Capital: An Empirical Test of the Keynesian vs. Neoclassical Assumptions," Journal of Macroeconomics, V. 8, #2 (Spring 1986, with James H. Grant).

"Advertising and Economic Welfare," American Economic Review, v. 75, #1, March 1985.

"Wage-Risk Premiums and Worker's Compensation: A Refinement of Estimates of Compensating Wage Differential," Journal of Political Economy, v. 92, #2, (April 1983, with Richard J. Arnould).

Select Grants at George Mason University

"Payment Reform and Evaluation Lead of Virginia's State Innovation Model Grant." February 2015-January 2016. $167,000.

"Using Payment Reform to Reduce Health Disparities," Robert Wood Johnson Foundation. 2014-2017. Role: Principal Investigator. $489,000.

"PCMH Evaluation for Care First," Blue Cross Blue Shield. 2013-2017. Role: Principal Investigator. $5.4 million

"Payment Reform Technical Assistance for Department of Medical Assistance Services." 2012-2015. Role: Principal Investigator: $1.8 million.

"Heart of Virginia Health Care/Evidence Now," Agency for Healthcare Research and Quality. 2015-2018. Role: Lead Evaluator. $2.2 million.

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