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Christopher Fleming

Health Affairs Names Jack Wennberg As The Most Influential Health Policy Researcher Of Past Quarter-Century

Dartmouth Researcher Documented Geographic Variations In Health Care
And Showed That More Care Did Not Mean Better Care

Bethesda, MD -- At its twenty-fifth anniversary health policy summit, Health Affairs named Jack Wennberg, a professor of medicine and community and family medicine at the Dartmouth Medical School, as the most influential health policy researcher of the past 25 years.

Through four decades of work, Wennberg has documented the geographic variation in the health care that patients in the United States receive. In 1988 he founded the Center for Evaluative Clinical Services (CECS) at Dartmouth Medical College. Together with his CECS colleagues, Wennberg has produced the Dartmouth Atlas of Health Care, a series of reports on how health care is used and distributed in the United States. In June of this year, Wennberg stepped down as director of the CECS, now known as the Dartmouth Institute for Health Policy And Clinical Practice (TDI).

“When Jack started his work, geographic variation in health care -- and the resulting variation in health care costs -- was largely unknown and unremarked upon,” said Health Affairs founding editor John Iglehart, who presented an award from the journal to Wennberg. “But thanks to Jack’s persistence, the idea that the care you receive is largely determined by where you live -- and not necessarily by what is most appropriate for you -- has become part of the common parlance of health policy.”

Indeed, Wennberg’s work has shown that areas that spend more and provide more services often experience worse outcomes than lower-spending areas that provide less intensive care. In a 2002 Health Affairs article, Wennberg proposed a Medicare reform plan based on reducing unwarranted regional variations in spending by the program. In the latest Dartmouth Atlas, Wennberg and colleagues state that “the Medicare system could reduce spending by at least 30 percent while improving the medical care of the most severely ill Americans.”

Wennberg’s recent work has focused on documenting outcomes and communicating outcomes information to patients. This focus is reflected in his article in the Nov/Dec 2007 issue of Health Affairs. In the first part of a two-part article, Wennberg and coauthors urge the Centers for Medicare and Medicaid Services (CMS) to use its pay-for-performance program to ensure that patients are both informed and empowered to choose appropriate discretionary treatments.

The Nov/Dec article represents the most recent of twenty-two times Wennberg has been published in Health Affairs. The first time came in the summer of 1984, when Wennberg headlined a thematic Health Affairs issue on health care variations. In that issue, Iglehart quoted the then-president of the Institute of Medicine, Frederick Robbins, as stating of widely varying health care practices: “It is not an appropriate way for [the medical profession] to behave.”

Robbins’ injunction notwithstanding, geographic variations in health care have persisted. But today we know far more about these variations, and are far more able to judge the relative cost-effectiveness of differing approaches to care, because of Jack Wennberg’s work.



Health Affairs, published by Project HOPE, is the leading journal of health policy. The peer-reviewed journal appears bimonthly in print with additional online-only papers published weekly as Health Affairs Web Exclusives at www.healthaffairs.org.


©2007 Project HOPE–The People-to-People Health Foundation, Inc.