Elliott Fisher is a researcher and advocate for improving health and health care.
Elliott Fisher is Professor of Health Policy, Medicine and Community and Family Medicine at the Dartmouth Institute and the Geisel School of Medicine. His early research revealed that US regions with higher Medicare spending did not achieve better quality or outcomes, revealing the magnitude of unnecessary care and providing evidence that universal insurance should be affordable. He worked with colleagues to develop the concept of Accountable Care Organizations and carried out the research that helped build the case for their inclusion in the Affordable Care Act. With two major NIH grants, he now leads the Primary Care and Population Health Lab, where he and his colleagues are focusing on how to strengthen primary care in the U.S.
Recent Work
Aligning Accountable Care Models With the Goal of Improving Population Health
Elliott S Fisher, Andrew Bindman, Michael Kopko | March 11, 2024| Health Affairs Forefront
“To improve population health, accountable care payment models should adopt stronger population-health focused measures and complete the transition from fee-for-service to capitation. A measure estimating current life expectancy based on modifiable risks is within reach and could be used to track and reward population health improvement and equity. All-payer capitation would strengthen the incentive to improve health, and, just as importantly, provide organizations the flexibility needed to do so.”
Addressing Greed in Health Care: If Not Us, Who? And How?
Elliott S Fisher, MD, MPH, George Isham, MD | April 18, 2023 | Health Affairs Forefront
“At the heart of US health care lies a paradox: Thanks to high and rising costs, this enterprise, the fundamental purpose of which is to improve well-being, has become an important cause of suffering. In this commentary, George Isham and I summarize the harms, describe how we in health care and others contribute, and suggest ways that individuals and organizations can work to address them.” Elliott Fisher
Reforming Health Care: The Single System Solution
Elliott S Fisher, MD, MPH | August 5, 2020 | NEJM Catalyst Innovations in Care Delivery
“The unsolved puzzle of US health care: Why is American healthcare so uniquely expensive and unequal? And what can we do about it? In addition to providing what I think are pretty good answers to these questions, I explain in this paper why ACOs have so far failed to achieve their promise.” Elliott Fisher
Abstract: The flaws of the U.S. health care system have been exposed and exacerbated by the coronavirus pandemic. This paper posits three underlying causes of our persistent poor performance: flawed assumptions; inadequate information; and fragmented delivery, payment, and insurance systems that make it easier to profit by shifting risk or costs to others than by improving value. To address these, Americans should adopt a single system approach to delivery, payment, and coverage where comprehensive, real-time information empowers providers and policy makers to deliver better care and protect the public’s health, and where better performance measures and payment models enable competitive markets at every level to reward only those suppliers, providers, and insurers that help deliver better, less expensive care. This approach can satisfy current stakeholders, aligns with key interests of those on the political right and left, and offers a path toward an inclusive, resilient, and high-performing delivery system.
Financial Integration’s Impact On Care Delivery and Payment Reforms: A Survey Of Hospitals And Physician Practices
Elliott S Fisher, Stephen M. Shortell, James O’Malley et al. | August 3, 2020 | Health Affairs