Partner-A.James Lee -
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Published on: 11/19/2006
Last Visited: 11/19/2006
A. James Lee (PhD)
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Partner: A. James Lee (PhD)
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Jim has worked in the health care field for more than 25 years, and has a unique mix of experience in government, private industry, management consulting, and health services research and evaluation.He has a doctorate in economics, with a minor in operations research, from the University of Wisconsin.He has published extensively in the peer-reviewed literature.
As a Partner in Lee Analytics since 1988, Jim focuses primarily on health care and related services.
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Jim is also Senior Scientist and a member of the research faculty at the Schneider Institute for Health Policy, in the Heller Graduate School of Brandeis University.
Since joining Lee Analytics, Jim has prepared a strategic review of a proposed HMO acquisition, developed a business plan and identified new product opportunities for a health information systems company, suggested strategies and tactics for growing a health care consulting company, and consulted on claims-based risk adjustment.
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For the Massachusetts Department of Mental Health, Jim assisted with the strategic and financial planning of a special mental health clinic for Cambodians.More recently, he assisted a Lowell-area mental health provider with financial and market planning.
Jim recently assisted the Massachusetts Department of Medical Assistance in estimating the need and costs of providing interpreter services to MassHealth eligibles.As part of this involvement, he also surveyed the 45 clinic members of the Massachusetts League of Community Health Centers on their medical interpreting capabilities, and conducted in-depth site visit interviews with selected CHCs.He is currently working with Health Economics Research, Inc. (under contract with West Virginia Medicaid) to analyze and compare the overall efficiency of West Virginia hospitals.
Jim is working with Don Shepard and others at Brandeis University (under contract to the Center for Medicare and Medicaid Services, formerly HCFA) to evaluate the Medicare Lifestyle Modification Program Demonstration,including both Dr. Dean Ornish's Program for Reversing Heart Disease and Dr. Herb Benson's Mind/Body Medicate Institute . He is also providing analytic assistance (e.g., needs analysis) to a national health care company in seeking a Certificate of Need for an ambulatory surgery.
Jim has a long-standing interest in the competitive structure and outlook for the managed care industry.Working as a health care consultant with Arthur D. Little (ADL), Jim authored a number of proprietary monographs and other publications on HMO market structure and performance.
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While Vice President of Health Economics Research, Jim spent much of his time researching and evaluating managed care programs for HCFA.On one project, he worked in association with Brandeis University to document practical experience with health systems budgeting in the United States.In this project, Jim conducted case studies of the budgeting, risk sharing and incentive management within five managed care entities (Harvard Community Health Plan, Kaiser, AHCCCS and two large IPA-model HMOs, plus DOD's capitation budgeting initiative).He was also a principal in HER's evaluation of Oregon's innovative health system reform initiative involving prioritization of services.For that project, Jim was responsible for the utilization/cost, organizational linkages and data systems analyses.He was also co-principal investigator for the joint RTI/HER evaluation of the Medicare SELECT Amendments that authorized a PPO-type alternative to Medicare risk contracting.
Jim has either directed or served as key staff on many other HCFA studies, including various demonstration evaluation projects (e.g., MAC-EAC, hospital rate setting, second surgical opinion, and urban clinics).At HER, he was task leader for case studies in HER's evaluation of demonstrations for extension of Medicaid eligibility to low-income families not otherwise qualified to receive Medicaid benefits.Jim was also a co-investigator on RTI's study for HCFA to design a survey to monitor consumer's access to care, use of health services, health outcomes and patient satisfaction.He further directed HER's work on provider and administrative implementation issues associated with HCFA's Provider Partnership Demonstration.Jim was also principal investigator in evaluating the Medicare ICA (Information, Counseling and Assistance) program.
Jim has extensive experience in conducting analyses from claims data.He used the National Claims History (NCH) data to develop and evaluate innovative alternatives for packaging ancillary services with physician visits.In support of the AHCPR panel developing guidelines for post-stroke rehabilitation, he used NCH data to analyze geographic variation in the costs and use of post-stroke rehabilitation services.He also directed a HCFA project that described and simulated the distributional implications of bundling post-acute care (PAC) together with the inpatient stay.
Jim's management consulting activities at Arthur D. Little were focused on managed care, and strategic and information systems planning for the health care industry.In particular, he provided technical assistance to a variety of managed care organizations -- e.g., assisting with market assessment, market strategy, information systems and regulatory requirements.As Vice President of a Blue Cross & Blue Shield third-party administrator subsidiary, Jim was responsible for research and development relative to health benefits administration.
As Deputy Director of the Maine State Planning Office, Jim directed a staff of nine in conducting economic and social policy analyses for the State.He was also member of the Governor's Health Policy Advisory Council and the State Employee's Health Commission.
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