Amol S. Navathe

About

Amol S. Navathe, MD, PhD, is a Professor of Medical Ethics and Health Policy at the University of Pennsylvania. He is also a Senior Fellow at the Leonard Davis Institute of Health Economics and serves as Co-Director of the Healthcare Transformation Institute at the University of Pennsylvania, as well as Co-Director of the Healthcare Transformation Institute at the Perelman School of Medicine. Additionally, he is the Founding Director of The Parity Center: Equity through Payment Reform at the Perelman School of Medicine. His educational background includes a B.S. in Electrical Engineering & Economic Systems from Stanford University, graduating Magna Cum Laude in 2001; a Ph.D. in Health Care Management and Economics from The Wharton School, University of Pennsylvania, in 2008; and an M.D. from the University of Pennsylvania Perelman School of Medicine in 2010. His research focuses on health policy, healthcare payment reform, health equity, and the application of economics and ethics to medical decision-making and health systems. He has contributed to understanding payment models, hospital participation in bundled payments, virtual specialty palliative care, and addressing racial bias in clinical algorithms, among other topics.

Research topics

• Business
• Actuarial science
• Medicine
• Finance
• Economics
• Public economics
• Environmental health
• Economic growth
• Political Science
• Family medicine

Selected publications

• The Impact of Medicare's Alternative Payment Models on the Value of Care

  Annual Review of Public Health · 2020 · 61 citations

  Over the past decade, the Centers for Medicare and Medicaid Services (CMS) have led the nationwide shift toward value-based payment. A major strategy for achieving this goal has been to implement alternative payment models (APMs) that encourage high-value care by holding providers financially accountable for both the quality and the costs of care. In particular, the CMS has implemented and scaled up two types of APMs: population-based models that emphasize accountability for overall quality and…

  DOI

• Spending and quality after three years of Medicare’s bundled payments for medical conditions: quasi-experimental difference-in-differences study

  BMJ · 2020 · 45 citations

  Senior authorCorresponding

  OBJECTIVE: To evaluate whether longer term participation in the bundled payments for care initiative (BPCI) for medical conditions in the United States, which held hospitals financially accountable for all spending during an episode of care from hospital admission to 90 days after discharge, was associated with changes in spending, mortality, or health service use. DESIGN: Quasi-experimental difference-in-differences analysis. SETTING: US hospitals participating in bundled payments for acute myo…

  DOI

• Value-Based Payment Models In The Commercial Insurance Sector: A Systematic Review

  Health Affairs · 2022 · 29 citations

  Value-based payment models are a prominent strategy in health reform. Although Medicare payment models have been extensively evaluated, much less is known about value-based payment models in the commercial insurance sector. We performed the first systematic review of the quality, spending, and utilization effects of commercial models, extracting results from fifty-nine studies. Forty-one of these studies evaluated outcomes. More studies had positive results for quality outcomes (81 percent of st…

  PublisherDOI

• Racial Bias in Clinical and Population Health Algorithms: A Critical Review of Current Debates

  Annual Review of Public Health · 2024-12-03 · 17 citations

  reviewOpen access

  Among health care researchers, there is increasing debate over how best to assess and ensure the fairness of algorithms used for clinical decision support and population health, particularly concerning potential racial bias. Here we first distill concerns over the fairness of health care algorithms into four broad categories: ( a ) the explicit inclusion (or, conversely, the exclusion) of race and ethnicity in algorithms, ( b ) unequal algorithm decision rates across groups, ( c ) unequal error…

  PublisherDOI

• Association of Participation in Medicare's Oncology Care Model With Spending, Utilization, and Quality Outcomes Among Commercially Insured and Medicare Advantage Members

  Journal of Clinical Oncology · 2024-10-02 · 9 citations

  articleOpen access

  PURPOSE The Oncology Care Model (OCM), a value-based payment model for traditional Medicare beneficiaries with cancer, yielded total spending reductions that were outweighed by incentive payments, resulting in net losses to the Centers for Medicare & Medicaid Services. We studied whether the OCM yielded spillover effects in total episode spending, utilization, and quality among commercially insured and Medicare Advantage (MA) members, who were not targeted by the program. PATIENTS AND METHOD…

  PublisherDOI

Frequent coauthors

• Joshua M. Liao

  The University of Texas Southwestern Medical Center

  201 shared

• Ezekiel Emanuel

  94 shared

• Ravi B. Parikh

  Penn Center for AIDS Research

  72 shared

• Jingsan Zhu

  University of Pennsylvania

  72 shared

• Kevin G. Volpp

  University of Pennsylvania

  64 shared

• Kevin G. Volpp

  Penn Center for AIDS Research

  54 shared

• Deborah S. Cousins

  University of Pennsylvania

  36 shared

• Rachel M. Werner

  30 shared

Labs

• Medical Ethics and Health PolicyPI

Education

• B.S., Electrical Engineering & Economic Systems

  Stanford University

  2001

• Ph.D., Health Care Management and Economics

  The Wharton School, University of Pennsylvania

  2008

• M.D.

  University of Pennsylvania Perelman School of Medicine

  2010

Awards & honors

• Senior Fellow, Leonard Davis Institute of Health Economics
• Co-Director, Healthcare Transformation Institute, University…
• Founding Director, The Parity Center: Equity through Payment…

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