Harkness Project Title: Hospital Payment Systems: What difference do they make?
Mentors: Alain Enthoven, Ph.D., and Harold S. Luft, Ph.D.
Placement: University of California, San Francisco
Biography at time of Harkness Fellowship: Stephen P. Dunn, a 2003-4 Commonwealth Fund Harkness Fellow in Health Care Policy, is a senior policy advisor in the Department of Health in England. He was one of the principal architects of the flagship NHS Foundation Trust policy and was primarily responsible for designing and implementing the financial regime that Foundation Trusts operate under. Dunn has previously been a policy advisor in the Strategy Unit in the Department of Health, providing policy advice directly to the Secretary of State for Health on a range of strategic issues. He was a principal contributor to the 20-year review and costing of health trends led by Derek Wanless which underpinned the Chancellor’s decision to nearly double UK health care expenditure between 2002-03 – 2007-08. He has also advised and served on several national committees on resource allocation, incentives in the healthcare system and public performance ratings systems, and published numerous articles on Post Keynesian economics and the economics of the firm in leading international journals. In 2000 Dunn received the prestigious K.William Kapp prize from one of Europe’s largest economics associations. Dunn is also an international authority on the economics of J.K.Galbraith. In his spare time Dunn is a serious painter, and his paintings can be viewed at www.artmarket.org.uk.
Project: Stephen Dunn examined the issues and lessons for the U.K. in implementing a U.S.-style prospective payment system (PPS) for hospitals. It particularly considered the impact of such payment schemes on care for patients with chronic diseases. It examined the evidence from a number of health systems, including the Veterans Health Administration, Kaiser Permanente, Health Partners, and Sutter Health, through a literature review, site visits, and interviews with senior staff from hospitals.
Career Activity Since Fellowship
Willcox S, Seddon M, Dunn S, Edwards RT, Pearse J, Tu JV. “Measuring and Reducing Waiting Times: Cross-National Comparison Of Strategies,” Health Affairs 2007 26(4): 1078-1087.
Dunn SP. “Stars and Gripes,” Health Services Journal 2004; 24(5902): 41-2.
Dunn SP. “Hospital Payments Monitoring Program: Overview and Assessment,” Confidential Government Briefing Paper, Department of Health, May 2004.
Dunn SP. “Medicare Integrity Program: Background Briefing Note,” Confidential Government Briefing Paper, Department of Health, May 2004.
Dunn SP. “Keynes, Uncertainty and the Competitive Process,” Research in the History of Economic Thought and Methodology 2004; 22A: 65-92.
Dunn SP. “Towards a Post Keynesian Theory of the Multinational Corporation: Some Galbraithian Insights.” In: Uncertainty and Economic Decision-Making: Ambiguity, Mental Models and Institutions; ed: Nielsen K. Cheltenham: Elgar, 2004.
Dunn SP, “Transforming Post Keynesian Economics: Critical Realism and the Post Keynesian Project.” In: Transforming Economics: Perspectives on the Critical Realist Project; ed: Lewis P. London: Routledge, 2004.