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Jacob West

2014–15 Harkness Fellow Director of Strategy King's College Hospital NHS Foundation Trust

Harkness Project Title: How Large-Scale Consolidation is Reshaping Health Care in the U.S.

Mentor: Ashish K. Jha, M.D., M.P.H. (Harvard School of Public Health)

Co-Mentor: Michael Chernew, Ph.D. (Harvard Medical School)

Placement: Harvard School of Public Health

Biography at time of Harkness Fellowship: Jacob West, M.P.P., a 2014–15 U.K. Harkness Fellow in Health Care Policy and Practice, is the director of strategy at King’s College Hospital, one of the leading academic hospitals in the U.K. West’s leadership has resulted in a number of transformations including a major integrated care program, the shift toward a paperless hospital, and the acquisition of two local hospitals. Prior to his current position, West served in various capacities in the Prime Minister’s Strategy Unit, including as deputy director and acting director, where he advised the Prime Minister on a range of public policy issues including health, education, and housing. His past positions also have included senior policy advisor in the Premier’s office of Queensland, Australia, and as a public sector consultant in California. West’s research interests include health strategy and reform, accountable care organizations, and mergers and acquisitions. He received a master’s degree in public policy from the University of California, Berkeley.

Project: “Big Healthcare” is reshaping the U.S. health care market. Hospitals are merging with each other, with physician groups, and with other providers at a growing rate. Most existing research concentrates on hospital-to-hospital mergers, and in particular the impact on prices. There is less research on the impact of vertical integration between hospitals, physician groups and other kinds of health care providers on quality and costs. Jacob’s research will examine how large providers are reshaping U.S. health care. He will first explore trends in consolidation among U.S. health care providers to understand the types of large organizations that are emerging, and what impact this may be having on quality and cost. Second, he will undertake a quantitative study to examine what impact “vertical integration” (between hospitals and physician groups) has on quality and costs. Third, through case studies he will compare vertically integrated organizations (where the hospital owns physician groups) with multispecialty medical groups that are not vertically integrated. He will examine how these different organizations are achieving higher quality care and reducing costs through clinical and functional integration. The case studies will include accountable care organizations and non- accountable care organizations.

Career Activity since Fellowship:

Current Positions: National Lead, Primary and Acute Care Systems, NHS England (updated 09/2015)

Email: [email protected]

Harkness Related Publications:

J. West, A. Mehrotra A. “The Future Ecology of Care,” Annals of Internal Medicine, 2016.