Structural and Funding Policy Unit
New South Wales (NSW) Department of Health
Harkness Project Title: Health-Based Risk Adjustment for Capitation Payment in the United States: Implications for Australia
Mentor: Gerard F. Anderson, Ph.D.
Placement: Johns Hopkins Bloomberg School of Public Health
Biography at time of Harkness Fellowship: James Pearse, a 2000-01 Commonwealth Fund Harkness Fellow in Health Care Policy, is director of the New South Wales (NSW) Department of Health’s Structural and Funding Policy Unit. He has led work on the establishment of annual hospital DRG cost data collection for public hospitals in NSW, led the preparation and analysis of case-mix standards for NSW public hospitals, and was a major contributor to NSW’s plan to increase efficiency and improve equity and quality in public hospitals. Pearse has also contributed to national and state health reform initiatives and the negotiation of Commonwealth/State funding arrangements for hospital services. Recently he participated in the development of a framework for measuring national health system performance. His publications have focused on the fiscal relationships among federal and state governments, case-mix classification, efficiency of Australian hospitals, and costs of providing health services to indigenous peoples. Pearse received his M.Sc. in health economics from the University of York. Pearse is spending his Harkness Fellowship conducting an evaluation of weighted capitation funding models and their potential use in United States and Australia at the Johns Hopkins University’s Bloomberg School of Public Health.
Project: James Pearse’s project sought to explore the rationale for implementation of risk adjustment in capitation payment, the barriers to adopting risk adjustment, and other elements of the policy framework required for successful operation of these arrangements. He interviewed 30 key informants representing a variety of perspectives, including from government, provider, insurer, and academic communities.
Career Activity Since Fellowship
- Associate Professor, Centre for Health Service Development, University of Wollongong, 2003
- Director, Health Policy Analysis Pty Ltd, 2003
- Honorary Senior Fellow, George Institute for International Health, 2003
- Adjunct Associate, Center for Primary Care and Outcomes Research, Stanford University
Current Positions: (Updated 1/2014)
- Associate Professor, Centre for Health Service Development, University of Wollongong
- Director, Health Policy Analysis Pty Ltd
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
Walker AE, Percival R, Thurecht L, Pearse J. Public policy and private health insurance: distributional impact on public and private hospital usage. Aust Health Rev. 2007 May;31(2):305-14.
Walker A, Pearse J, Thurecht L, Harding A. Hospital admissions by socio-economic status: does the 'inverse care law' apply to older Australians? Aust N Z J Public Health. 2006 Oct;30(5):467-73.
Walker A, Percival R, Thurecht L, Pearse J. Distributional impact of recent changes in private health insurance policies. Aust Health Rev. 2005 May;29(2):167-77.
Gibbs A, Pearse EJ, Sheehan JA, Meleady KT, Jayasinha H and Jones N. “Estimating and Projecting Sub-Acute Care Demand: Finding from a review of international models.” Australian Health Review 2008. 32 (4): 778-785.