Université Paris Descartes—Sorbonne Paris Cité
Placement: Harvard School of Public Health
Mentor: Katherine Swartz, Ph.D. (Harvard School of Public Health)
Co-Mentor: David Grabowski (Harvard School of Medicine)
Project Title: Long-Term Services and Supports for Frail Elders in the United States: Is the State-Level Performance Associated with Lower Disability Risks?
Thomas Rapp, Ph.D., is a 2015–16 French Harkness Fellow in Health Care Policy and Practice. He is currently an associate professor in economics at Université Paris Descartes—Sorbonne Paris Cité. He is also adjunct director of the health economics research center at Université Paris Descartes – Sorbonne Paris Cité, where he leads the agenda to develop a research program that analyzes policies targeting elderly people who face autonomy loss risks. Rapp is also currently leading the health economics work-package of a five-year grant sponsored by the Innovative Medicine Initiative program of the European Commission. His roles in this project are to lead economic evaluations and to develop a network of European health policy experts working on long-term care issues. Rapp is also the masters’ director in health economics at University Paris Sorbonne Abu Dhabi, in the United Arab Emirates. His past positions have included research project leader at the University Hospital Toulouse, postdoctoral fellow at the University of Maryland and the Toulouse School of Economics, research and teaching assistant at University of Paris-Dauphine, and research assistant at CEPII, a French research institute affiliated with the economic policy planning for the French Prime Minister. Rapp has published his research in a number of journals, including Value in Health, Medical Care, Journal of the American Geriatrics Society, and Social Science and Medicine. He holds a Ph.D. and a master’s degree in economics from the University of Paris-Dauphine.
In both the U.S. and France, there is a growing cohort of vulnerable, frail elders who are a high-need and potentially high-cost population. Fragmentation and lack of efficiency of long-term services and supports (LTSS) reduce the performance of health systems to deliver the services this population needs. Consequently, there is an urgent need to define policy actions targeting frail elders, solving their needs, and monitoring them in the long-term. Overall, this research aims to explore which health policy actions should be taken to improve the performance of the U.S. system to deliver LTSS for frail elders. Rapp will use LTSS Scorecard data, an innovative tool measuring States’ performance in LTSS delivery for older adults and people with disabilities, merged with data from the Health and Retirement Study. Using these two data sets, Rapp will determine how residents of low-performance states face higher disability risks than residents of high-performance states, and which of the 5 Scorecard dimensions should be considered a priority by policy-makers to prevent disability risks in the frail elderly population. Further, within the 5 dimensions (which includes affordability, choice, quality, caregiver support, and effective transitions) he will observe which of the 26 Scorecard performance indicators contribute the most to decrease frail elders’ disability risks. The project results will be translated into recommendations for developing federal policies to reduce disability risks in the frail elderly population in both France and the U.S.
Career Activity since Fellowship:
Current Positions: Co-Editor, Value in Health (updated 09/2016)
Harkness Related Publications:
T. Rapp. “Genèse, bilan et futur de l’ObamaCare,” Revue Politique étrangère de l’IFRI/ IFRI. 2017 (“ObamaCare's Genesis, Record and Future, ” Foreign Policy Journal). 2017.