University of Vermont

College of Medicine

Health Economist Jones Sheds New Light on Treatments, Links Medicine and Business

Dr. Chris Jones

The economy, like the weather, has its ups and downs and prompts daily discussions and even national movements. Health care follows a similar pattern. Bring the two topics together and you have health economics – the examination of health care interventions, the respective cost of these treatments, and the resulting outcomes in populations.

Health economist Christopher Jones, Ph.D., assistant professor of surgery and director of the Global Health Economics Unit at the University of Vermont’s Center for Clinical and Translational Science, says the health economist’s point of view can “shine light” on which medical interventions are best from the standpoint of reducing costs while improving patient outcomes. He currently collaborates with surgeons, behavioral psychologists, and obstetrics and gynecology specialists at UVM and Fletcher Allen Health Care to create models that predict the best course of action for treating a specific condition. His current research focuses on using incentives to attain cost-effective and cost-beneficial treatments for chronic disease.

This month, the Institute for Clinical and Economic Review (ICER), a leading academic comparative effectiveness research group based at the Massachusetts General Hospital’s Institute for Technology Assessment, announced that Jones was among a group of new members named to the 2012 New England Comparative Effectiveness Public Advisory Council (CEPAC). The 19 members of CEPAC come from all six New England states. The group’s goal is to provide objective, independent guidance on the application of medical evidence to clinical practice and payer policy decisions across the region. Supported by a federal grant from the Agency for Healthcare Research and Quality (AHRQ), and with backing from a consortium of New England state health policy leaders, CEPAC consists of practicing physicians and methodologists with experience in evaluating and using evidence in the practice of healthcare, as well as patient/public members with experience in health policy, patient advocacy and public health.

Jones brings unique expertise to CEPAC and UVM. A native of Gilford, N.H., he earned a bachelor’s degree from the University of Michigan, and Master of Science and Doctor of Philosophy degrees from the University of Oxford in England. His doctoral dissertation was the first to examine cost of treatments and cost of outcomes following treatments of in-vitro fertilization, as an interaction and at the population level, an endeavor which eventually led to national policy changes.

Prior to joining the UVM faculty in 2011, Jones worked in international finance and in industry, most recently as director of global health economics for a publicly traded pharmaceutical firm specializing in rare diseases. He spent five years collaborating with the National Institute for Health and Clinical Excellence (NICE) in London where he served as health economist for the Royal Institute of Psychiatrists’ National Guideline Development Group on six U.K. mental health initiatives. This experience included evaluating voucher-based incentive programs for treating substance misuse and changing health-related behaviors.

Today, Jones relies on that voucher-based incentive program experience in his work with Stephen Higgins, Ph.D., professor of psychiatry, who essentially established the voucher incentive system working with cocaine-dependent individuals more than 25 years ago. They are incentivizing women to lose weight pre-pregnancy and will then examine the impact of this pre-pregnancy weight loss on the caesarean section rate. A 2003 AHRQ study found that the average charge for childbirth-related hospitalizations was $8,300, but varied widely depending on whether the delivery was vaginal or C-section, with C-sections with complications averaging 2.5 times the average charge for vaginal births without complications.

For another study, he is collaborating with faculty in obstetrics, gynecology and reproductive sciences, and involving several medical students, to study infertility treatment on several levels. Jones, who created an algorithm that provided the foundation for a fertility prediction tool housed at www.formyodds.com, is mentoring Class of 2013 medical student Olivia Carpinello. She and Jones are looking at the cost-effectiveness of different embryo transfer policies used for in vitro fertilization (IVF) from a national perspective, using Society for Assisted Reproductive Technology data.

Working with Andrew Stanley, M.D., UVM associate professor of surgery and a vascular surgeon at Fletcher Allen, Jones is developing predictive cost-effectiveness models related to carotid artery surgery in New England, another project that hopes to incorporate incentives in a study of carotid endarterectomy patients.

“Smokers are more likely to need to come back for vascular problems and they consume scarce resources,” says Jones, who hopes to find answers to these questions: “Can incentives help doctors and caregivers get better and better at what they do, which is how bonuses work in the business world? Can the patient be paid to do what’s ultimately right for them, keep a healthy lifestyle, tell us how they’re doing and reduce the need for costly care so that more money and time are available at the end of the day?”

“Metaphorically, I’m surgically dissecting the healthcare system,” Jones explains.