Fisher Appointed Director of TDI

Hanover — Longtime health services research and health policy researcher and administrator Elliott Fisher has been tapped to head The Dartmouth Institute for Health Policy & Clinical Practice, succeeding James Weinstein, who stepped down last fall to become CEO of the Dartmouth-Hitchcock health system.

Fisher has been a part of TDI, formerly Center for the Evaluative Clinical Sciences, since 1986, two years before it opened. During his tenure, he has served in many roles — founding programs, leading research groups and teaching classes. But the work all connects back to TDI’s main focus, which Fisher describes as “trying to fix healthcare through research, educational programs and partnerships with health systems around the country and, increasingly, around the globe.”

He takes the reins as health care reform is gathering momentum across the country.

“It’s a great moment,” Fisher said yesterday. “Dartmouth can really make a difference here.”

As director, Fisher said his goals include strengthening the institute’s research and education programs, helping leverage TDI’s strengths, “and identifying our additional strengths that we need to develop,” he said.

Fisher earned his undergraduate and medical degrees from Harvard University and completed a residency in internal medicine and a master’s degree in public health at the University of Washington. He is a member of the Institute of Medicine of the National Academy of Sciences.

Formerly the director of the Center for Health Policy Research, his current roles at TDI include director for Population Health and Policy, which he founded, and co-director of the Dartmouth Atlas of Health Care. He is also a professor at the Geisel School of Medicine.

His research at TDI has helped shaped current tends in health care reform.

During the past decade , Fisher studied discrepancies in Medicare spending in different parts of the country. He found that more spending did not result in better health care.

Donald Berwick, former administrator for the Centers for Medicare and Medicaid Services, called the work “perhaps the most important health care research of the past several decades.”

“He has fundamentally changed thinking, in the U.S. and around the world, about the immense opportunities we have to improve health care while lowering costs,” Berwick said in a statement yesterday. “Patients, communities and nations are the beneficiaries of his intellectual leadership and energy.”

Fisher later began looking at ways to apply his findings. He worked with former CMS administrator Mark McClellan to lay the groundwork for a new payment and delivery model.

Accountable care organizations are designed to improve the efficiency and quality of health care, while lowering the costs.

“The basic notion is you achieve savings by improving care,” Fisher said. “If you pay attention to people who are sick, you can ... by improving their care, reduce costs.”

Providers who cut back on costs while offering high quality care are rewarded — insurance companies and government programs like Medicare split the savings with them. The benchmarks used to judge an accountable care organization’s (ACOs) success include patient satisfaction surveys and qualitative measures, Fisher said.

The model is currently in use as part of two major federal initiatives — the Medicare Shared Savings program and “Pioneer” ACOs, a group of 32 providers, including Dartmouth-Hitchcock, that began adopting the model in January. A number of private payers are also moving forward with ACOs, Fisher said.

Health care, which accounts for about one-sixth of the United States’ gross domestic product, “has never been as unstuck” as it is right now, he said. “We have an incredible opportunity to help under these new payment models.”

Just a few hours into his first day on the job, Fisher said he was honored to have been chosen to lead TDI. And, he added, the new position is “a slightly scary responsibility.”

“I’m excited,” he said, “and I will do the best I can.”

Aimee Caruso can be reached at or 603-727-3210.