Medical care prices in the United States are not only the most expensive in the world, but there are wide variations in what physicians are paid. Doctors at the frontlines of medical care who manage complex conditions argue that they receive disproportionately lower fees than physicians performing services such as minor surgeries and endoscopies.
Miriam J. Laugesen researches physician fees, payment reform, and how physician groups influence health policy. Her latest book is Fixing Medical Prices: How Physicians are Paid, forthcoming from Harvard University Press in November 2016. The book explores the Resource-Based Relative Value Scale (RBRVS)Ã¢â‚¬â€the basis for physician payments by Medicare and most private insurersÃ¢â‚¬â€and the role of a physician-led group called the Specialty Society Relative Value Scale Update Committee (RUC) in influencing those payments.
She is the author, with Robin Gauld, of Democratic Governance and Health: Hospitals, Politics and Health Policy in New Zealand (Otago University Press, 2012). Laugesen has also authored and co-authored over 30 book chapters and journal articles on state and local public health policies, public opinion, public health insurance coverage expansions, and health insurance benefit regulation.
Laugesen is a Public Voices Fellow in The Op-Ed Project's Columbia University Cohort 2015-2016, and a past recipient of a Robert Wood Johnson Foundation Investigator Award in Health Policy Research. She serves on the editorial boards of the Journal of Health Politics, Policy and Law, Health Economics, Policy and Law, and the Journal of Health Services Research and Policy.
Laugesen teaches a required course, "Health Policy and Political Analysis" (Fall and Spring), and an elective class, "Interest Group Politics" (Fall). She serves as the faculty lead for the Certificate in Health Policy Analysis (for HPM students), and the Certificate in Health Policy and Practice (for students in other Mailman departments). Both certificates are popular choices among Mailman students, with around 100 students enrolled at any one time.
Health Economics, Policy and Law
Journal of Health Politics, Policy and Law
Journal of Health Services Research and Policy
Affiliated Faculty, Master of Science in Bioethics Program
Honors & Awards
Areas of Expertise
Select Urban Health Activities
Mainstreaming Public Health in the Bloomberg Administration: A Model for Reform?: Dr. Laugesen was a co-investigator on a project led by Professor Kim Isett on the expansion of public health policies under Mayor Bloomberg. The study was funded by the Robert Wood Johnson Foundation. The project addressed three key questions (1) how were widespread reforms passed and implemented, (2) have these policies been effective, and will they be sustained, and, (3) what lessons, if any, can other cities learn from Mayor Bloomberg?s approaches in New York?
Select Global Activities
Democratic Governance and Health [book] , New Zealand: Governments in many countries are interested in increasing public participation in health care policy decision-making. One option is to create elected health boards of citizen representatives serving specific geographic areas. New Zealand is the only country in the world where elected health boards have been a core and enduring feature of the governance of its health system since the 19th Century. Elected boards have survived health system reform attempts by governments on the left and right. Much like Social Security in the US, this 'third rail' issue is one that generally receives strong public support. One attempt in the 1990s did succeed; hospitals were depoliticized and required to operate as profitable businesses. That effort ran aground, due to voter resistance (see Laugesen, "Why Some Market Reforms Lack Legitimacy" 2005). Democratic Governance in Health, coauthored by Miriam J. Laugesen and Robin Gauld was published by Otago University Press in 2012. It critically surveys the origins and endurance of elected boards in New Zealand, drawing on original archival research as well as recent survey data. The authors dispassionately consider the boards in the context of changing priorities of a regionalized, quality-oriented health care system in New Zealand.
Insurance coverage and health care across borders, Mexico: Previously, most analyses of insurance coverage and healthcare across borders explored specific countries or regions. European analyses often focused on treatment for specialty or high-cost services. In contrast, the high cost of US healthcare and the lack of basic coverage motivates some people to travel to Mexico for routine health care services. With Professor Arturo Vargas-Bustamante (UCLA), Dr. Laugesen sought to develop a more universal conceptual framework that would "travel" across a variety of health care system types, and reflect differences in insurance coverage and health care costs. The authors presented the framework at a European Consortium for Political Research workshop in 2009, and the paper was published in Health Policy in 2010. Next, with colleagues from the University of Texas, Dr. Laugesen and Dr. Vargas Bustamante researched how Medicare could potentially cover US retirees living in Mexico at a lower cost than in the US, and how uninsured Mexican nationals in the US could receive coverage through public programs sponsored by Mexico, or through private insurance plans operating in California. This analysis was published in Revista Panamericana de Salud/Pan American Journal of Public Health (with M. Caban, & P. Rosenau) in 2012.
Laugesen, M.J. (In press, Fall 2016) Fixing Medical Prices: How Physicians are Paid. Cambridge: Harvard University Press.
Oberlander, J. and M.J. Laugesen. 2015. Leap of Faith ÃƒÆ’Ã‚Â¢ÃƒÂ¢Ã¢â‚¬Å¡Ã‚Â¬ÃƒÂ¢Ã¢â€šÂ¬Ã‚Â MedicareÃƒÆ’Ã‚Â¢ÃƒÂ¢Ã¢â‚¬Å¡Ã‚Â¬ÃƒÂ¢Ã¢â‚¬Å¾Ã‚Â¢s New Physician Payment System. New England Journal of Medicine 373 (13) September 24, 1185-1187.
Laugesen, M.J. 2015. Commentary: Policy Disruption and Payment Policy Drift. Journal of Health Politics, Policy and Law 40(4) August.
Laugesen, M.J. 2015 Reflecting on Cross-National Comparisons of Human Resources for Health: What can we learn? Health Economics, Policy and Law 10 (April): 1-5.
Laugesen, M.J. 2014 The Resource-Based Relative Value Scale and Physician Reimbursement Policy. 146(5): 1413-1419.
Laugesen, M.J., R. Mistry, K. Carameli, K. Ribisl, J. Needleman, and R. Bastani. 2014. Early policy responses to the Human Papillomavirus Vaccine in the United States, 2006-2010. Journal of Adolescent Health 55(5): 659-664.
Laugesen, Miriam J. and Kimberley R. Isett. 2013. Evidence Use in New York City Public Health Policymaking. Frontiers in Public Health Services and Systems Research Vol. 1: No. 4.
Laugesen, M.J. and R. Gauld. 2012. Democratic Governance and Health: Hospitals, Politics and Health Policy in New Zealand. Dunedin: Otago University Press Dunedin.
Laugesen, M.J., R. Wada and E. Chen. 2012. In Setting Doctors' Medicare Fees, CMS Almost Always Accepts The Relative Value Update Committee Panel's Advice on Work Values Health Affairs 31 965-972.
Laugesen, M.J. and S.A. Glied 2011. Higher Fees Paid to US Physicians Drive Higher Spending for Physician Services Compared to Other Countries Health Affairs 30 1647-1656 2011