J. William (Bill) Thomas, J.D., M.B.A.

July 1, 2008

Bill Thomas, Ph.D., M.B.A., is a professor of health policy and management at the University of Southern Maine and a Professor Emeritus of health management and policy at the University of Michigan School of Public Health. In recent years, Dr. Thomas's research has focused on measuring efficiency and quality of care performance of health care providers. During the 1980s and early 1990s, his work focused primarily on hospital inpatient care, and then later on the economic profiling of physicians.

Dr. Thomas holds both an M.B.A. and a Ph.D. in managerial science and applied economics from the Wharton School at the University of Pennsylvania. He also holds a bachelor's degree in mechanical engineering from the Georgia Institute of Technology.

Dr. Thomas has been the principal investigator on several HCFO-sponsored projects. Currently, he is conducting the second phase of a study designed to measure the degree to which fears of medical malpractice litigation motivate physicians to practice positive defensive medicine, which includes ordering tests, procedures, and/or medications that offer little or no clinical benefit to patients. In the first phase, Dr. Thomas and his colleagues at the University of Southern Maine constructed a database of tort signals and health claims data. Dr. Thomas said, "Our early findings show no association between medical liability costs and the monetary amount physicians charge for their services. We now want to explore possible relationships between medical liability costs and the number of services provided. We hope these studies will help researchers, practitioners, and policymakers better understand the effects of medical liability on our health care system."

In another current HCFO-funded study, Dr. Thomas is analyzing alternative strategies for measuring specialist physician cost efficiency. A principal objective of this study is to improve methods for measuring the cost efficiency of specialist physicians in order to provide stakeholders with more reliable means for developing physician networks, assigning tiers, and implementing public reporting.

In earlier HCFO-funded work, Dr. Thomas explored the use of tiered hospital and physician networks in employer-sponsored health plans. He concluded that while there is some evidence that tiered networks control health care cost increases, there is no evidence that the quality of care is impacted. "We found that it is not clear that incentives, by themselves, motivate providers to improve performance," said Dr. Thomas. He also examined the use of physician profiling methodologies, which assess the efficiency of both primary and specialty physicians. "Although we observed moderate consistency among different risk-adjusted primary care physician rankings," said Thomas, "consistency of measures does not prove that practice efficiency rankings are valid, and health plans should be careful in how they use practice efficiency information." In an analysis of cost outlier methodology on the accuracy of specialists' economic profiles, Dr. Thomas concluded that "no consistent combination of outlier methodology and episode attribution methodology was found to be superior for identifying cost-inefficient physicians."

For more information on Dr. Thomas and a list of publications, please visit http://muskie.usm.maine.edu/m_view_person.jsp?id=1386.