John Fox, MD, MHA, is senior medical director and associate vice president, medical affairs at Priority Health. He is responsible for medical technology assessment (medical and pharmaceutical), utilization and case management, physician profiling and pay-for-performance programs. He is also responsible for development of new programs, including shared decision making, advanced care planning, integrated specialty pharmacy program and value-based benefit designs. He is currently engaged in payment reform strategies, including oncology medical home initiatives and bundled payments with Prometheus.
The author of many articles, Dr. Fox has written on the use of firearms in suicides, firearm-related deaths and hospitalizations, breast cancer mortality rates, asthma hospitalizations, hip fractures among the elderly and the impact of spine management programs on surgery rates. He has also written and lectured on value-based benefit design, the impact of genomics and proteomics on the future of medical practice, and role of shared decision making in reducing unwarranted variations in healthcare utilization, including end-of-life. His current interests include the use of cost-effectiveness and number-needed-to-treat analyses in coverage determinations, specialty pharmacy management, the effect of pay for performance programs on health outcomes, and the role of advanced care planning in improving patient experience and health outcomes.