R. Adams Dudley , MD, MBA

Professor of Medicine and Health Policy

Associate Director for Research

Dr. Dudley is Professor of Medicine and Health Policy and Associate Director for Research at UCSF’s Philip R. Lee Institute for Health Policy Studies. In 2005, he became the first physician at UCSF to receive the prestigious Robert Wood Johnson Foundation Investigator Award in Health Policy. He has been elected to the American Society for Clinical Investigation.

His major research interests include developing measures of quality, appropriateness, and efficiency of care; assessing the impact of strategies intended to improve performance (including payment reform, pay-for-performance, public reporting, and incentives for consumers); and financial risk adjustment (adjusting premiums and capitation rates to reflect the severity of illness of enrollees). He has three primary projects currently. The California Intensive Care Outcomes (CALICO) project involves developing reports of hospital-specific ICU quality of care and efficiency for ICUs in California. The California Hospital Assessment and Reporting Task Force (CHART), which he founded and leads, has convened representatives of consumers, purchasers, health plans, and hospitals in California to establish a consensus, universal, robust hospital performance reporting system. (CHART was recently named the best hospital performance public reporting program in the country by the Center for Studying Health System Change and the CHART web site, www.CalHospitalCompare.org, receives over 1.5 million page views annually.) Finally, he leads a national study of public reporting web sites. He also is working with public and private purchasers to summarize the research on quality-based purchasing and consumer-driven health care strategies to identify optimal approaches to health care purchasing.

Dr. Dudley’s mentees have an outstanding track record, including winning Young Investigator and Article of the Year Awards from such organizations as AcademyHealth, the American College of Cardiology, and the Society of General Internal Medicine. Eight different mentees have had first author papers in JAMA and the New England Journal of Medicine. Dr. Dudley’s mentees have also published in health services research journals such as Medical Care and Health Affairs, and in specialty journals such as the Journal of the American College of Surgeons, Kidney International, Diabetes Care, and CHEST. In addition, they have obtained K awards or equivalent career development awards from NIH, AHRQ, the Robert Wood Johnson Foundation, and specialty organizations such as the American Heart Association. Current or former mentees are on the faculties at the University of Witten/Herdecke (Germany), Harvard, Penn, RAND/Pitt, Vanderbilt, UCSF, Stanford, and the University of Hawaii.

Publications: 

Yoo, EJ, Dudley, RA. Evaluating Telemedicine in the ICU. JAMA, 2009; 302(24):2705-2706.

Kahn, JM, Scales, DC, Au, DH, Carson, SS, Curtis, JR, Dudley, RA, Iwashyna, TJ, Krishnan, JA, Maurer, JR, Mularski, R, Popovich, J, Rubenfeld, GD, Heffner, JE. An Official American Thoracic Society Policy Statement: Pay-for-Performance in Pulmonary, Critical Care, and Sleep Medicine. American Journal of Respiratory and Critical Care Medicine, in press.

Kernisan, LP, Lee, SJ, Landefeld, CS, Dudley, RA. Association between Hospital-reported Leapfrog Safe Practices Scores and Inpatient Mortality. JAMA, 2009; 301(13):1341-1348.

Bardach, NS, Dudley, RA. Public Reporting: A Decision Guide. AHRQ Publication No. Pending. Rockville, MD: Agency for Healthcare Research and Quality. In Press.

Vasilevskis, EE, Kuzniewicz, MW, Dean, ML, Clay, T, Rennie, DJ, Vittinghoff, E, Dudley, RA. Mortality Probability Model III and Simplified Acute Physiology Score: Assessing their Value in Predicting Length of Stay and Comparison to APACHE IV. CHEST, in press. 

Gregg, EW, Karter, AJ, Gerzoff, RB, Safford, MM, Brown, A, Tseng, CW, Waitzfielder, B, Herman, W, Mangione, CM, Selby, J, Thompson, J, Dudley, RA. Characteristics of Insured Patients with Persistent Lapses in Diabetes Care Services: The Translating Research in to Action for Diabetes (TRIAD) study. Medical Care, in press.

Lin, GA, Dudley RA, Lucas, FL, Malenka, DJ, Vittinghoff, E, Redberg, RF. Frequency of Stress Testing to Document Ischemia Prior to Elective Percutaneous Coronary Intervention. JAMA, 2008; 300(15):1765-1773. 

Kuzniewicz, MW, Vasilevskis, EE, Lane, R, Dean, ML, Trivedi, NG, Rennie, DJ, Clay, T, Kotler, PK, Dudley, RA. Variation in ICU Risk-adjusted Mortality: Impact of Methods of Assessment and Potential Confounders. CHEST, 2008; 133(6):1319-27.

Werner, RM, Goldman, LE, Dudley, RA. Comparison of change in quality of care between safety-net and non-safety-net hospitals. JAMA, 2008; 299(18):2180-2187. Named one of the “Ten Most Influential Papers of 2008” in peer voting sponsored by the Robert Wood Johnson Foundation. 

Goldman, LE, Dudley, RA. United States Rural Hospital Quality in the Hospital Compare Database—Accounting for Hospital Characteristics. Health Policy, 2008; 87(1):112-27. 

Anderson Rothman, A, Park, H, Hays, RD, Edwards, C, Dudley, RA. Can Additional Patient Experience Items Improve the Reliability of and Add New Domains to the CAHPS® Hospital Survey? Health Services Research, 43(6):2201-22. 

Lin, GA, Dudley, RA, Redberg, RF. Why Physicians Favor Use of Percutaneous Coronoary Intervention to Medical Therapy: A Focus Group Study. Journal of General Internal Medicine, 2008; 23(9):1458-63. 

Tseng, CW, Mangione, CM, Brook, RH, Keeler, EM, Dudley, RA. Identifying Widely Covered Drugs and Drug Coverage Variation Among Medicare Part D Formularies. JAMA, 2007; 297(23):2596-2602. 

Goldman, LE, Henderson, S, Dohan, DP, Talavera, JA, Dudley, RA. Public Reporting and Pay-for-performance: Safety Net Hospital Executives’ Concerns and Policy Suggestions. Inquiry, 2007; 44(2):137-45. 

Rosenthal MB, Dudley RA. Pay-for-Performance: Will the Latest Payment Trend Improve Care? JAMA, 2007; 297(7):740-744. 

Goldman, LE, Vittinghoff, E, Dudley, RA. Quality of Care in Hospitals with a High Percent of Medicaid Patients. Medical Care, 2007; 45(6):579-83. 

Frolich, A, Talavera, JA, Broadhead, P, Dudley, RA. A Behavioral Model of Clinician Responses to Incentives to Improve Quality. Health Policy, 2007; 80(1):179-93. 

Mehrotra, A, Grier, SA, Dudley, RA. The Relationship Between Health Plan Advertising and Market Incentives: Evidence of Risk Selective Behavior. Health Affairs, 2006; 25(3):759-65. 

Dudley, RA, Rosenthal, MB. Pay for Performance: A Decision Guide for Purchasers. AHRQ Publication No. 06-0047. Rockville, MD: Agency for Healthcare Research and Quality, 2006. Available online at www.ahrq.gov/qual/p4pguide.htm.

Robinowitz, DL, Dudley, RA. Public Reporting of Provider Performance: Can it Improve Quality? Can Its Impact Be Made Greater? Annual Review of Public Health, 2006; 27:517-536. 

Dudley RA. Pay-for-performance research: how to learn what clinicians and policy makers need to know. JAMA. 2005; 294(14):1821-3. 

Lipton, HL, Agnew, JD, Stebbins, M, Kuo, A, Dudley, RA. Managing the Unmanageable: The Nature and Impact of Drug Risk in Physician Groups. Journal of Health Politics, Policy and Law, 2005; 30(4):719-50. 

Jha, AK, Perlin, JB, Kizer, KW, Dudley, RA. Effect of the Transformation of the Veterans Affairs Health Care System on the Quality of Care. New England Journal of Medicine, 2003; 348(22):2218-27. 

Mehrotra, A, Bodenheimer, T, Dudley, RA. Employers’ Efforts To Measure And Improve Hospital Quality: Determinants of Success. Health Affairs, 2003; 22(2):60-71. 

Dudley, RA, Medlin, CA, Hammann, LB, Cisternas, MG, Brand, R, Rennie, DJ, Luft, HS. The Best of Both Worlds? The Potential of Hybrid Prospective/Concurrent Risk Adjustment. Medical Care, 2003; 41(1):56-69. 

Dudley, RA, Rittenhouse, D, Bae, R. Creating a Statewide Hospital Quality Reporting System. Oakland, CA: California Health Care Foundation; 2002. 

Gupta, N, Kotler, PK, Dudley, RA. A Report Card Approach to ICUs. Journal of Intensive Care Medicine, 2002; 17(5):211-218. 

Dudley, RA, Hricak, H, Scheidler, J, Yu, K, Kahlben, C, Powell, CB, Schwartz, L, Yetter, EM, O’Malley, CM, Warren, R. Shared Patient Analysis: A Method to Assess the Clinical Benefits of Patient Referrals. Medical Care, 2001; 39(11):1182-1187. 

Dudley, RA, Luft, HS. Managed Care in Transition. New England Journal of Medicine, 2001; 344(14):1087-1092. 

Dudley, RA, Johansen, KL, Brand, R, Rennie, DJ, Milstein, A. Selective Referral to High Volume Hospitals: Estimating Potentially Avoidable Deaths. JAMA, 2000; 283(9):1159-1166.

Selected Projects: