Draft:Adam Elshaug

Overview

Professor Adam Elshaug
Adam Elshaug in 2023
Born	1974 Mount Gambier
Citizenship	Australian
Alma mater	University of South Australia (B.A.), The University of Adelaide (B.Sc (Hons), M.P.H., Ph.D.)
Organization(s)	University of Adelaide (Department of Public Health), Harvard University (Department of Health Care Policy), University of Sydney (Menzies Centre for Health Policy and Economics), University of Melbourne (Centre for Health Policy, Melbourne School of Population and Global Health), Lown Institute (Brookline MA), The Brookings Institution (Washington DC), Commonwealth Fund (US)
Known for	Health services and policy research; health economics; health technology assessment; value in health care
Website	https://findanexpert.unimelb.edu.au/profile/873534-adam-elshaug

Adam Elshaug (born 1974 in Mount Gambier, Australia) is an Australian academic researcher and policy advisor. His research specialties include health system safety and efficiency, with a focus on measuring and reducing waste and low-value care for optimisation of value in healthcare delivery. Professor Elshaug practises an applied policy approach, spending up to 50% of his time working directly with policy partners, including national and state governments and third-party payers, to design and implement reforms to optimise health care safety and value, including the design and evaluation of alternative health delivery and payment models. Professor Elshaug is employed at the University of Melbourne as a Professor and Chair in Health Policy with joint appointments in the Melbourne School of Population and Global Health (MSPGH) and Melbourne Medical School. He also serves as Director of MSPGH’s Centre for Health Policy, in 2024 home to over 130 academic staff.

Education

Professor Elshaug attended the University of South Australia in Adelaide, where he obtained a Bachelor of Arts (B.A.) in Psychology and Sociology. Subsequently, he moved to the University of Adelaide and earned Honours in Science (B.Sc.(Hons) in Physiology. He then completed a Master of Public Health (M.P.H.) at the University of Adelaide in 2003, specialising in Health Policy and Epidemiology. Professor Elshaug went on to earn a Ph.D. in Health Economics and Policy also from the University of Adelaide in 2007, under the supervision of A/Prof John Moss and Professor Janet Hiller.

Career

After obtaining his doctorate in 2007, Professor Elshaug was awarded a series of prestigious fellowships beginning in 2008 as a Hanson Institute Research Fellow based in the School of Public Health, University of Adelaide, one year later in 2009 becoming Senior Research Fellow. The University of Adelaide remained his home institution upon being selected as the 2010-11 Commonwealth Fund Harkness Fellow in Health Care Policy and Practice at the Agency for Healthcare Research and Quality (AHRQ) in Washington DC, USA, mentored by Jean Slutsky, Dr. Carolyn Clancy, and Professor Alan Garber. Professor Elshaug was also awarded a NHMRC Sidney Sax Public Health (overseas) Fellowship, undertaken in the Department of Health Care Policy at the Harvard Medical School for 2011-13. From 2012-13, he was invited to be the Inaugural Visiting Fellow at the Commonwealth Fund in New York City.

Professor Elshaug returned to Australia in 2013 to become the Head, Value in Health Care Division (Lab), Associate Professor of Healthcare Policy, and was awarded the HCF Research Foundation Principal Research Fellowship, at the Menzies Centre for Health Policy at the University of Sydney. In 2016, he was promoted to full Professor, awarded the HCF Research Foundation Professorial Research Fellowship, and became Co-Director of the Menzies Centre for Health Policy at the University of Sydney.

Professor Elshaug returned to the US for 2019-20 to become Visiting Fellow in the Economics Studies’ Brookings Schaeffer Initiative for Health Policy at The Brookings Institution in Washington DC. Since 2014, Adam has maintained a strong relationship with The Lown Institute in Massachusetts as a non-resident Senior Fellow and has been economic and policy advisor to Cancer Australia.

In September 2020, Professor Elshaug moved to The University of Melbourne to become Professor and Chair in Health Policy and Director of the Centre for Health Policy in the Melbourne School of Population and Global Health (MSPGH), with a joint Chair appointment in the Melbourne Medical School. He remains an Honorary Professor at the Menzies Centre for Health Policy and Economics at the University of Sydney.

In the first three years of his appointment as Director at Melbourne University, the Centre for Health Policy grew from 35 to 130 academic staff and 50 PhD students.

Research and Advocacy Contributions

Professor Elshaug's research focuses on enhancing safety and efficiency within health system with a particular emphasis on measuring and mitigating waste, such as low-value care, to optimise value in health care utilising administrative health date. Engaging in an applied policy approach, Professor Elshaug dedicates up to half of his time collaborating directly with policy stakeholders. Together, they devise and enact reforms aimed at curbing waste and enhancing safety and value in healthcare. This includes crafting and assessing alternative payment models.

Professor Elshaug’s doctoral thesis highlighted shortfalls in Australia’s policy approach to reviewing the safety, effectiveness, and cost-effectiveness of health care services longstanding or entrenched on the Medicare Benefits Schedule (MBS), sometimes for decades, in stark contrast to new and emerging technologies now subject to stringent health technology assessment processes. He described this issue as being ‘stuck with the old and overwhelmed by the new.’ This work led to Professor Elshaug holding contiguous Ministerially-appointed advisory roles for the past 15 years to both Australian Labor and Liberal Coalition governments, appointed by multiple Federal Health Ministers and Deputy Secretaries to enact new review processes of all existing items on the Medicare Schedule through a safety, quality, and value lens.

He also contributed to the first-of-kind measurement of low value health care on a national scale in the Medicare program in the United States – with the method subsequently adopted by the Centers for Medicare and Medicaid Services (CMS). He expanded this work in Australia where all health care payer groups (Commonwealth, four states, private insurance, Veterans Affairs, workers compensation) have requested low-value care measurement be conducted within their systems. Several of these payers now licence the algorithms to carry out real-time measurement of low-value care within their respective systems.  

Professor Elshaug has been invited to conduct similar projects in the UK, South Korea, Canada, Spain, Norway, Sweden, and Thailand. As of January 2024, he has collaborated to attract over AUD$150 million (USD$100 million) in research funding and has received over 200 invitations to address conferences, government, academic, insurance, and health technology assessment groups internationally. Examples include as an invited speaker at The Commonwealth Fund's International Symposium in Washington, D.C. to address to Health Ministers and Secretaries from Australia, Canada, France, Germany, Israel, NZ, Netherlands, Norway, Sweden, Switzerland, the United Kingdom, and the United States; methodological briefings to the OECD Health Care Quality Indicator (HCQI) expert reference panel; the international Federation of Health Plans CEO forum; the Academy Health/ABIM Foundation/Donoghue Foundation Summits, and the Bill & Melinda Gates Foundation.

Professor Elshaug is a high-profile advocate for reducing use of low-value care. He has appeared before the Australian Senate Select Committee on Health to advocate change and has participated in over 40 media interviews across television, including an ABC ‘4 Corners’ 50- minute, nationally- televised special “Wasted” on low-value health care in Australia, newspapers (New York Times, Washington Post; The Australian, Medical Observer), and radio. One of Elshaug’s 2014 co-authored papers featured in Atul Gwande’s 2015 New Yorker article ‘America’s epidemic of unnecessary care’.

Select Contributions to Policy

Professor Elshaug holds/has held several committee and board roles, including (select at 2024):  

• Health Economics and Policy Advisor to Cancer Australia, which includes designing and overseeing economic modelling across the spectrum of cancer care (2014-current)
• Member of the Australian Health Department’s Scope of Practice Review (‘Unleashing the potential of our health workforce’) (2023-2015)
• Member of the Medicare Benefits Schedule Review Advisory Committee (MRAC) at the Australian Commonwealth Department of Health and Aged Care (2021-current)
• Member of the Expert Advisory Committee for Evidence-based Interventions (Academy of Medical Royal Colleges, NHS Clinical Commissioners (NHSCC), the National Institute for Health and Care Excellence (NICE), NHS England and Improvement) (2019-current)
• Member of the Australian Strengthening Medicare Taskforce at the Commonwealth Department of Health. Health Minister as the Chair of Taskforce (2022-2023)
• Member of the Victorian Perioperative Learning Health Network Advisory Group and; Quality and Safety Executive Council, Safer Care Victoria (current)
• Member of the MBS Review Taskforce, including its Principles and Rules Sub-Committee (2015-2020)
• Member of the Health Expert Working Group at the National Australian Broadband Advisory Council (2020-2022)
• Board Director at the New South Wales Bureau of Health Information (2017-2022)
• Elected Member of the Executive Committee of the Health Services Research Association of Australia and New Zealand (HSRAANZ) (2013-2017)

Awards and Honours

In 2020, Elshaug earned the Health Services Research Association of Australia & New Zealand (HSRAANZ)’s Health Services and Policy Research Impact Award, recognizing significant contributions to health services research and policy application in Australia. In 2016, he was the inaugural recipient (group award) of Research Australia’s Data Innovation in Health and Medical Research Award. In 2022, Professor Elshaug was a finalist in Research Australia’s Health and Medical Research Awards – Health Services Research Award category.

In his formative years, Professor Elshaug won Best Conference Presentation by a New/Emerging Researcher in 2005 and the Most Popular Session award in 2004. He also received the Australian Physiotherapy Association (APA) Medical School Scholarship in 1997 for his Honours degree and the Applied Research Award in 1996 from the University of South Australia School of Psychology, as well as a Merit Award from the World Federation of Sleep Research and Sleep Medicine Societies in 2007. These diverse accolades underscore Professor Elshaug’s consistent dedication to advancing health and medical research.

Publications

Elshaug has published over 185 technical reports and peer reviewed articles with first author publications. His publications have appeared in the Lancet (co-lead of the 2017 Right Care Series), the New England Journal of Medicine (NEJM), the British Medical Journal (BMJ), the Journal of the American Medical Association (JAMA), and the [Journal of Australia] (MJA). As of January 2024, he has received more than 6,700 citations, with a H-index of 38 and i-10 index of 64. Attesting to the applied policy approach to his work, as of January 2024 his work had garnered 299 citations across 218 policy documents, and 68 of those policy documents have been cited a further 625 times in 500 other policy documents.

Selection of peer-reviewed journal articles:

• Elshaug, A. G., Rosenthal, M. B., Lavis, J. N., Brownlee, S., Schmidt, H., Nagpal, S., Littlejohns, P., Srivastava, D., Tunis, S., Saini, V. (2017). Levers for addressing medical underuse and overuse: achieving high-quality health care. The Lancet, 390(10090), 191-202.
• Brownless, S., Chalkidou, K., Doust, J., Elshaug, A. G., Glasziou, P., Heath, II., Nagpal, S., Saini, V., Srivastava D., Chalmers, K., Korenstein D. (2017). Evidence of overuse of medical services around the world. The Lancet, 390(10090), 156-168.
• Badgery-Parker T, Pearson SA, Chalmers K, Brett J, Scott IA, Dunn S, Onley N, Elshaug AG. Low-value care in Australian public hospitals: prevalence and trends over time. BMJ Qual Saf. 2019 Mar;28(3):205-214.
• Schwartz, A. L., Landon, B. ., Elshaug, A. G., Chernew, M. E., McWilliams, J. M. (2014). Measuring low-value care in Medicare. JAMA Internal Medicine, 174(7), 1067-1076.
• Parkinson B, Sermet C, Clement F, Crausaz S, Godman B, Garner S, Choudhury M, Pearson SA, Viney R, Lopert R, Elshaug AG. Disinvestment and Value-Based Purchasing Strategies for Pharmaceuticals: An International Review. Pharmacoeconomics. 2015 Sep;33(9):905-24.
• Elshaug, A. G., Watt, A. M., Mundy, L., Willis, C. D. (2012). Over 150 potentially low-value health care practices: an Australian study. Medical Journal of Australia, 197(10), 556-560.
• Wade, V. A., Karnon, J., Elshaug, A. G., Hiller J. E. (2010). A systematic review of economic analyses of telehealth services using real time video communication. BMC Health Services Research, 10, 1-13.
• Morgan DJ, Brownlee S, Leppin AL, Kressin N, Dhruva SS, Levin L, Landon BE, Zezza MA, Schmidt H, Saini V, Elshaug AG. Setting a research agenda for medical overuse. BMJ. 2015 Aug 25;351:h4534. doi: 10.1136/bmj.h4534.
• Elshaug AG, Moss JR, Littlejohns P, Karnon J, Merlin TL, Hiller JE.Identifying existing health care services that do not provide value for money. Med J Aust. 2009 Mar 2;190(5):269-73.
• Elshaug AG, Hiller JE, Tunis SR, Moss JR. Challenges in Australian policy processes for disinvestment from existing, ineffective health care practices. Aust New Zealand Health Policy. 2007 Oct 31;4:23.