Miriam Laugesen, PhD

  • Associate Professor of Health Policy and Management
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Overview

Miriam Laugesen, PhD, is an Associate Professor (with tenure) and Faculty Lead for the Certificates in Health Policy Analysis and Health Policy and Practice in the Department of Health Policy and Management (HPM) at the Mailman School of Public Health, Columbia University. She teaches courses in health policy and political analysis, the integration of public health science and practice, policy advocacy, and personal leadership in public health. From 2023 to 2024, Laugesen was a Robert Wood Johnson Health Policy Fellow at the National Academy of Medicine. During this time, she served as a Legislative Fellow in the office of Senator Elizabeth Warren, contributing to Senator Warren’s private equity legislation, congressional oversight of private equity investors, and Medicare payment policy.

Laugesen is an expert in physician reimbursement, primary care, and private investment in healthcare. She has authored 75 publications, including 50 peer-reviewed papers in leading journals, as well as two books. Her book, Fixing Medical Prices: How Physicians Are Paid (Harvard University Press, 2016), examines the role of a committee of medical organizations that advises Medicare on physician services. The book was foundational in shaping the National Academy of Medicine’s primary care recommendations in 2021 and 2025, and influenced the bipartisan "Pay PCPs Act," introduced in the U.S. Senate in 2024, which proposed changes to Medicare’s advisory structure.

Laugesen's previous research, conducted with Sherry Glied, found that prices for hip replacements and office visits in the U.S. exhibited greater price differentials compared to other countries. Surprisingly, however, U.S. primary care fees showed less deviation from international prices. While prior research had argued that higher U.S. prices led to higher expenditure, this study used novel data sources to create granular cross-national price comparisons. Rather than showing uniformity in U.S. prices, it demonstrated variation within service types. This prompted renewed conversations about the relationship between U.S. expenditure and U.S. prices, as well as primary care fees.

Laugesen’s first book, Democratic Governance and Health (Otago University Press, 2012), coauthored with Robin Gauld, explores the historical and contemporary development of locally elected hospital boards in New Zealand. She is currently coauthoring a book on reimbursement practices in France, Germany, and Japan.

Her work has been featured in media outlets globally, including radio and television interviews on Marketplace, WNYC’s Brian Lehrer Show, and Al Jazeera. It has also been covered in The New York Times, The Wall Street Journal, Politico, The Washington Post, The Atlantic, The Washington Monthly, STAT News, The San Francisco Chronicle, The Los Angeles Times, Toronto Star, The Guardian (London), The Independent (London), and Neue Zürcher Zeitung (Zurich).

In 2023, Laugesen was named a Council on Foreign Relations International Affairs Hitachi Fellow to Japan. She is a past Columbia University Provost Leadership Fellow, awarded to Columbia’s outstanding mid-career and senior faculty members; a Tow Faculty Scholar, for outstanding and innovative research and thought leadership by mid-career faculty; a former Robert Wood Johnson Foundation Investigator Awardee; and a former Fulbright Scholar.

Laugesen has served on expert panels on national government and nonprofit initiatives related to physician payment and currently serves on the National Academy of Medicine Workgroup on Private Investment in Healthcare. She has previously served as President of the American Political Science Association’s Health Politics and Policy Section, as a member of Academy Health’s Education Council, and was Book Review Editor for the Journal of Health Politics, Policy and Law.

Laugesen earned her PhD in Political Science from the University of Melbourne and was a Special Student in Harvard University’s Health Policy PhD Program. She completed postdoctoral training in health services research at RAND–UCLA. She holds a BA (Hons) (First Class) in Politics and Public Administration from Victoria University of Wellington and an MA in Political Science from Washington University in St. Louis.

Academic Appointments

  • Associate Professor of Health Policy and Management

Administrative Titles

  • Certificate Lead for Health Policy Certificates, Department of Health Policy and Management
  • Faculty, Obesity Prevention Initiative
  • Affiliated Faculty, Master of Science in Bioethics Program
  • Advisory Board, Center for Health Policy
  • Director, Faculty Lead

Credentials & Experience

Education & Training

  • BA, 1992 (First Class Honors) Victoria University of Wellington
  • 1992 Harvard University Health Policy PhD Program (non-degree program)
  • MA, 1993 Washington University in St. Louis
  • PhD, 2000 University of Melbourne

Committees, Societies, Councils

Editorial Boards

Health Economics, Policy and Law

Journal of Health Politics, Policy and Law

Journal of Health Services Research and Policy

Honors & Awards

Council on Foreign Relations International Affairs Hitachi Fellow to Japan, 2023

Columbia University Provost Leadership Fellow, 2021-2023

Tow Faculty Scholar, 2019-2021

Gold Award, Legislative/Government Article, Association of American Society of Healthcare Publication Editors, with Kim Isett and David Cloud

Leonard S. Robins Best Paper Award 2014, American Political Science Association, Section on Health Politics and Policy. For best health politics paper presented at the 2013 Annual Meeting

Robert Wood Johnson Investigator Award in Health Policy Research, 2009

Fulbright Graduate Scholar, 1992

Research

A problem well stated is a problem half-solved. (Charles Kettering)

Research Interests

  • Healthcare Policy

Selected Publications

Gusmano, M.K., Laugesen, M., Rodwin, V.G. and Brown, L.D., 2020. Getting The Price Right: How Some Countries Control Spending In A Fee-For-Service System: Study examines mechanisms commonly used by some countries to set and update health care prices. Health Affairs, 39(11), pp.1867-1874.

Laugesen, Miriam J. 2019. How the American Medical Association's Rent-Seeking Strategy Compensated for Its Loss of Members. Journal of Health Politics Policy and Law 44 (1): 67-85.

L Gross, Tal and Miriam J. Laugesen. 2018. ""The Price of Health Care: Why Is the United States an Outlier?"" Journal of Health Politics Policy and Law October 43 (5): 771-791.

Laugesen, Miriam J. 2018. Regarding ""Committee Representation and Medicare Reimbursements: An Examination of the Resource-Based Relative Value Scale"" Health Services Research 53(6): 4123-4131.

Laugesen, Miriam J. 2018. Do Other Countries Have a Better Mix of Generalists and Specialists? Journal of Health Politics Policy and Law 43 (5): 853-872.

Spivack, Steven B., Miriam J. Laugesen, Jonathan Oberlander. 2018. No Permanent Fix: MACRA, MIPS, and the Politics of Physician Payment Reform. Journal of Health Politics Policy and Law 43 (6): 1025-1040.

Laugesen, M.J. (2016) Fixing Medical Prices: How Physicians are Paid. Cambridge: Harvard University Press. http://www.hup.harvard.edu/catalog.php?isbn=9780674545168

Oberlander, J. and M.J. Laugesen. 2015. Leap of Faith: New Physician Payment System. New England Journal of Medicine 373 (13) September 24, 1185-1187.

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

Global Health Activities

Fixing Medical Prices: Global Lessons (expected completion 2021), France, Germany, Japan: International Evidence from Better Health Systems (2016-): Accurate healthcare pricing of physician services is fundamental for creating the right incentives in a healthcare system. Our paper (2020) in Health Affairs provided an overview of the mechanisms other countries use to set prices. Our book manuscript addresses fee-for-service reimbursement, alternative payment models, and the use of incentive payments in a selected number of high-income countries to evaluate the advantages and disadvantages of different payment methods. The project also aims to identify strategies countries use to balance prices, utilization and expenditure suitable for adoption in the US by private and public payers. PI: Miriam Laugesen with Michael Gusmano (Rutgers), Lawrence Brown (Columbia), Victor Rodwin (NYU)

Insurance coverage and health care across borders (Completed), 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.

Democratic Governance and Health [book] (Completed 2012), 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 are a core and enduring feature of the governance of its health system. Elected boards have survived health system reform attempts by governments on the left and right. One attempt in the 1990s succeeded--for a time-- 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"" Journal of Health Politics, Policy and Law, 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.

Urban Health Activities

Developing a New Terminology for Funding Social Services: With funding from the Robert Wood Johnson Foundation Systems for Action program, this project (Miriam Laugesen and Sara Abiola, co-PIs) is studying the feasibility of developing billing systems for reimbursing providers for social and health services in one system. Even if policymakers agree we need to address social determinants of health, aligning social and health services requires communication between a network of national payers and providers. As in the business sector, compatible information systems are key for alignment, and we need a common language that works across a variety of state and federal programs, as well as private payers.

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?