HENRY G. DOVE, Ph.D.

Education

Ph.D. Yale University, 1976. School of Organization and Management; and Health Services Research Center, Institution for Social and Policy Studies. Dissertation Title: A Technique to Develop Conditional Process Criteria to Evaluate the Quality of Diagnostic Workups. Dissertation Advisor: Robert B. Fetter, D.B.A.

M.B.A., University of California at Berkeley, 1968. Major: operations research. Curriculum emphasized the application of quantitative methods in the public sector.

B.B.A, University of Texas at Austin, 1966. Major: accounting; Minor: mathematics.

Honors

Finalist, “Outstanding MBA Teacher,” University of Connecticut, School of Business Administration (1997).
"Distinguished Teacher of the Year" (1994), Yale University Department of Epidemiology and Public Health. Yale University Outstanding Teaching Award (1985, 1988). Health Insurance Association of America Faculty Fellow, 1992. Beta Gamma Sigma, Phi Kappa Phi, Beta Alpha Psi, Phi Eta Sigma. University of Texas Accounting Scholarship. University of California Fellowship. U.S. Public Health Service Fellowship.

Experience

1997 - present. Consultant to health maintenance organizations, group practices, hospices, and health benefits consultants, and health information consulting firms. The consulting practice involves providing technical advice and performing analyses on patient classification systems, physician incentive and reimbursement strategies, and severity adjustment to analyze the cost, utilization and quality of health care.

The patient classification systems frequently used include Diagnosis Related Groups (DRGs), Refined DRGs, Episode Treatment Groups (ETGs), Adjusted Clinical Groups (ACGs), Clinical Risk Groups (CRGs), and the Resource-Based Relative Value Scale (RBRVS). Consulting engagements frequently require knowledge of risk-adjustment methodologies, ICD-9-CM and CPT-4 coding systems, claims data, data analysis, clinical epidemiology, and financial modeling.

1995 - 1997. Associate Professor, Center for Health Systems Management and Department of Finance, University of Connecticut at Storrs. Taught graduate and undergraduate students in the School of Business Administration. Organized and supervised student internships in various HMOs, hospitals, consulting firms, nursing homes, pharmaceutical firms, and faculty practice plans in New England.

1989 - 1995. Health Care Consultant. Independent consultant to hospitals, multihospital systems, insurance companies, state health care cost commissions, and information systems software vendors. The consulting practice involved lecturing, performing analyses, and providing technical advice on patient classification systems, reimbursement methodologies, and statistical methods.

1984 - 1988. Vice President, Iris Corporation. Founding officer in a privately held startup company producing software products for the health care industry. Participated actively in the design, documentation, marketing, training, and technical support of all Iris products. The systems are used by hospital administrators, clinicians, nurses, HMO managers, and corporate benefits administrators for utilization review, quality assurance and provider contracting.

Two innovative software products were developed with venture capital financing. The Iris Resource Manager enabled hospitals to perform utilization review, discharge planning, risk management, physician credentialing, concurrent DRG assignment, infection control, and operating room analysis. QualiCheck is an episodes-of-illness based physician profiling system for utilization review and quality control in managed care organizations.

1982 - 1983. Research Scientist, Alcoholism Ambulatory Service, West Haven Veterans Administration Medical Center. Collaborated with psychiatrists on problems relating to the diagnosis, treatment, and management of veterans in the Alcohol Treatment Program.

1976 - 1982. Director, West Haven Veterans Administration Medical Center - Yale University Health Services Research Program. Designed and executed applied research projects involving the cost, quality, and access to medical care. Supervised research staff and graduate students on interdisciplinary projects involving biostatistics, epidemiology, computer science, operations research, microeconomics, clinical medicine, and organization theory.

1976 – 1995; and 1997 - present. Lecturer, Department of Epidemiology and Public Health, Yale University School of Medicine. Taught graduate courses to masters and doctoral students in the Division of Health Policy and Administration. Supervised master’s theses and community/research projects.

Teaching (The Department of Finance/Center for Health Systems Management, University of Connecticut, Yale University School of Medicine, and Virginia Commonwealth University, Department of Health Administration)

Health Care Finance (reimbursement modeling and analysis).

Clinical Information Systems Management (acquisition and applications of clinical information; coding systems, patient classification systems, and reimbursement methodologies).

Quality Improvement in Health Care Delivery Systems (statistical quality methods to assess and improve the quality of care).

Operations Management/Quantitative Techniques in Health Care Administration (applications of linear programming, simulation, decision analysis, and project management in health care organizations).

Health Care Planning and Evaluation (information systems and reengineering in health care).

Advanced Topics in Health Systems Management (trends in the organization, delivery and evaluation of managed care organizations).

Current Research Interests

• Patient Classification Systems for Reimbursement and Outcomes Assessment.
• Application and Evaluation of Risk Adjustment Systems for Paying Health Plans and Evaluating Health Plans).
• Design of Reimbursement and Profiling Systems for Physicians in Managed Care Organizations.
• Disease Modeling (Markov models and cost-effectiveness analyses to improve clinical decision-making and program evaluation).

Workshops and Lectures (partial list)

University of Connecticut-Managed Care Executive Program
“Applications of Decision Models in Managed Care”
“Financial Modeling for HMOs”

Healthcare Financial Management Association:
“Using ETGs for Evaluating Physician Productivity and Profiling Physicians’ Performance”
“Minimizing Risk And Improving Financial Performance in Hospital-Owned Group Practices”
“Ambulatory Patient Classes: What Will They Mean to Hospitals?
"Applications and Limitations of Refined DRGs"
"Using Severity Adjusted Data in Managed Care Negotiations"
"An Introduction to Risk Adjustment and Its Relevance for Providers and Insurers”
“Innovative Disease Management Programs in Home Health Care”

Medical Group Management Association:
“Episode Treatment Groups: Structure and Applications”

Health Information Management Systems Society
“Operations Management”

Johnson Foundation Clinical Scholars Program, Yale University:
"Quality of Care Assessment: Current Issues, Methods, and Methodological Problems"
"AUTOGRP: An Interactive Computer Language"
"Quantitative Techniques in Medical Decision-Making"

COMMUNITY/CIVIC ACTIVITIES

Chairman, Hamden Group Health Insurance Committee, 1999-present
Fire Commissioner, Town of Hamden, CT (1992-1997)
Elected Member, Democratic Town Committee, Hamden, CT (1992-1998)
Political Advocacy Chairman, Connecticut Public Health Association (1997-2000)
Political Action Committee, American Association of University Professors-Univ. of Connecticut (1995-1997)
Founder, Hamden Girls Lacrosse Association, 1989
Executive Committee, Spring Glen Civic Association
Founder and Director, North Haven Chess Club
Research Advisory Board, Cognio.com
Advisory Board, SMA Informatics, Inc.
Weekly Volunteer, Habitat for Humanity

Recent Consulting Clients

IntelliClaim, Inc.
Sanford Bernstein, LLC
Apple Health
Oxford Health Plans
LandaCorp, Inc.
Anthem Blue Cross of Connecticut
Jasperon, Inc.
William Mercer, Inc.
Connecticut Hospice and John D. Thompson Research Institute
Medical Group Practice Association-Center for Research in Ambulatory Health Care Administration
The Delta Group
Sachs-HCIA, Inc.
Emron, Inc.

RESEARCH GRANTS AWARDED (as Principal Investigator)

The Application of Prognostic Criteria for Outpatient Quality Assessment. Funded by the Health Service Research and Development Service, VA Central Office, Washington, D.C.

The Use of 'Conditional Discriminators' in Medical Audits. Funded by the Health Services Research and Development Service, VA Central Office, Washington, D.C.

The Value of Management Incentives in Outpatient Cost Containment. Funded by the VA Medical Center, West Haven, Connecticut and VA Central Office.

Biochemical Diagnosis of Alcoholism: Development of a Screening Tool Using Discriminant Function Analysis. Funded by the Psychiatry Service, VA Medical Center, West Haven, CT.

Publications

Dove, HG, Duncan I, Robb, A. A prediction model for targeting low-cost, high-risk members of managed care organizations. American Journal of Managed Care, 2003; ((5), 381-89.

Forthman, M.T., Dove, H.G. and Wooster, L.D. “Episode Treatment Groups (ETGs): A Patient Classification System for Monitoring Outcomes Performance by Episode of Illness.” Topics in Health Information Management, 2000; 21(2), 21-29.

Dove, H. and Greene, B. Medical Group Practices Benchmarking Products Using Claims Data: Past, Present and Future. Journal of Ambulatory Care Management 2000; 23(4): 67-77.

Dove, H. and Forthman, T. A New Graphical Approach to Variance Analysis. Healthcare Financial Management 1995; 49:52.

Dove, H. Use of the Resource-Based Relative Value Scale for Private Insurers. Health Affairs
1994; 13(5): 193.

Leary, R. and Dove, H. Refined Diagnosis-Related Groups--A New Perspective on Patient Classification. Topics in Health Information Management 1993; 14(2):77.

Dove, H. Refined DRGs. For the Record 1991; 3:1.

Dove, H. An Introduction to Refined DRGs. Quality Matters 1991; 10:1.

Schnitt, J. and Dove, H. Issues in Development of Alcoholism Screening Models Using Discriminant Function Analysis. Substance Abuse 1986; 7:38.

Dove, H. Post-Installation Evaluation of Computerized Management Support Systems. Journal of Ambulatory Care Management 1985; 8:59.

Dove, H. and Schneider, K. Identifying Patients Who Need Social Work Services: An Interdisciplinary Analysis. Social Work 1985; 30:214.

Dove, H. and Schneider, K. Evaluating Quality of Care and Predicting Outcome of Stroke. Stroke 1984; 15:858.

Schnitt, J. and Dove, H. Biochemical Tests of Alcoholism: A Critical Review. Psychiatric Medicine 1984; 2:425.

Dove, H. and Fries, B. A Short-Term, Cost-Effective Pharmacy Information system. Journal of Medical Systems 1983; 7:35.

Schneider, K. and Dove, H. High Users of VA Emergency Room Facilities: Are Outpatients Abusing the System or Is the System Abusing Them? Inquiry 1983; 20:57.

Dove, H., Schneider, K. and Richardson, F. Evaluating the Quality of Care In-Patients Following Lower Extremity Amputation: An Analysis of Baseline, Process, and Outcome. American Corrective Therapy Journal 1982; 36:94.

Dove, H., Fries, B., and Schneider, K. The Analysis of Clinic No-Show Rates to Establish Optimal Outpatient Scheduling Quotas. Journal of Ambulatory Care Management 1982; 5:24.

Dove, H. and Schneider, K. The Usefulness of Patients' Individual Characteristics in Predicting No-Shows in Outpatient Clinics. Medical Care 1981; 19:734.

Hughes, J., Dove, H., Feinstein, A. and Gifford, R. Duration of Blood Pressure Elevation in Accurately Predicting Surgical Cure for Renovascular Hypertension. American Heart Journal 1981; 101:408.

Dove, H. and Schneider, K. The Application of Prognostic Criteria in Outpatient Quality Assessment: Control of Hypertension. Journal of Medical Systems 1980; 4:45.

Dove, H., Schneider, K. and Gifford, R. The Trips of Slips: A Study of Time Delays in Laboratory and X-Ray Data for Outpatients in a Teaching Hospital. Journal of the American Medical Association 1980; 243:537.