“…improving the value of care in the United States is one of the biggest challenges our health care system faces. We also face challenges in providing care in a way that is equitable and that addresses other drivers of health, including social factors.”

Executive Director of the University of Pennsylvania’s Leonard Davis Institute of Health Economics (LDI)

By Donald Gilpin | Photos by Hoag Levins

Rachel Werner, M.D., Ph.D., took over last May as the first female and the first physician-economist executive director of the University of Pennsylvania’s Leonard Davis Institute of Health Economics (LDI). She is a professor of both medicine at Penn’s Perelman School of Medicine, and health care management at the Wharton School; a member of the National Academy of Medicine; and a practicing physician at Philadelphia’s Corporal Michael J. Crescenz VA Medical Center. 

Werner came to Penn in 1994 after graduating from Macalester College in Minnesota. She earned her M.D. in 1998 and her Ph.D. in health economics in 2004. She joined the Penn faculty in 2005 as an assistant professor of medicine and an LDI senior fellow. A longtime member of LDI’s executive committee, Werner has played an important role in expanding LDI data services and was director of the LDI health economics data analyst pool that provides LDI fellows with statistical analysts.

Werner has received numerous awards, including the National Science Foundation’s Presidential Early Career Award for Scientists and Engineers for demonstrating “exceptional potential for leadership at the frontiers of scientific knowledge.”

She was also awarded a 2018 Excellence in Teaching award in Penn’s Master of Science in Health Policy Research program, which she co-directed.

Her research in recent years has focused on the effects of health care payment and organization on post-acute care, the continuing care services many patients require after they are discharged from a hospital into rehab facilities, nursing facilities, or home health programs.

“Rachel is one of the smartest health services researchers I have ever met,” said Judith Long, M.D., chief of the Division of General Internal Medicine, Perelman School professor, and LDI senior fellow in an interview in a recent issue of the LDI’s eMagazine Health Economist. “As a woman, she is a role model for all of us.”

LDI, established in 1967, two years after Congress enacted Medicare, now sits at the center of an array of health services research initiatives within various Penn departments and centers. Penn’s hub for data-driven and policy-focused research to improve the nation’s health system, LDI connects and supports researchers across schools and disciplines to accelerate interdisciplinary research and initiatives.

I asked Werner a few questions about health care, her work at LDI, her new position as the first woman leader in the Institute’s 51-year history, and her priorities for her career and the future of LDI.

The Leonard Davis Institute of Health Economics (LDI) is based in the Colonial Penn Center on Locust Walk, at the heart of Penn’s campus. (Image Source: Wikipedia)

DG: U.S. health care was described by the late Princeton University economist Uwe Reinhardt as “a system that’s both cruel and inefficient,” costing more and delivering less here than in almost all other developed countries in the world. Do you agree? What should we do about that?

RW: I do agree — improving the value of care in the United States is one of the biggest challenges our health care system faces. We also face challenges in providing care in a way that is equitable and that addresses other drivers of health, including social factors.

LDI will be focusing its efforts on improving health care delivery in a few key areas. We have selected areas that are strongly connected to LDI’s core mission, have faculty actively engaged in research, and are timely issues in health policy. LDI’s current four priority areas are the care of vulnerable populations, coverage and access to health care, health care for aging populations, and the opioid epidemic.

DG: What has been on the top of the agenda for you and LDI since you took charge in May?

RW: LDI’s mission is to catalyze and support innovative research to shape and improve health and health care delivery, and to translate and disseminate research to increase its visibility and impact both at Penn and nationally. My main priority is to support that mission.

Within that mission, we will be working to further engage Penn faculty in LDI’s mission, to facilitate collaborations across disciplines and across campus, to expand the ways in which we can support their research and dissemination, and to extend the impact of research in shaping health care policy and delivery.

DG: How has your background and training as a physician-economist helped you in pursuing these priorities and your work at LDI?

RW: As a physician-economist, I am at the crossroads between two large disciplines that make up LDI and contribute to the field of health economics more generally, making my background a good fit for LDI. It presents an opportunity to further existing collaborations between Penn’s Perelman School of Medicine and the Wharton School. Fostering these cross-school collaborations has been a vital part of LDI’s success.

Having gone back and forth between these disciplines many times myself gives me unique insights into both the challenges and benefits of such collaborations, including the importance of using rigorous economic methods to answer questions that matter the most to patients.

DG: Has being the first woman leader of LDI given you any advantages? Disadvantages? Perspectives that might be different from past leadership?

RW: I am honored to be chosen as the first woman leader of LDI and, after more than 50 years, to break down that barrier. It has been important to many people across Penn to see a woman appointed to this leadership position. Having visible female role models is vital to younger faculty and trainees who aspire to be in leadership positions. I hope my appointment will make it easier for others to succeed.

At the same time, it is both surprising and frustrating that it took over 50 years to have a woman appointed as the executive director of LDI. I have benefited so much from the women ahead of me who have broken down barriers and made it possible for me to be in this position. But it reminds me that we still have a long way to go to get to a time when it will no longer be surprising or novel to have women in leadership positions. But mostly, I hope I am remembered for being an effective executive director rather than simply being remembered as the first woman executive director.

DG: What is the best part of the job for you?

RW: I believe strongly in the importance of LDI’s mission at Penn and more broadly. LDI has been integral to my career, from when I was a Ph.D. student in health economics at Wharton to this day. An LDI pilot grant supported my dissertation; LDI-affiliated faculty mentored me; and LDI seminars introduced me to leaders in the field.

Since I joined the faculty at Penn in 2005, LDI has provided the soup-to-nuts research support I needed to be successful; from the data infrastructure to support my research to the translation and dissemination of the results to promote their impact. It is wonderful to lead an institute that I have such a deep and important connection to, and, more importantly, to work to ensure that others have the same benefits from LDI that I have had.

DG: What is the most challenging part of the job for you?

RW: Trying to balance this with my ongoing research, teaching, and clinical work! It is important to me to continue with these endeavors as they help inform and focus LDI’s mission.

DG: As you look ahead to the next 10 years, what are some of your most ambitious goals?

RW: To be determined. It is still early in my tenure…

DG: Any surprises in the past six months since you became executive director?

RW: I have been pleasantly surprised at people’s enthusiasm for and commitment to LDI. I have spoken to many Penn faculty over the last four months and am gratified to know that so many people think so highly of LDI and have felt its positive impact on their experience as a researcher at Penn, on the larger Penn community, and on the health policy landscape more broadly.