MD – University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
Residency – University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC

Biography: Dr. David Johnson, urologist, is interested in studying and implementing value-based care redesign to better align patient values with treatment decisions and incentivize high value, patient-centered care. He worked with multiple sectors of the health system and the Department of Urology during his fellowship to model the impact of alternative payment models on health system finances for an episode of surgical care. He plans to expand the scope of this work to establish a framework for developing physician-led, disease-specific bundled payments.  

Dr. Johnson worked with his mentor team including Drs. Chris Saigal, Mark Litwin, Tom Rice, and the ValU Care Redesign team at UCLA, on a project entitled “The financial impact of an episode-based bundled payment for prostate cancer surgery – the business care for value-based care redesign.”  The goal of the study was to explore how to develop and evaluate episode-based alternative payment models to determine whether this type of payment reform has the potential to incentivize high value, interdisciplinary care coordination and delivery. The study had four aims, including: 1) defining institution-specific episode-related costs of robotic radical prostatectomy; 2) developing bundled payment targets for robotic radical prostatectomy based on historical Medicare payment data; 3) identifying opportunities for value enhancement within the robotic radical prostatectomy service line; and 4) quantifying the potential impact on hospital and provider finances of charges in costs and payments under an episode-based bundled payment model.  Dr. Johnson analyzed the financial data of Medicare patients who underwent elective robotic radical prostatectomy for prostate cancer at the UCLA Ronald Reagan and Santa Monica Medical Centers from January 2014 to December 2015.  Dr. Johnson was selected for a poster presentation of this study at the 2018 American Urological Association national meeting and presented a poster at UCLA Bioscience Innovation Day, 2019. 

Dr. Johnson also worked on several additional research projects. He worked with a team at UCLA on a project entitled, “Cost Effectiveness of 68-Ga-PSMA PET/CT in early biochemical recurrent prostate cancer.”  He additionally worked with mentors Drs. Robert Reitner and Steven Raman on four projects, including: 1) Contemporary prostate cancer detection with multiparametric MRI – an updated single institution series; 2) Underdiagnosis of bilateral prostate cancer in candidates for unilateral hemigland ablation; 3) Radiographic predictors of extracapsular extension for men undergoing robotic radical prostatectomy for prostate cancer; and 4) Correlation of radiographic tumor size with histopathologic tumor size.  During fellowship, he also worked on the projects entitled, “Population-based management of incidental small renal masses in an integrated delivery system” and “Reducing the burden of lethal prostate cancer in Cuba.”  Dr. Johnson also co-authored an editorial with NCSP Director Dr. Joann Elmore.  The editorial was published in Cancer, and entitled “Implications of False-Positives for Future Cancer Screenings.” Aside from research activities, Dr. Johnson also instructed residents in clinic at the VA and as the on-call attending, and taught urologic examination to medical students.  

Dr. David Johnson has now joined Blue Cross Blue Shield of North Carolina as Medical Director of Healthcare Transformation for specialty care. He will be working in partnership with 5 of the state’s most prominent academic medical centers and health systems to overhaul the payment and delivery system in support of higher value specialty care and improving the patient and provider experience.  Specifically, he will be working with the health systems to design and implement alternative payment models for specialty care, supporting research into high value care, and facilitating innovative value-based care redesign efforts.  Dr. Johnson’s work on health outcome based payment models in North Carolina has already been featured in the media, such as the New York Times (https://www.nytimes.com/2019/08/26/business/north-carolina-health-care-outcomes.html).  The project is being championed by the state’s Department of Health and Human Services, which oversees payments for Medicaid, and Blue Cross Blue Shield of North Carolina.  He will continue care for patients and educate residents as an assistant professor of urologic oncology at the University of North Carolina, Chapel Hill. He also plans to remain involved with the National Clinician Scholars Program at the Duke University site.