Andrew M. Kramer, MD
CEO, Founding Partner
“For me, Providigm represents a continuation of the mission I embarked on more than 30 years ago,” explains Dr. Kramer. “Through work that bridges research and practice, it provides the opportunity to develop cutting-edge solutions for providers that are both effective and practical to implement.”
Beginning in his third year at Harvard Medical School, Dr. Kramer became interested in working to improve chronic care for older persons. Rotating in hospitals, physician offices and nursing homes, he realized that health care often did not meet the chronic care needs and preferences of frail elders. Behind this failure, he discovered, were health policies that were not aimed at addressing the quality of care and life issues most important to older persons.
As an assistant professor at the University of Colorado (CU) School of Medicine, Dr. Kramer’s interests in health policy research and geriatric medicine grew. He began to conduct research related to quality of care for frail elders in collaboration with a statistician and health economist. Together, they built the CU Center for Health Services and Policy Research, gaining a national reputation for assessing and assuring quality of care.
A defining moment for Dr. Kramer in the 1980s was attending several meetings of the Institute of Medicine Committee on Nursing Home Reform, which exposed him to the true intent of the landmark Nursing Home Reform Act (OBRA ’87). An interest in being on the front lines of this legislation prompted him to compete on a research team that won the Centers for Medicare & Medicaid Services (CMS) contract to evaluate the implementation of OBRA ’87 in the early 1990s. As the clinical research lead for this study, he designed a staged, resident-centered quality assessment process for nursing home residents, which reflected the intent of OBRA ’87. This staged assessment of both quality of care and quality of life in nursing homes was the archetype to the Quality Indicator Survey (QIS).
Fifteen years later, after leading three further CMS studies in this area, testifying at Senate and House hearings, and participating in numerous meetings with CMS staff and stakeholder groups, Dr. Kramer finally saw CMS decide to move forward with national implementation of the QIS. The two greatest needs for QIS to realize its potential, in Dr. Kramer’s eyes, were rigorous training of the state survey agencies in the conduct of QIS, and development of a parallel provider system to assist nursing homes in continuously improving care to meet the higher resident-centered standards of QIS. In 2007, Dr. Kramer established Nursing Home Quality (NHQ) with his brother Peter, a company with the ability to meet these two goals and implement an aligned policy and practice solution on a large scale.
Dr. Kramer’s work on QIS, however, was only part of his academic and policy career. An influential study he co-authored in the New England Journal of Medicine in 1990 described the impacts and implications of the Hospital Prospective Payment System on post-acute care settings. This study spurred two other major areas of his research: optimizing rehabilitation care and outcomes for older persons following acute events, and providing the necessary skilled services after acute care to reduce decline and readmission to hospital. In subsequent years, he published extensively in these areas including a landmark paper on outcomes and costs of rehabilitation published in the Journal of the American Medical Association in 1997.
In his 28 years as a full-time faculty member, Dr. Kramer oversaw more than $80 million in research grants and founded a new Division of Health Policy and Research within CU’s Department of Medicine. He also co-founded the Hartford-Jahnigen Center of Excellence in Geriatric Medicine and served as its director for 10 years. This Center was the culmination of another of his interests: training and mentoring younger faculty in health care research in aging. In 2008, he became the first community research co-director for the National Institutes of Health’s Colorado Clinical Translational Sciences Institute, where he led the development of a program to translate research findings into clinical practice in Colorado communities.
As CEO and founder of Providigm, and lead of Providigm’s Research Team, Dr. Kramer is the visionary driving the science behind transforming research and policy into practical solutions that help providers deliver improved quality of care and enhance the lives of aging patients.