Samuel R. Nussbaum, M.D. is a Strategic Consultant with EBG Advisors, Inc. Dr. Samuel Nussbaum brings expertise across the spectrum of health care. Having served as the Chief Medical Officer of WellPoint/Anthem and, previously, Executive Vice President for BJC HealthCare, he has executive experience in population health, care management, data analytics, provider contracting, and medical and pharmacy policy and contracting. As a professor and clinical leader at Harvard Medical School and Massachusetts General Hospital he has led basic science research, drug discovery, clinical studies, teaching and patient care.
Nussbaum’s work has placed him at the center of health care transformation. At BJC, he was involved in building affiliated health plans. At WellPoint/Anthem, he was a principal architect of provider partnerships, and deployed new approaches to value-based payment. These achievements position Dr. Nussbaum to offer strategic guidance as health systems increasingly take responsibility for population health and financial risk, become ACOs and, potentially, migrate to health plan sponsorship or alignment with health insurers.
Nussbaum serves as Chair of a public-private work group established by the Department of Health and Human Services to develop the framework for alternate payment models to enhance patient-centered care and reduce waste in healthcare. Dr. Nussbaum brings deep knowledge of the drivers of health care costs, including specialty pharmaceuticals, and has crafted strategies and applied solutions to better manage these costs for Medicare, Medicaid, and commercial health plans. He has led public health initiatives to improve diabetes care, childhood obesity and hospital safety and quality. Nussbaum has been an influential voice in the health care reform dialog and has strong relationships with hospitals and health systems, physician organizations, insurers, pharmaceutical companies and consumer and patient advocacy groups. He is a frequent speaker at national health care forums.
From 2000 until 2016, Nussbaum served as Executive Vice President, Clinical Health Policy, and Chief Medical Officer for Anthem. In that role, he was the key spokesperson and policy advocate and oversaw clinical strategy and corporate medical and pharmacy policy. Dr. Nussbaum was responsible for HealthCore, Anthem’s clinical outcomes research subsidiary. He helped construct the model that has evolved into the current FDA Safety Sentinel System. In collaboration with other medical leaders, he helped design and promote patient-centered medical homes and assessed their impact on the quality and cost effectiveness of care.
During his tenure at Anthem, he was responsible for over $100B in health care expenditures through business units focused on care and disease management and health improvement, and provider network contracting. Nussbaum was instrumental in developing contracting approaches that link hospital reimbursement to quality, safety and clinical performance. Under his leadership, HealthCore has built partnerships with Federal agencies and academic institutions to advance drug safety, comparative effectiveness and outcomes research.
Dr. Nussbaum currently serves on the Boards of the OASIS Institute, NEHI, BioCrossroads (an Indiana-based public-private collaboration that advances and invests in the life sciences), and America’s Agenda. He serves as Chair of the Centers for Education & Research on Therapeutics (CERTs) Steering Committee (a cooperative agreement between AHRQ and the FDA), is a member the HHS Health Care Payment Learning and Action Network (LAN) Guiding Committee, and participates in Institute of Medicine activities, including serving on the Roundtable on Value & Science-Driven Health Care.
Dr. Nussbaum has served as President of the Disease Management Association of America, Chairman of the National Committee for Quality Health Care, and Chair of America's Health Insurance Plans’ (AHIP) Chief Medical Officer Leadership Council. He has served on the boards of AHIP, the National Quality Forum, and on the Secretary of Health and Human Services’ Advisory Committee on Genetics, Health, and Society. Dr. Nussbaum received the 2004 Physician Executive Award of Excellence from the American College of Physician Executives and Modern Physician magazine and has been recognized by Modern Healthcare as one of the “50 Most Influential Physician Executives in Healthcare.”
Prior to joining Anthem, Dr. Nussbaum served as executive vice president, Medical Affairs and System Integration of BJC Health Care, where he led integrated clinical services and served as President of its medical group and chairman of its commercial (HealthPartners of the Midwest) and Medicaid (CarePartners) health plans. Under his leadership, BJC acquired the medical group aligned with Coventry Health Care’s Group Health Plan, and created a continuum of care which enabled BJC to enter into fully-capitated contracts with insurers. Under his leadership, BJC received the National Quality Award.
Nussbaum had a 20 year academic career at Massachusetts General Hospital and Harvard Medical School where he led the Clinical Endocrine Group Practice. As a professor at Harvard Medical School, his basic and clinical research on hormones and factors that control calcium metabolism and bone growth led to clinical trials of treatments for osteoporosis and skeletal complications of cancer; and FDA approved drugs that have important roles in clinical care. He also developed new technologies and approaches to measure hormones in blood and helped commercialize these laboratory tests.
Nussbaum received his undergraduate degree from New York University and his MD from Mount Sinai School of Medicine. He trained in internal medicine at Stanford University and Massachusetts General Hospital and in endocrinology and metabolism at Harvard Medical School and Massachusetts General Hospital. Dr. Nussbaum is a Professor of Clinical Medicine at Washington University School of Medicine and serves as adjunct professor at the Olin School of Business, Washington University.
- Icahn School of Medicine at Mount Sinai (M.D.)