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Rachael Smithson

2011-12 Harkness Fellow

Bio: Rachael (Addicott) Smithson, Ph.D., a 2011-12 U.K. Harkness Fellow in Health Care Policy and Practice, has been a senior policy research fellow at The King's Fund, where her portfolio includes research on models of accountability in U.K. health care, including work on Foundation Trusts, employee ownership, integrated care, and the new White Paper reforms. In 2009, she organized a summit on end of life care that produced a publication and recommendations, which have fed into the government's new End of Life Care Strategy. Previously, she was a lecturer at the University of London, and before moving to the U.K., she worked in the Department of Human Services in Melbourne. Addicott has 10 peer-reviewed publications, in journals including International Journal of Palliative Nursing, Journal of Health Organization and Management, Public Money and Management. Addicott holds a Ph.D. in organizational behavior from Imperial College, London, and a bachelors in sociology from Swinburne University of Technology in Australia.

Placement: University of California

Mentors: Franics Crosson, M.D., Permanente Federation; Stephen Shortell, Ph.D., M.P.H., M.B.A., University of California, Berkeley

Project: Collaborative Governance through Accountable Care Organizations

Description: The aim of this project was to examine how the adoption of accountable care organizations (ACOs) has been received by medical professionals and other health care providers in the U.S., including the receptivity of organizations to such reform to determine whether the model represents a genuine shift towards accountability. Addicott first conducted interviews with expert national stakeholders in order to better understand the drivers of policy and expected implementation issues. She then conducted four case studies at ACO sites, which involved interviewing with ACO observations of meetings, and document review.