Zirui Song, MD, PhD

Zirui Song, MD, PhD is an assistant professor of health care policy at Harvard Medical School and an internal medicine physician at Massachusetts General Hospital.

Dr. Song’s research has focused on changes in health care spending and quality under global payment, the impact of Medicare fee policies on spending and physician behavior, and the economics of Medicare Advantage. This work has aimed to provide evidence to inform policies on payment and delivery system reform.

Dr. Song is a recipient of the AcademyHealth Article-of-the-Year award, Daniel Ford Award for health services and outcomes research from Johns Hopkins, Seema Sonnad Emerging Leader in Managed Care Research Award from the American Journal of Managed Care, and the Mack Lipkin Sr. Award from the Society of General Internal Medicine. He was a member of the Forbes 30 Under 30 in Science and Healthcare and Top Doctors in Training from Boston Magazine. During medical residency, he received the Hospital-Wide Individual Research Award from Massachusetts General Hospital, a state and national resident research award from the American College of Physicians, and the Award for Clinician Investigation from the New England region of the Society of General Internal Medicine.

Dr. Song has worked on Medicare policy in the Office of the Assistant Secretary for Planning and Evaluation in the U.S. Department of Health and Human Services. He has also served as a Visiting Fellow at the Health Policy Commission for the Commonwealth of Massachusetts and a Special Guest at the Center for Social and Economic Dynamics in the Brookings Institution. Locally, Dr. Song was a member of the Massachusetts Medical Society Task Force on Health Care Reform and the Boston Advisory Board of the Albert Schweitzer Fellowship. He currently serves as an Associate Editor of Healthcare and on the Editorial Board of PLOS Medicine. He is a faculty affiliate in the Center for Primary Care at Harvard Medical School.

Dr. Song has taught on payment reform in the Introduction to Health Policy course at Harvard Medical School. He has also lectured in the Advanced Topics in Global Health and Health Policy course at Harvard College, Economics for Health Policy course at the Harvard School of Public Health, the Health Policy course at Partners Healthcare, the Department of Medicine curriculum at Massachusetts General Hospital, and the Health Care Systems and Health Care Management and Strategy courses at the University of Pennsylvania. He has received three Certificates of Distinction in Teaching from Harvard University and two tutorial teaching awards from Harvard Medical School.

Dr. Song completed his residency training at Massachusetts General Hospital, where he was selected by peers for the Morton N. Swartz, M.D. Humanism in Medicine Award. He received his M.D. from Harvard Medical School, magna cum laude, and Ph.D. in Health Policy (Economics track) from Harvard University, where he was a fellow in Aging and Health Economics at the National Bureau of Economic Research. He received his B.A. in Public Health Studies with honors from Johns Hopkins University.

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Honors and Awards

NIH Director’s Early Independence Award
National Institutes of Health

Pricing and Pass-through in Response to Subsidies and Competition: Evidence from Medicare Advantage Before and After the Affordable Care Act (with Daria Pelech)

After years of growth, payments to Medicare Advantage plans began to decline after the Affordable Care Act (ACA). The impact of this change in subsidies and the extent to which they are passed through to beneficiaries are unknown. We examined changes in plan behavior and enrollee benefits pre- and post-ACA by exploiting the variation in updates in federal payments to plans. We find a largely symmetrical change in plan bids and beneficiary pass-through in response to both increases and decreases in federal payments, suggesting that plans generally operate above cost. When the federal subsidy decreased after the ACA, plans reduced less salient benefits by a larger magnitude than they had raised them in response to subsidy increases before the ACA, but changed more salient benefits by roughly similar amounts in both periods. Plans in more competitive markets were less responsive to changes in federal subsidies than plans in less competitive markets, implying that competition pushes plan bids closer to costs. The plan bid response, combined with quality bonuses and growth in risk scores, helped soften the impact of decreasing subsidies on Medicare beneficiaries, which may help to explain the continued growth in Medicare Advantage enrollment after the ACA.

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