Curriculum Vitae Gerard M. La Forgia, Lead Health Specialist

Curriculum Vitae Gerard M. La Forgia, Lead Health Specialist Vasant Vihar, A 7/8 New Delhi, Índia Languages: English, Spanish, Portuguese Tel. link. 5785x187 E-mail: glaforgia@worldbank.org Married; two children GENERAL BACKGROUND, EXPERIENCE, AND INTERESTS I have 24 years of experience in producing policy analyses, research and evaluation on a range of health system features and issues, conducting policy dialogue with clients at the national and subnational levels, and designing and supervising Bank lending operations (SILs, SWAps, APLs, DPLs, TAs) in Health in 11 low- and middle-income countries (Afghanistan, Argentina, Brazil, Colombia, Ecuador, El Salvador, Guatemala, India, Mexico, Nicaragua, Panama and Uruguay). I have a Sc.D. (Doctor of Science) in Health Service Administration and an MS in Community Health Services, and consider myself a health management and finance specialist. During my nearly 13-year career at the World Bank, I have accumulated a diversified portfolio of contributions and experience, consisting of lending operations, research/sector work, corporate contributions, multi-sectoral work, and strategy development. Research and Sector Work: I have maintained an active agenda in research, evaluation and policy analysis, and have made an effort to publish in refereed journals or Bank publications. Current research and project design interests include: integrated network design, public/private contracting, hospital management and governance, impact evaluation, results-based management and finance in health, extension of insurance coverage to low-income populations, health service quality improvement, and application of performance-based financing schemes in World Bank investment lending. A summary of selected products follows (see publications and reports). Recent and Current Work on Health Systems (2002 to present) (see publications below for specific references) Book (forthcoming, 2011): co-author of policy research on government-sponsored health insurance in India. Article (2009): Lead author on published article on Hospital PPPs in Sao Paulo, Brazil (Health Affairs) Book (2008): Coordinated and main author of policy research on hospital performance in Brazil, which will result in book. Coordinated 8 research studies analyzing specific aspects of hospital performance: efficiency, costs, quality, governance, and management. This is perhaps the first comprehensive research on hospitals in the Bank. Monograph (2007): Coordinated and co-authored policy research on health system governance and resource management in Brazil (based on PETS survey). Regional Monograph (2007): Coordinated and co-authored comparative analysis of hospital governance practices and their relation to performance in four countries, (Brazil, Argentina, 1

Mexico and Colombia). The research draws on a survey of a sample of hospitals in each country. Edited volume (2005) Co-authored three papers on health system reforms and innovations in Central America in seven-paper Bank publication which I edited. The three papers concern: processes of government contracting (PPPs) of NGOs in Guatemala, an evaluation comparing the performance of direct contracting (PPP), mixed contracting and traditional public delivery models in Guatemala, and assessment of an innovative social insurance scheme in Nicaragua. Published article (2004) Lead author of paper government failure in the Dominican Republic (Health Policy). Operational Experience: As a task manager at the World Bank (13 years) and Inter-American Development Bank (5 years), my work has centered on the design and implementation of operations containing health system strengthening and reform components. Health system innovations introduced in these loans include: (i) contracting out and contracting in of basic service delivery; (ii) performance-based contract management; (iii) hospital corporatization/autonomy initiatives; (iv) provider payment mechanisms; (v) performance-based resource allocation; (vi) reconfiguration of delivery system into organized health care networks; (vii) legal and regulatory reform; (viii) alternative risk-pooling mechanisms; and (ix) staff incentive schemes. Specific experiences include: Lead policy dialogue and AAA work for HNP portfolio in India (2008-present) Prepared proposal and hypothetical project on disbursement-linked indicator approach to investment lending for Indian Health Ministry/Finance Ministry (2010) Lead the policy dialogue, technical design and preparation of eight health lending operations in the areas of health systems (4); family/child/mother health (3); and disease surveillance (1). Brazil, El Salvador, Guatemala, and Nicaragua, (2000-2007) Lead preparation of Bank s first health loan to El Salvador. Also initiated policy discussions with the Guatemalan government resulting in an agreement to initiate preparation of the Bank s first health project there. Restructured two health reform operations (Nicaragua and Panama), turning unsatisfactory projects into high performers. As an IDB task leader, designed and implemented the Guatemala Health Services Strengthening Project which extended basic care to over 3 million mostly indigenous people through contracting NGOs. The project won the prestigious José Luis Bobadilla International Award in Health Policy Innovations. Strategy Development and Client Engagement: Country Health Strategy India (2008): I was the main author of the Bank s India Health Strategy for 2008-2010. India Health Policy Notes: 2009-present: Creator and co-editor of Indian Health Beat. A policy note series distributed to public and private stakeholders throughout India. Four series of 5-9 notes published between 2009 and 2011. 2

National and State Policy Workshop Series: 2009-present: Organizer of biannual workshop series with senior national and state policy makers on selected themes. Four workshops conducted in 2008-2009 on human resources and results-based financing. Country Health Strategy - Brazil (2007): I was the main author of the Banks Brazil Health Strategy 2007-2010. Health Policy Briefs (2006): Prepared six policy briefs drawing on Bank-sponsored ESW/research. These briefs were presented to the Ministry of Finance and the Ministry of Planning. Briefs have contributed to government efforts to control health spending and improve value for money. Brazil Country Assistance Strategy - CAS (2003): I was also a core member of the team that prepared the HD inputs for the results-based Brazil CAS (2003); main author of CAS sections on health; and contributed to draft development strategies for Amazon and impoverished Northeast Regions of Brazil. Health Policy Notes (2003): Authored Health Sector chapter for published volume on sector challenges and recommendations presented to the incoming President and Health Minister. The Notes were well-received and elements have contributed to Ministry policy statements. EDUCATION Doctor of Science & Hygiene Masters of Science Health Services Administration, Graduate School of Public Health, University of Pittsburgh, 1990 Community Health Services, Graduate School of Public Health, University of Pittsburgh, 1985 Bachelors of Science Northwestern University, 1975 PROFESSIONAL EXPERIENCE Lead Health Specialist, World Bank 2003-present Senior Health Specialist, World Bank 1999-2003 Senior Health Officer, Inter-American Development Bank 1993-1999 Research Associate, The Urban Institute, Washington, DC 1990-1993 Independent Consultant (health systems) 1987-1990 3

LANGUAGES English Spanish Portuguese Native language Near native fluency Very good PUBLICATIONS (peer reviewed) La Forgia, GM and S. Nagpal, 2011 (forthcoming): Are Your Covered? Government-Sponsored Health Insurance in India. Washington, DC: The World Bank La Forgia, GM and A. Harding. 2009 Can Public-Private Partnerships Raise Public Hospital Performance in Developing Countries? Lessons from São Paulo, Brazil. Health Affairs. La Forgia, GM and B. Couttolenc 2008: Hospital Performance in Brazil: The Search of Excellence. Washington, DC. The World Bank. (published in English and Portuguese) Bogue. RJ, Hall, CH and G. La Forgia. 2007. Hospital Governance in Latin America: Results from a Four-Country Survey. World Bank,. HNP Discussion Paper, April. (published in English and Spanish). La Forgia, G, Couttolenc, C. and Y. Matzuda. 2007. Governance in Brazil s Unified Health System: Raising the Quality of Public Spending and Resource Management. World Bank. Report no. 36601-BR, February (published in English and Portuguese) La Forgia, G. (ed.,). 2005. Health System Innovations in Central America: Lessons and Impact of New Approaches. Washington, D.C.: The World Bank, Working Paper no. 57. (published in English and Spanish). La Forgia, G. Mintz, P and C. Cerezo. 2005. Is the Perfect the Enemy of the Good? A Case Study of Large-scale Contracting for Basic Health Services in Rural Guatemala. in G. La Forgia (ed.) Health System Innovations in Central America: Lessons and Impact of New Approaches., Washington, D.C.: The World Bank, Working Paper No. 57. Fiedler, J and G. La Forgia. 2005. Nicaragua s Health Insurance System: A Work in Progress. in G. La Forgia (ed.) Health System Innovations in Central America: Lessons and Impact of New Approaches., Washington, D.C.: The World Bank, Working Paper No. 57. Danel. I and G. La Forgia. 2005. Contracting for Basic Health Services in Guatemala: Comparison of the Performance of Three Delivery Models. in G. La Forgia (ed.) Health System Innovations in Central America: Lessons and Impact of New Approaches. Washington, D.C.: The World Bank, Working Paper No. 57. Vledder M. and G. La Forgia. 2005. Introduction. in G. La Forgia (ed.) Health System Innovations in Central America: Lessons and Impact of New Approaches., Washington, D.C.: The World Bank, Working Paper No. 57. La Forgia, G. and R. Levine. 2004. Fend for Yourself: Systemic Failure In the Dominican Health System. Health Policy. : 173-186. 4

La Forgia, G. 2003. Health Sector in Brazil: Equitable, Competitive and Sustainable, Contributions for Debate. Washington, D.C.: World Bank: La Forgia, G. 2002 Desafios e Inovações Revista Brasíleira de Saúde da Família Vol. 2, no. 6, December La Forgia, G. 2000. "Understanding Health Sector Reform: A Financial and Service Flow Model and the Colombian Case." In María Cruz-Saco and Carmelo Mesa-Lago, eds. Reforming Pension and Health Care Systems in Latin America: What are the Options?. University of Pittsburgh Press, 2000. Lewis, M, Sulvetta, M. and G. La Forgia. 1996. "Measuring Public Hospital Costs: Empirical Evidence From the Dominican Republic." Social Science & Medicine, Vol. 43, No. 2: 221-234. La Forgia. G. 1994. "From Domination to Accommodation to Confrontation: Physicians and the State in Panama." Studies in Third World Societies, No. 55, June: 85-132. La Forgia. G. 1992. "Belize: Sliding Fee Scales for Health Ministry Medical Services." in Margaret E. Grosh (ed.) From Platitudes to Practice: Targeting Social Programs in Latin America World Bank: Latin America and Caribbean Technical Department, Regional Studies Program, Report 21, September. La Forgia. G. 1992. "Dominican Republic: Means Testing in Health Ministry Facilities in the Dominican Republic." in Margaret E. Grosh (ed.) From Platitudes to Practice: Targeting Social Programs in Latin America World Bank: Latin America and Caribbean Technical Department, Regional Studies Program, Report 21, September, Mesa-Lago and G. La Forgia. "The Dominican Republic." in Carmelo Mesa-Lago (ed.), Health Care for the Poor in Latin America and the Caribbean: Problems, Cases and Solutions. Rosslyn, VA: Pan American Health Organization and the Inter-American Foundation, 1992.. Lewis, M., Sulvetta, M. and G. La Forgia. 1991. "Productivity and Quality of Public Hospital Medical Staff: A Dominican Case Study." International Journal of Health Planning and Management. vol 6: 287-308. Lewis, M., Sulvetta, M. and G. La Forgia. 1990. "Measuring Costs, Efficiency, and Quality in Public Hospitals: A Dominican Case." Internal Discussion Paper No. IDP-90. World Bank, Latin America and the Caribbean Region, August TECHNICAL REPORTS (external review) Technical Note: Brazil s FOME 0 Program. Brazil Country Office, World Bank, 2003, co-authored Contracting Health Services: Getting From Here to There. World Bank, 2001 (co-authored) Growing Pains: The Nicaraguan Social Insurance Health Model in Transition. Barcelona: IESE and the World Bank, 2000. Large-Scale Contracting for the Extension of Basic Care: The Guatemalan Experience. Barcelona: IESE and the World Bank, 2000. Co-authored. 5

"Programa Agrícola de Salud." (Rationale and design for extension of social insurance to farm workers in Guatemala). InterAmerican Development Bank, Region 2 Discussion Papers No. 2, 1995 "Decentralización en salud: las lecciones aprendidas de la experiencia." InterAmerican Development Bank, Region 2 Discussion Papers No. 3, 1995. "Health Policy Reform in Latin American: Framework and Guidelines for Health Sector Assessment." InterAmerican Development Bank, 1993. co-authored. "Extending Coverage and Benefits of Social Financing Systems in Developing Countries: A Review of Concepts and Experience" HFS Major Applied Research Report No. 3. Bethesda, Heatlh Financing Sustainability Project, 1993, co-authored. "Health Insurance in Practice: Fifteen Case Studies From Developing Countries." HFS Small Applied Research Report No. 4. Bethesda, Heatlh Financing Sustainability Project, 1993: author of five case studies, introduction, and conclusion). "Decentralizing Health Services in Colombia: A Review of Progress and Problems." Report submitted to the World Bank, July 17, 1992. "Health Financing in Ecuador: A Challenge for the 1990s." Report presented to USAID/Quito, Bethesda, Health Financing Sustainability Project, August, 1993, co-authored. "Cost Recovery in Public Sector Hospitals in Ecuador." Bethesda, Health Financing Sustainability Project, August, 1993, co-authored. "Cost Recovery in Public Hospitals in Belize." HFS Technical Report No. 5., Bethesda, Health Financing Sustainability Project, February, 1992, co-authored. "Health Services for Low-income Families: Extending Coverage Through Prepayment Plans in the Dominican Republic." HFS Technical Report No. 2., Bethesda, Health Financing Sustainability Project, December, 1990. "Sustainability of Health Sector PVOs in the Dominican Republic: An Economic and Institutional Analysis." HFS Technical Report., Health Financing and Sustainability Project, forthcoming, January, 1993. WORKING PAPERS "Stepping into Health Sector Reform Through Redirecting Financial Flows: A Review of Reform Proposals in Two Latin American Countries." Paper presented at the XVIII Latin American Studies Association Congress, Atlanta, March 10, 1994. "The Potential for Financial Sustainability of PVO-Provided Health Services: Lessons From the Dominican Republic." Paper presented at the 120th annual meeting of the American Public Health Association, November 11, 1992. "Economic Costs of Hospital Services in the Dominican Republic." REACH Project Technical Report, 1990, co-authored. 6

"The Private Medical Sector in Belize." HFS Field Report presented to UDAID/Belize, November, 1990, co-authored. "Social Security in Belize: Present Situation and Prospects for Health Care Benefits." HFS Field Report, Bethesda, Health Financing Sustainability Project, 1992. "Estudio de costos hospitalarios: Metodología para medir los costos directos: consulta externa, emergencia, salas y servicios diagnósticos." Urban Institute, Washington, D.C., March, 1989, [Research design, methodology, and training manual for hospital cost analysis]. "Challenging Health Service Stratification: Social Security - Health Ministry Integration in Panama." Paper presented at the Latin American Studies Association Conference, San Juan, Puerto Rico, December, 1989. "User Fees, Quality of Care, and the Poor: Lessons From the Dominican Republic." Inter-American Foundation, September, 1989. "Health Committee Federations in Panama." Inter-American Foundation, December, 1987. PAPERS PRESENTED Government-Sponsored Health Insurance Schemes in India. FICCIs Health Insurance Conference, July 19, 2011. Promoting Quality in Health Care through Health Insurance. FICCI s Health Insurance Conference July 30, 2010, Federation House, New Delhi Pay-for-Performance in Health Definitions, Measures, and Global Experience. International Conference on Health System Strengthening, May 7-10, 2010, Chennai, India International and India Experiences in Hospital PPPs: Getting the Governance Model Right The Cases of São Paulo, Brazil and Karnataka, India. PPP Workshop, Srinagar, India, May, 24, 2009 Raising Performance of Public Hospitals through Governance Reforms: Presentation at State Health Policy Workshops. Gujarat, Rajasthan, West Bengal, Uttarakhand and Delhi, April 6-17, 2009 Is the Perfect the Enemy of the Good? Large Scale Contracting of Basic Health Services for the Poor in Latin America. WBI Course of PPPs, Lucknow, India, Dec. Dec. 15-20, 2008. Impact Evaluation of Contracting Experiences: Approaches, Methods and Some Results. WBI Course of PPPs, Lucknow, India, Dec. Dec. 15-20, 2008. The Search for Excellence: Efficiency, Costs, Governance, and Quality of Brazilian Hospitals. Latin American Congress on Health Services; São Paulo, June, 2008 Hospital Performance in Brazil Gertulio Vargus Foundation. São Paulo. Sept., 2007 Hospital Governance in Latin America. Paper presented at HD week, April, 2006. The Social Organization Arrangement in São Paulo, Brazil: A PPP Model for Hospital Care 7

Evaluation Results, 2006. Comparative Study of Performance in PPP Hospital in São Paulo State. Health Institute of São, Paulo, July, 2006 Bogue. RJ, La Forgia, G, Hall, CH. Governance Types and Hospital Performance in Latin America. AcademyHealth Annual Research Meeting. Seattle, WA. Jun 25. 2005 Bogue. RJ, La Forgia, G, Hall, CH. Conexiones de Liderazgo: Mecanismos de reforma, gobernabilidad y la eficacia de hospitales Latinoamericanos. Séptimo Congreso Colombiano de Hospitales y Clínicas. Asociación Colombiana de Hospitales y Clínicas. Bogotá, Colombia. Mar 30. 2005 Bogue. RJ, Hall, CH, LaForgia, G. Hospital Governance in Latin America: Results from a Four Nation Survey. Annual Meeting of the American Public Health Association Poster Presentation. Philadelphia. Dec 13. 2005 The Brazil Family Health Extension Project: Pooled Funding Approach (SWAp): Concepts, Mechanics and Lessons Learned. HD week, 2003. Toward Performance-based financing in SILs: HD Week, 2003. Hospital Efficiency: Are We There Yet? VIII Brazilian Congress on Hospital Costs and Financial Management, Sao Paulo, June 11, 2003 Reforma do Sistema de Saúde na América Latina. International Seminar on Trends and Challenges of the Health Systems in the Americas, Sao Paulo, August 12, 2002. Toward Performance-based Financing, the Brazil Family Health Extension Project: HD week, March 2002. Large-scale Contracting of NGO for Basic Health Care: Evaluation of the Guatemalan Experience: HD Learning Week, March, 2002. Fend for Yourself: Systemic Failure of the Dominican Health Market. IHEA Conference, Rotterdam, 1999. Reforma del Sector Salud: Lecciones aprendidas de las lecciones aprendidas: Seminario-Taller: Experiencias de reforma del sector salud en Latinoamérica y los Estados Unidos. Guatemala City, June 1998. Design for Health Sector Reform: The Case of the Dominican Republic. Economics Department and Center for Latin American Studies, University of Pittsburgh, March 1998. Fortalecimiento del financiamiento, gestión y el desempeño de los hospitales públicos dentro del contexto de la reform del sistema de salud. Seminaro sobre Fortalecimiento de la Gestión Hospitalaria, Inter-American Development Bank, November, 1997. Health Reform: Concepts, Framework and the Colombian Case. Economics Department and Center for Latin American Studies, University of Pittsburgh, March 1996. 8

New Directions in Public-private Partnerships in Health Finance and Delivery. Institute of the Americans, La Jolla, CA, July, 1994. Descentralización en Salud en Colombia. Lecciones Aprendidas. Inter-American Development Bank, May, 1994. 9