The Conference That Continues to Shape U.S. Health Policy

October 26, 2021

Red tinted photo of capitol building in Washington, D.C.

By Bethany Romano, MBA’17

Many of the most transformational health policy ideas of the last quarter century originated from a small annual gathering with a big reputation, and a simple name that belies its importance: “The Princeton Conference.” 

Out of the Princeton Conference have emerged key provisions of President Joe Biden’s American Rescue Plan and major unveilings of new health care payment and delivery models — all with the goal of making U.S. health care more accessible and efficient. 

That’s thanks to the leadership of Stuart Altman, Heller’s Sol C. Chaikin Professor of National Health Policy, who has advised five U.S. presidents and long been regarded as one of the country’s top health policy experts. He’s designed a conference that brings together the nation’s top academics and analysts to sit shoulder to shoulder with industry leaders and state and federal policy staffers from both sides of the aisle.

‘Real solutions to the biggest problems in health policy today’

Twenty-eight years ago, Princeton Professor Uwe Reinhardt convened a group of leading health economists to provide expert analysis on President Bill Clinton’s health reform plan. Reinhardt’s funder, the Robert Wood Johnson Foundation (RWJF), saw potential in regular gatherings of health policy experts and decided to fund the creation of an annual Princeton Conference.

RWJF turned the endeavor over to Altman, and offered its headquarters in Princeton, New Jersey, as a meeting site. For the last 26 years, Altman says, “The Princeton Conference has invited the leading health policy analysts in the country, over a three-day period, to discuss the major issues of the day.”

The Princeton Conference differs from a traditional conference because it’s invitation-only and is limited to about 140 people. It’s also not a for-profit event; attendees cover their travel expenses and lodgings, but there’s no registration fee or hall of sponsor-vendors to wade through on the way to the coffee station. Altman raises more than $250,000 each year from over 30 organizations to keep it that way.

The invitees — a diverse group of the nation’s top health policy minds — are hand-selected by Altman and his advisory board. “It’s both a core component of senior people who have been coming for many years, and a growing group of younger people who are making a name for themselves,” says Altman. 

“It’s a who’s-who of health economists and health policymakers,” adds conference director  Associate Professor Michael Doonan, PhD’02. “Some conferences only focus on the research. This brings research and policy together, with people who really do the work.” The 2020 conference (held virtually) included presentations from Surgeon General Vivek Murthy and Wendell Primus, House Speaker Nancy Pelosi’s top health policy adviser. 

Beyond big names and top organizations, the Princeton Conference is “limited to those who are truly dedicated to making a positive impact in the American health care system,” says Sarah Emond, MPP’09, executive VP and COO of the Institute for Clinical and Economic Review.

Emond received an invitation shortly after graduating from the Heller School. “Stuart and Mike make sure the next generation of policy thinkers are there. At first I was just listening, and realizing I was listening to someone I’d read six papers by in graduate school.”

Altman and his advisory board also strive to ensure that the group is meaningfully diverse both demographically and politically, taking great care to ensure strong representation from both sides of the aisle and multiple sectors of the health world.

“I love the bipartisan nature of the conference,” says Emond. “There’s lots of respectful disagreement in the room. I think it’s one of the last places we can have honest conversations about real solutions to the biggest problems in health policy today.”

The ‘Meet the Press’ of conferences

“The things that get discussed and the connections that get made at the Princeton Conference can change where the nation goes,” says Karen Feinstein, PhD’83, president and CEO of the Jewish Healthcare Foundation. “I know that sounds like an exaggeration, but at some level I believe in that.”

It was at a Princeton Conference that Dr. Mark McClellan, former head of the Centers for Medicare and Medicaid Services and the Food and Drug Administration under President George W. Bush, first introduced the concept of Accountable Care Organizations. The new health care payment and delivery model has since grown rapidly in popularity. 

“It’s the ‘Meet the Press’ of conferences,” says Chris Jennings, a former senior adviser to presidents Clinton and Obama. He adds that the conference always features experts who are respected across the political spectrum to discuss issues that are timely and relevant to the moment.

Past debates have included the possibility of a physician shortage in the U.S., and efforts to contain rising health care costs in Massachusetts compared to other states. The group has analyzed Medicare payment models and completely reimagined the Medicaid program for a possible future where managed care is the norm.

One recent conference focused heavily on shortfalls of the Affordable Care Act, including the lack of affordability of private insurance in state marketplaces. That debate formed the basis for some of the provisions in President Biden’s American Rescue Plan, which reduces health care costs and expands access to insurance coverage for low-income people.  

“In recent years we’ve focused more on the social determinants of health, and the importance of non-clinical care to improve population health,” says Altman, “We’ve also emphasized the problems of our mental health delivery system, including how we finance it and whether the U.S. has adequate mental health personnel. It’s evolved over time.”

The intimate format and insistence on audience involvement are hallmarks of the event, which eschews the traditional “sage on the stage” culture of other conferences. President and CEO of the Blue Cross Blue Shield of Massachusetts Foundation Audrey Shelto, MMHS’82, says the incredibly robust discussions “make for tremendous learning in all directions … Stuart and Mike often have trouble getting everyone back into the room!” 

Some poke fun at the “mutually inconvenient” location in Princeton, but for Altman it was a conscious decision to keep the conference out of Washington or another large city. “I wanted to get them away from their desks, and to do this over several days,” he says. “It allows for a lot of interchange among the participants. It’s more designed to be like a retreat that way.” 

Inspired and empowered to do better

Attendees regularly note how much they look forward to the Princeton Conference, with Emond calling it “the highlight of my year.” In addition to the unique format, high-value networking opportunities and unparalleled presentations and debates, it is clear that Altman’s leadership is key to the continued enthusiasm of the attendees. 

“He’s the center of energy that ties it all together — his tremendous knowledge, credibility and the affection that the health policy community have for him,” says Chip Kahn, president and CEO of the Federation of American Hospitals.

With 28 conferences in the books, Altman and the rest of the conference team and advisory board are planning a return to in-person events in 2022. After two years of the COVID-19 pandemic and with midterm elections on the horizon, there will be no shortage of critical health-policy topics to address.

For those dedicated to improving the U.S. health care system, the Princeton Conference remains an essential space for fostering positive change. As Jennings puts it, “People walk out the door informed and inspired and empowered to do better, wherever they are. That is the magic potion of the conference.”