Michael Sherman, MD, MBA, MS
Chief Medical Officer and Senior Vice President for Health Services , Harvard Pilgrim Health Care
Dr. Michael Sherman, chief medical officer and senior vice president for health services at Harvard Pilgrim Health Care, is widely recognized as a pioneer in the race to control skyrocketing drug costs. His work in the development of value-based payment agreements with pharmaceutical companies, which tie payment for a drug to patient outcomes, has placed him at the forefront of the issue. Dr. Sherman is credited with cementing Harvard Pilgrim’s position as a leader among insurers in crafting agreements with pharmaceutical companies that tie payments for a drug to its performance. In 2018, he received Xconomy’s “Contrarian Award” for his contributions, which include having signed the nation’s first such payment model for a gene therapy, helping pave the way for the development of innovative financing models.
Harvard Pilgrim is a not-for-profit health plan that has been recognized by NCQA as one of the top health plans in the nation for over a decade and which provides a variety of insurance options to 1.2 million members in Massachusetts, New Hampshire, Maine, and Connecticut. As Harvard Pilgrim’s chief physician executive, Dr. Sherman has focused the organization on introducing innovative outcomes-based reimbursement models that more effectively engage providers, pharmaceutical companies, and diagnostics companies. He is responsible for medical trend management, pharmacy management, provider engagement strategy, clinical policy and utilization management, disease and care management services, quality, and wellness offerings.
Dr. Sherman is chair of the Board of Managers of the Harvard Pilgrim Health Care Institute, which encompasses the Department of Population Medicine at Harvard Medical School—the nation’s only appointing medical school department based in a health plan. He holds additional board appointments with several well-respected nonprofit organizations, including the Institute for Clinical and Economic Review (ICER), the Personalized Medicine Coalition, the Harvard Business School Healthcare Initiative, and the Center on Media and Child Health. Until recently, he chaired AHIP’s CMO Leadership Council, a trade association comprising chief medical officers from health plans throughout the United States, and also served as a board member and as Co-President of the Harvard Business School Healthcare Alumni Association. Dr. Sherman has also served as a mentor for emerging physician executives enrolled in the AHIP Executive Leadership Program.
Prior to joining Harvard Pilgrim in 2011, Dr. Sherman served as corporate medical director for physician strategies at Humana, where he developed collaborative provider-payer partnerships with provider organizations to support their mutual goal of delivering the highest quality care to patients. He also served as vice president of network and consumer solutions for UnitedHealth Group’s subsidiary Ingenix (now part of Optum) and as chief business development officer for United’s Medicare Part D business. Formerly, Dr. Sherman held the position of vice president and general manager at Thomson Medstat (now IBM Truven), and he previously held management roles at Immusol, a San Diego-based biotechnology company; HealthAllies, an organization created to provide discretionary medical benefits to the cash-pay market, which was purchased by UnitedHealth Group; and Da Vita, a national provider of dialysis services.
Before pursuing an M.B.A. at Harvard Business School, Dr. Sherman received his M.D. from Yale and practiced as a cardiac anesthesiologist. He also holds a B.A. in Anthropology and Natural Sciences and an M.S. in Biomedical Anthropology from the University of Pennsylvania. Dr. Sherman is a diplomate of the American Board of Anesthesiology and the American Board of Medical Management. In 2009, he was named a fellow of the American College of Physician Executives in recognition of his national contributions to the field of medical management. Dr. Sherman frequently speaks at regional, national, and international conferences and lectures as a faculty member of Harvard Medical School’s Department of Population Medicine. He has also been called upon to provide legislative testimony at the national level. Speaking at the White House in 2017, Dr. Sherman presented Harvard Pilgrim’s efforts to combat the opioid epidemic at a meeting of the President’s Commission on Combating Drug Addiction and the Opioid Crisis.