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John Fox, MD

Associate Vice President of Medical Affairs

John Fox, MD, MHA, is the Senior Medical Director and Associate Vice President of Medical Affairs for Priority Health, a provider-sponsored health plan with 640,000 members headquartered in Grand Rapids, Michigan. He is responsible for technology assessment (medical and pharmaceutical) and utilization and case management. He is engaged in new program development including physician profiling, pay for performance programs, integrated specialty pharmacy, and value-based benefit designs. He is currently involved in development of payment reform strategies, including oncology medical home. In addition, he works with a talented group of clinicians and programmers to develop Web-based cost and quality comparison tools, personal health records and patient registries.

Dr. Fox received his Doctor of Medicine from Johns Hopkins University School of Medicine and completed a pediatric internship and residency at the Johns Hopkins Hospital. He also earned a Masters in Health Administration from University of Wisconsin. Prior to joining Priority Health, he was the Senior Medical Director at Physicians Plus Insurance in Madison, Wisconsin. He has also worked for the Indian Health Service and with the Epidemic Intelligence Service in the Centers for Disease Control and Prevention (CDC).

The author of many articles, Dr. Fox has written on the use of firearms in suicides, physiatrist-led multidisciplinary spine clinics, oncology medical homes, breast cancer mortality rates, asthma hospitalizations, hip fractures among the elderly, and end-of-life care. He has also written and lectured on value-based benefit design, the impact of genomics and proteomics on the future of medical practice, and role of shared decision making in reducing unwarranted variations in healthcare utilization. His current interests include the use of cost-effectiveness and number-needed-to-treat analyses in coverage determinations, specialty pharmacy management, the effect of pay for performance programs on health outcomes, and implementation of bundled payment models.

He is married to Kristine and has three children. He is very committed to youth leadership development and is active in the Boy Scouts of America as a scoutmaster and board member. He continues to practice medicine in third world countries, including Honduras, and leads one to two trips there annually with his church, where they focus on public health initiatives such as clean water systems and infection prevention. He helps keep nature nearby through the Land Conservancy of West Michigan where he serves as a work crew leader and on its board of directors.

Last modified: April 23, 2015
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