Dr. Billi serves as Professor in Internal Medicine and Learning Health Sciences (Medical School), Health Management and Policy (Public Health), and Integrated Systems and Design (Engineering) at the University of Michigan. Dr. Billi's management and research interests are in health services delivery, especially the use of lean thinking to improve quality and efficiency, population health, clinical practice transformation tied to value-based reimbursement, the creation and use of evidence-based guidelines, and conflict of interest management.
For the past 13 years, Dr. Billi led the Michigan Quality System (MQS), the University of Michigan Health System’s (UMHS) business strategy to help transform clinical and administrative operations through development and deployment of scientific problem solving and coaching at all levels. MQS builds on classic continuous quality improvement, incorporating holistic principles of lean thinking such as supporting workers and managers to take initiative to fix root causes of problems daily, supported by daily management systems, value stream management, and strategy alignment (Hoshin planning). The goal of MQS is to improve safety, quality, timeliness, financial stewardship, and people engagement (SQTFP) in healthcare delivery through problem solving by all workers (including physicians, nurses, and other front-line workers), managers, and leaders throughout the organization. A founding member of Catalysis, the Healthcare Value Network, UMHS also spread this improvement philosophy among regional physician groups and hospitals through a Blue Cross Blue Shield of Michigan-funded Collaborative Quality Initiative. Dr. Billi leads workshops on lean thinking in healthcare delivery within and outside UMHS, including a joint program with the UM College of Engineering with a nationwide draw (isd.engin.umich.edu/professional-programs/lean-healthcare/index.htm).
For over three decades Dr. Billi has been involved in the interface of population health and academic medicine. After serving as the first medical director (1985-1989) for MCARE, UM’s HMO and PPO insurance program, he expanded his focus to include both the provider and employer perspectives. From 1997 to 2005, Dr. Billi led the UMHS development and implementation of innovative health programs with high intensity medical and disease management. First used in pilot insurance products with Ford and General Motors (Partnership Health and ActiveCare), current UMHS initiatives using these programs include the Medicare Accountable Care Organization (built on the successful Physician Group Practice Medicare Demonstration Project), the BCBSM Physician Group Incentive Program, the management of UMHS Medicaid populations, the UMHS development of the Patient Centered Medical Home, and other population health initiatives. For several years he led the Greater Washtenaw Area Care Partners Organized System of Care for BCBSM, a short-lived attempt to take responsibility for population health’s triple aim for the entire County’s population across three Physician Organizations and the hospital systems in the county. Currently Dr. Billi serves on the Steering Committee for the Washtenaw Health Initiative (WHI), which coordinates safety net services, social determinant-health service interface, and ACA enrollment for the local county. The WHI serves as the local Community Health Innovation Region backbone, one of five selected by the State of Michigan under the State Innovation Model (SIM), a federal CMMI Demonstration Project. Dr. Billi serves on several SIM advisory groups. He also serves as Executive Sponsor for the Michigan Data Collaborative (MDC) , a multi-payer claims data repository and analytic function operated by UM serving statewide population health programs. MDC provides multipayer analysis and reporting for statewide population health programs, including the State Innovation Model (SIM), its predecessor demonstration project MiPCT (Michigan Primary Care Transformation – the Michigan version of the CMMI Multipayer Advanced Primary Care Program), and the Physician Group Incentive Program (PGIP – the BCBSM-funded population health program).
Dr. Billi helped found and for 10 years co-chaired the Board of the Center for Healthcare Research and Transformation (CHRT). Originally formed as a joint venture between UMHS and BCBSM, now an independent non-profit, CHRT’s goals are to improve the quality and cost of healthcare delivery in Michigan through policy analysis and education essential to creating and implementing effective health policy at the local, state and national level. For the past five years Dr. Billi has served on the AMA’s Professional Satisfaction and Practice Sustainability Task Force, dedicated to ensuring clinical practitioners have the skills and knowledge to lead their local teams to improve their practice and prevent burnout.
In the mid 2000s, Dr. Billi helped develop and build consensus around the Ideal Patient Care Experience, the UMHS vision of patient care consistent with the IOM report, Crossing the Quality Chasm. He served on the University-wide advisory committee that studied the escalating drug costs and recommended this innovative program by which the University took responsibility for its pharmacy benefits. He was founding chair of the University’s Pharmacy Benefit Oversight Committee, which helped guide the University’s successful pharmacy self-funded carve-out. He was founding chair of the UMHS Ambulatory Formulary Committee, coordinating the health system’s approach to pharmacy issues. He led the effort at UMHS to revamp vendor policies which eliminated drug samples in UMHS sites, eliminated industry gifts of any kind, eliminated provision of food or beverages, limited vendor visits to scheduled appointments, and mandated badging, with strict enforcement.
Dr. Billi is active in statewide and regional initiatives to improve quality and efficiency of care, especially the use of community collaboration to support coordinated quality improvement. He chairs the Michigan State Medical Society's (MSMS) Committee on Health Care Quality, Efficiency, and Economics. He served as Secretary on the MSMS Board of Directors and chaired the Board’s Health Care Delivery Committee from 2009 to 2012. He also serves on the Professional Provider Relations Advisory Committee, which advises BCBSM on policies and philosophy of care and reimbursement transformation. He co-chairs the Michigan Quality Improvement Consortium (MQIC) Medical Director’s committee, a statewide group that consolidates evidence-based practice guidelines and coordinates implementation across Michigan DHHS and 13 commercial and Medicaid healthplans representing over six million members in Michigan. In addition, UMHS serves as the coordinating center for 20 statewide Collaborative Quality Initiatives (CQIs) funded by Blue Cross Blue Shield of Michigan (BCBSM); Dr. Billi serves as UMHS Executive Sponsor for these collaboratives. Dr. Billi serves on the Greater Detroit Area Health Council (GDAHC) Board of Directors, and previously served in a leadership role in GDAHC’s Cost Quality Initiative, a regional consortium of employers, insurers, hospitals and physician organizations that coordinates community-wide public reporting and cooperative quality improvement programs across all stakeholders in Southeast Michigan. In 2006 he received the Symond R. Gottlieb Award from GDAHC for longstanding collaboration and service to the health council and the Southeast Michigan community. In 2007 he received the Presidential Citation from the Michigan State Medical Society in recognition of distinguished service. He also received the MQIC Distinguished Service Award.
For over 30 years, Dr. Billi has contributed to American Heart Association emergency cardiac care committees and the International Liaison Committee on Resuscitation (ILCOR). These organizations develop evidence-based consensus on science and treatment recommendations, leading to nationwide practice guidelines and educational programs to improve outcomes in cardiac resuscitation. Dr. Billi developed and co-leads conflict of interest management activities for ILCOR’s consensus on science process.
Dr Billi’s management roles at UM include 15 years as Associate Vice President for Medical Affairs, over 20 years as Associate Dean of the Medical School, and almost 20 years as the liaison officer between the Medical School and the Ann Arbor VA Health System, chairing the VA Dean’s Committee to coordinate academic and clinical programs.
Dr. Billi received his M.D. degree from the State University of New York, Buffalo in 1977. He completed residency training in Internal Medicine at the University of Michigan Medical Center in 1981. Dr. Billi practices as a general internist in a primary care clinic at the University of Michigan. He is an avid bicycler, cross-country skier, and fly fisher.
Areas of Interest
Research and scholarly interests: Health services delivery. The use of decentralized scientific problem-solving (lean thinking) to improve quality and efficiency. The creation and use of evidence-based guidelines. Conflict of interest management.
Subject-matter expertise: Teaching scientific problem solving at all levels in healthcare and academic institutions. Related terms: operations excellence, quality improvement, performance improvement. The creation and use of evidence-based guidelines, especially in resuscitation. Organizational changes to support population health, including clinical practice transformation tied to value-based reimbursement. Conflict of interest management.