Shantanu Agrawal, M.D., is president and CEO of the National Quality Forum. A board-certified emergency medicine physician who has worked in both academic and community settings, he is the former deputy administrator for the Centers for Medicare & Medicaid Services (CMS) and director of one of its largest centers, the Center for Program Integrity (CPI). At CMS, Agrawal led an effort to improve the physician experience with Medicare by working to minimize the administrative tasks with which doctors contend. He also was one of the main architects of CMS’s strategy and action plan to address the national opioid misuse epidemic. Agrawal’s focus at CPI was on improving healthcare value by lowering the cost of care through detecting and preventing waste, abuse, and fraud in the Medicare and Medicaid programs. From 2012 through 2014, CPI’s prevention efforts saved Medicare and Medicaid over $50 billion.
Agrawal previously served as CPI’s chief medical officer and was instrumental in launching new initiatives in data transparency and analytics, utilization management, assessment of novel payment models, and stewarding the Health Care Fraud Prevention Partnership, a major public-private collaboration between CMS and private payers.
In addition to leading the National Quality Forum, Agrawal is co-chair of the Department of Veterans Affairs Secretarial Fraud, Waste, and Abuse Prevention Advisory Committee, and also serves on the board of the Grameen Foundation, the Presidential Advisory Council of Brown University’s School of Public Health, and the editorial board of the journal Population Health Management. He is an adjunct senior fellow at the Leonard Davis Institute of Health Economics at the University of Pennsylvania and an associate clinical professor of emergency medicine at the George Washington University Hospital.
Agrawal has testified numerous times before Congress and is a frequent national speaker on healthcare and cost. He is a well-published author with articles in Journal of the American Medical Association, New England Journal of Medicine, and Annals of Emergency Medicine, among others.
Prior to joining CMS, Agrawal was a management consultant at McKinsey & Company, serving the senior management of hospitals, health systems, and biotech and pharmaceutical companies on projects to improve the quality and efficiency of healthcare delivery. He also worked for a full-risk, capitated delivery system as its leader for clinical innovation and efficiency.
Agrawal completed his undergraduate education at Brown University, medical education at Weill Medical College of Cornell University, and clinical training at the Hospital of the University of Pennsylvania. He has a master’s degree in social and political sciences from Cambridge University.