Elliott S. Fisher is a health policy researcher and advocate for improving health system performance in the United States. He helped develop the concept of accountable care organizations and championed their adoption by Medicare. The development of the Affordable Care Act was influenced by his research on disparities in healthcare spending and utilization across the United States. He has strongly supported a rapid transition from fee-for-service to pay-for-performance models in the U.S. healthcare industry. He is a tenured faculty member at Dartmouth College, where he teaches in the Masters in Public Health program. Personal life and education Fisher earned a BA from Harvard College in East Asia Studies in 1976; an MD from Harvard Medical School in 1981; and a MPH in health research from the University of Washington in 1985. He is the son of late Harvard academic Roger Fisher and brother of Peter R. Fisher. Career In 1986, Fisher became a member of the faculty at Dartmouth Medical School (now the Geisel School of Medicine), where he continues to teach. He also served as a physician at the Veterans Affairs Medical Center in White River Junction, Vermont, from 1986 to 2004. Fisher served as the director of The Dartmouth Institute for Health Policy and Clinical Practice from 2013 through 2019 and he served as the institute's Director of the Centers for Population Health and Healthy Policy Research from 2007 through 2009. Early research on health system performance A general internist, Fisher's early research focused on the promise and pitfalls of using of large databases, such as vital records, census data, and Medicare claims to study health care. In the last three decades, Fisher led studies that used claims data and other data sources to explore the causes and consequences of the dramatic differences in spending and utilization of health care across the country, research that revealed that the excess spending in high cost regions was largely due to overuse of discretionary—often avoidable—services and that higher utilization was not associated with better quality or health outcomes. He concluded that the United States is wasting a substantial portion of spending on avoidable and potentially harmful care. The landmark research was cited by Peter R. Orszag as President Barack Obama's administration crafted the Patient Protection and Affordable Care Act. Accountable care organizations In the mid-2000s, as consensus emerged that health costs were rising at an unsustainable rate and that fragmented, poorly