Center for Studying Health System Change

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HSC's RESEARCH AGENDA

As of August 2001

SC’s research focuses on three key policy areas:

  • private insurance coverage
  • access to care for the uninsured
  • managed care and markets

Each of these policy areas is described in more detail in the HSC 2000 Annual Report.

PUBLISHED RESEARCH: Abstracts of journal articles and the complete texts of HSC publications using Rounds 1 and 2 of the CTS survey data can be viewed on this website under Publications.

PROJECTS UNDERWAY: Recently completed, ongoing, and planned HSC analyses using CTS survey data include the following topics:

  • Private Insurance Coverage
    • Why is private health insurance eroding?
    • What factors affect small firms’ decisions to offer health insurance?
    • What has been the effect of HIPAA legislation on rates of private insurance coverage?
    • How have recent expansions of public insurance eligibility affected insurance coverage among low-income and low-wage workers?
    • Will expansions in public coverage be successful in reducing the high rates of children’s uninsurance in some communities?
    • Did SCHIP decrease private insurance coverage among low-income families?
    • How effective would tax credits be in expanding coverage if offered through employers or in the individual insurance market?
    • How does insurance coverage differ for the chronically ill?
    • How and why do health insurance premiums vary across local markets?

  • Access to Care for the Uninsured
    • Is access to needed medical care getting better or worse?
    • Care vs. coverage: Which is more effective in improving access to care for low income and uninsured persons?
    • Has physicians’ provision of charity care been affected by changes in practice arrangements?
    • How do minority physicians differ from white physicians in terms of their ability to get needed services for patients?
    • Are the disparities in access, service use, and trust among minorities and whites observed in managed care plans greater than those disparities observed in other plans?
    • What are the effects of insurance coverage and availability of services on racial and ethnic disparities in access, service use, and trust?

  • Managed Care and Markets
    • Are HMO enrollees healthier?
    • Does HMO profit status affect enrollees’ access to care and assessments of care?
    • Are consumers with choice of health plans more satisfied with care in HMOs?
    • How do insurance product features such as gatekeeping and capitation affect consumers’ access, service use, and satisfaction?
    • Does the type and amount of managed care in a market affect service use?
    • How does access and continuity of care for chronically ill patients compare across different types of health plans?
    • How has the use of managed care tools in physicians’ practices been changing?
    • How have physician practice arrangements been changing?
    • How often are quality and other performance based measures used to determine physician compensation?
    • What are the determinants of physicians’ ability to obtain needed services for their patients?
    • What factors influence primary care physicians’ ability to obtain mental health services for their patients?
    • Does the use of physician profiling, either with or without financial incentives, influence physicians’ perceptions of the quality of care they deliver or their ability to obtain needed services?
    • What factors explain variations in physicians’ practice patterns (vignettes)?
    • Is physician satisfaction changing over time and what factors contribute to these changes?
 

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The Center for Studying Health System Change Ceased operation on Dec. 31, 2013.