Providing Insights that Contribute to Better Health Policy
Insurance Coverage & Costs Access to Care Quality & Care Delivery Health Care Markets Issue Briefs Data Bulletins Research Briefs Policy Analyses Community Reports Journal Articles Other Publications Surveys Site Visits Design and Methods Data Files
he mission of the Center for Studying Health System Change (HSC) is to inform policy makers and private decision makers about how local and national changes in the financing and delivery of health care affect people. HSC strives to provide high-quality, timely and objective research and analysis that leads to sound policy decisions, with the ultimate goal of improving the health of the American public.
ased in Washington, D.C. the nonpartisan Center for Studying Health System Change (HSC) conducts health policy research and analysis focused on the U.S. health care system to inform the thinking and decisions of policy makers in government and private industry. Additionally, HSC studies contribute more broadly to the body of health care policy research that enables decision makers to understand the national and local market forces driving changes in the health system.
Founded in 1995 by the Robert Wood Johnson Foundation (RWJF) and led by HSC President Paul B. Ginsburg, a nationally known health care economist and health policy expert, HSC conducts rigorous surveys and in-depth case studies to identify emerging trends in the nation’s health care system. From 1995 to 2003, RWJF served as HSC’s exclusive funder, allowing HSC researchers to develop a reputation for conducting high-quality, independent and nonpartisan research. Since 2003, HSC, which is affiliated with Mathematica Policy Research, has sought support from many different sources: foundations, governmental entities and private organizations. To preserve HSC’s high standards for research devoid of bias, HSC developed principles for research funding that ensure HSC maintains editorial control of all research findings.
In addition to a wide array of funders, the National Institute for Health Care Reform (NIHCR), a nonpartisan, nonprofit 501 (c)(3) organization established by the International Union, UAW; Chrysler Group LLC; Ford Motor Company; and General Motors, contracts with HSC to conduct health policy research and analyses that meet HSC's rigorous standards for quality and objectivity. Along with his role as HSC president, Ginsburg serves as NIHCR research director.
HSC does not take policy positions and is a resource for decision makers on all sides of the issues because of its reliable data and objective analysis.
Health Care in Communities
Ultimately, all health care is organized and delivered at ground level—in local communities—where HSC collects information about the changing health system. As part of the Community Tracking Study (CTS), HSC periodically makes intensive site visits to 12 metropolitan communities selected randomly to be representative of the nation. HSC also conducts other site-visit studies, for example, of six California communities, and smaller qualitative studies focused on narrower topics, such as health information technology. Along with fielding national surveys of consumer households and physicians, HSC researchers conduct studies using other survey data and administrative data, such as medical claims. HSC researchers combine quantitative and qualitative findings to provide policy makers with a vibrant picture of changing health care market dynamics and the implications for health care policy.
HSC Key Research and Policy Analysis AreasHSC’s focus on local market dynamics allows it to provide targeted research and analysis that can contribute to better health policy. To assist policy makers, HSC focuses on four key policy areas:
Site Visits to 12 Nationally Representative Communities
HSC periodically conducts intensive site visits to Boston; Cleveland; Greenville, S.C.; Indianapolis; Lansing, Mich.; Little Rock, Ark.; Miami; northern New Jersey; Orange County, Calif.; Phoenix; Seattle; and Syracuse, N.Y. In each community, HSC researchers interview about 50 local health care leaders, including employers, physicians, hospital executives, policy makers, safety net providers and insurers. HSC completed the seventh round of site visits in 2010.
National Household and Physician Surveys
Since 1996, HSC has conducted six national surveys of American households and five national surveys of physicians.
Health Tracking Household Survey.Approximately 17,000 people took part in the 2010 survey. The survey focuses on assessing whether consumers’ access to health care is improving or declining over time. The survey also explores patients’ satisfaction with the care they receive and with their insurance coverage.Health Tracking Physician Survey.Approximately 4,700 practicing physicians across the country took part in the 2008 survey, providing information about how the practice of medicine is changing. Physicians respond to questions about their ability to provide needed services for patients, how much charity care they provide, how they are compensated and many other topics.