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) was to inform policy makers and private decision makers about how local and national changes in the financing and delivery of health care affected people. HSC aspired to provide high-quality, timely and objective research and analysis that contributed 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) conducted 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 contributed more broadly to the body of health care policy research that enabled 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 conducted 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.
Beginning in 2003, HSC, which was affiliated with Mathematica Policy Research, sought support from many different sources: foundations, governmental entities and private organizations. To preserve HSC's reputation for high-quality, independent and nonpartisan research, nurtured and sustained during the long period when RWJF was the sole source of support, HSC only accepted funding when it retained the right to publish all research results, and final methodological and editorial decisions ultimately resided with HSC.
HSC did not take policy positions and was a resource for decision makers on all sides of the issues because of its reliable data and objective analysis.
For nearly 20 years, HSC was on the forefront of identifying and analyzing emerging health care trends at the community level. On Dec. 31, 2013, HSC merged with Mathematica Policy Research and ceased operations as an independent organization.
Health Care in Communities
Ultimately, all health care is organized and delivered at ground levelin local communitieswhere HSC collected information about the changing health system. As part of the Community Tracking Study (CTS), HSC periodically makde intensive site visits to 12 metropolitan communities selected randomly to be representative of the nation. HSC also conducted 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 conducted studies using other survey data and administrative data, such as medical claims. HSC researchers combined 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 allowed it to provide targeted research and analysis that can contribute to better health policy. To assist policy makers, HSC focused on four key policy areas:
Site Visits to 12 Nationally Representative Communities
HSC periodically conducted 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 interviewed 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.