Providing Insights that Contribute to Better Health Policy
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Center for Studying Health System Change (HSC)
HSC is a nonpartisan policy research organization focused on changes in the financing, delivery and quality of health care in the United States, with a particular emphasis on the policy implications of these changes. Founded in 1995 by the Robert Wood Johnson Foundation (RWJF) and led by HSC President Paul B. Ginsburg, Ph.D., a nationally known health care economist and health policy expert, HSC conducts rigorous surveys and in-depth cases studies to identify emerging trends in the nation’s health care system. From 1995 to 2003, RWJF served as HSC’s exclusive funder. Since 2003, HSC has sought support from many different sources: foundations, governmental entities and private organizations. Regardless of funder, HSC maintains editorial control of all research findings. Instead of advocating for particular policies, HSC serves as an honest broker of information for policy makers, the news media, employers, health care providers, insurers and the public. Based in Washington, D.C., HSC is affiliated with Mathematica Policy Research.
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.
HSCs Key Policy Research Areas
HSCs focus on local market dynamics allows it to provide targeted research that can contribute to better health policy. To assist policy makers, HSC focuses on four key policy research 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 recently completed the seventh round of site visits.
National Household and Physician Surveys
Since 1996, HSC has conducted six national surveys of American households and five national surveys of American 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. The 2010 survey is nearing completion.
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.
The National Institute for Health Care Reform