Center for Studying Health System Change

Providing Insights that Contribute to Better Health Policy

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Hot Issues

Emerging Market Trends

RWJF State Health Reform Assistance Network Initiative

As part of the Robert Wood Johnson Foundation’s (RWJF) State Health Reform Assistance Network initiative, HSC examined commercial and Medicaid health insurance markets in eight U.S. metropolitan areas: Baltimore; Portland, Ore.; Denver; Long Island, N.Y.; Minneapolis/St. Paul; Birmingham, Ala.; Richmond, Va.; and Albuquerque, N.M. The study examined both how these markets function currently and are changing over time, especially in preparation for national health reform as outlined under the Patient Protection and Affordable Care Act of 2010. The site visits took place in 2012-13. HSC will publish Community Reports for each community and two cross-site analyses based on findings from the site studies. More information can be found here.

2013 RWJF Reform Community Reports

Richmond Community Report - Federal Exchange Option and Indecision on Medicaid Expansion Create Uncertainty for Richmond, Va., Market
Long Island Community Report - Long Island Follows Bumpy New York Road to National Health Reform
Minneapolis Community Report - Minneapolis-St. Paul: Health Care Market Overcomes Early State Resistance to National Reform
Portland Community Report - Portland, Oregon: Health Insurance Market Geared Up for National Health Reform
Denver Community Report - Competitive Insurance Market Awaits National Health Reform
Baltimore Community Report - Health Insurance Market Primed for National Health Reform

Community Tracking Study (CTS) Site Visits

As part of the CTS, HSC studies how local health systems are changing through site visits to 12 randomly selected U.S. communities. Since 1996, researchers have visited the 12 communities approximately every two-three years to conduct in-depth interviews with leaders of the local health system. In 2010, HSC completed its seventh round of site visits and has published Community Reports from each site. More information can be found here.

2010 CTS Site Visit Products

Cross-Site Analyses

Issue Brief No. 138 - Small Employers and Self Insured Health Benefits: Too Small to Succeed?
Issue Brief No. 137 - Employer-Sponsored Health Insurance: Down but Not Out
Issue Brief No. 136 - Rising Hospital Employment of Physicians: Better Quality, Higher Costs?
Issue Brief No. 135 - Key Findings from HSC's 2010 Site Visits: Health Care Markets Weather Economic Downturn, Brace for Health Reform

Research Brief No. 25 - Local Public Hospitals: Changing with the Times
Research Brief No. 21 - A Long and Winding Road: Federally Qualified Health Centers, Community Variation and Prospects Under Reform

Journal Article - Health Plan-Provider Price Negotiations: Passing the Buck to Employers
Journal Article - Hospitals' Geographic Expansion in Quest of Well-Insured Patients: Will the Outcome be Better Care, More Cost, or Both?

Community Reports

Boston Community Report - State Reform Dominates Boston Health Care Market Dynamics
Cleveland Community Report - Cleveland Hospital Systems Expand Despite Weak Economy
Greenville Community Report - Greenville & Spartanburg: Surging Hospital Employment of Physicians Poses Opportunities and Challenges
Indianapolis Community Report - Indianapolis Hospital Systems Compete for Well-Insured, Suburban Patients
Lansing Community Report - Lansing's Dominant Hospital, Health Plan Strengthen Market Positions
Little Rock Community Report - Little Rock Health Care Safety Net Stretched by Economic Downturn
Miami Community Report - Economic Downturn Strains Miami Health Care System
Northern New Jersey Community Report - Northern New Jersey Health Care Market Reflects Urban-Suburban Contrasts
Orange County Community Report - Physicians Key to Health Maintenance Organization Popularity in Orange County
Phoenix Community Report - Economic Downturn Slows Phoenix's Once-Booming Health Care Market
Seattle Community Report - Seattle Hospital Competition Heats Up, Raising Cost Concerns
Syacuse Community Report - Syracuse Health Care Market Works to Right-Size Hospital Capacity


California Site Studies

As part of the California Health Care Almanac project, the California HealthCare Foundation (CHCF) funded HSC to conduct interviews in six California communities in 2011-12 to assess how the organization, financing and delivery of health care are changing, including preparations for health reform. CHCF will publish regional market reports for each community and two cross-site analyses based on findings from the site studies. A previous round of California site studies was conducted by HSC researchers in 2008. More information can be found here.


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