Policy Analyses

Title Date

Bridging the Disconnect Between Patient Wishes and Care at the End of Life

NIHCR Policy Analysis No. 12

Along with people’s reluctance to discuss death and dying, barriers to high-quality end-of-life care include a fragmented delivery system that hinders communication of patients’ wishes across care settings and payment policies that discourage end-of-life care discussions and encourage aggressive ...

Hospital Quality Reporting: Separating the Signal from the Noise

NIHCR Policy Analysis No. 11

Amid the proliferation of quality measures, reporting requirements and transparency efforts, purchasers often find it difficult to separate the signal from the noise when determining what hospital quality measures are important, how to interpret and use quality information in a meaningful way, and how ...

Adapting Tools from Other Nations to Slow U.S. Prescription Drug Spending

NIHCR Policy Analysis No. 10

Tools commonly used in other developed nations to help slow prescription drug spending growth offer potential lessons for the U.S. health system, according to a new Policy Analysis from the nonprofit, nonpartisan National Institute for Health Care Reform (NIHCR).

Addressing Hospital Pricing Leverage through Regulation: State Rate Setting

NIHCR Policy Analysis No. 9

Amid growing evidence that rising prices—especially for hospital care—play a key role in rising premiums for privately insured people, policy makers may want to revisit a tool—rate setting—used decades ago by a number of states to constrain hospital costs, according to a new Policy Analysis from ...

State Benefit Mandates and National Health Reform

NIHCR Policy Analysis No. 8

While the national health reform law requires states to pay for health benefit mandates that exceed a minimum package of covered services, states' financial liability for mandates is likely to be relatively small, according to a new Policy Analysis from the nonprofit, nonpartisan National Institute for ...

Matching Supply to Demand: Addressing the U.S. Primary Care Workforce Shortage

NIHCR Policy Analysis No. 7

While there is little debate about a growing primary care workforce shortage in the United States, precise estimates of current and projected need vary. A secondary problem contributing to addressing capacity shortfalls is that the distribution of primary care practitioners often is mismatched with patient ...

Promoting Healthy Competition in Health Insurance Exchanges: Options and Trade-offs

NIHCR Policy Analysis No. 6

While federal and state policy makers face many complex decisions about the design and operation of new state-based health insurance exchanges, the overarching goal of the exchanges is straightforward—promoting healthy competition among insurers to provide better health care at lower total cost, according ...

Policy Options to Encourage Patient-Physician Shared Decision Making

NIHCR Policy Analysis No. 5

While evidence suggests that patients’ medical decisions in the United States, even momentous ones, are seldom well informed, greater use of shared decision making between clinicians and patients might help bridge the gap between the care patients want and the care they actually receive, according ...

Geographic Variation in Health Care:
Changing Policy Directions

NIHCR Policy Analysis No. 4

While research on geographic variation in health care use and spending has pushed the twin issues of uneven care and costs to the fore, it’s ultimately the broader health care system—not geography—that matters most in improving efficiency and quality, according to a new Policy Analysis from the ...

Comparative Effectiveness Research and Medical Innovation

NIHCR Policy Analysis No. 3

Determining what treatments work best for which patients in real-world settings—known as comparative effectiveness research (CER)—can help foster beneficial medical innovation, according to a new Policy Analysis from the National Institute for Health Care Reform (NIHCR).

Health Coverage for the High-Risk Uninsured: Policy Options for Design of the Temporary High-Risk Pool

NIHCR Policy Analysis No. 2

While 5.6-million to 7-million Americans may qualify for health coverage through the new temporary national high-risk pool program, the $5 billion allocated until 2014 will cover only a small fraction of those in need, according to a new Policy Analysis from the National Institute for Health Care Reform ...

Episode-Based Payments: Charting a Course for Health Care Payment Reform

NIHCR Policy Analysis No. 1

As consensus grows that true reform of the U.S. health care system requires a move away from fee-for-service payments, designing alternative payment methods, including episode-based payments, has emerged as a high priority for policy makers.

Rough Passage: Affordable Health Coverage for Near-Elderly Americans

HSC Policy Analysis No. 2

Among the policy options to expand health coverage for Americans aged 55 to 64—the near elderly—comprehensive reform of the individual insurance market, coupled with a Medicaid expansion for those with very low incomes, would be the most effective and far-reaching approach, according to a new Policy ...
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The National Institute for Health Care Reform (NIHCR) contracted with the Center for Studying Health System Change (HSC) between 2009 and 2013 to conduct health policy research and analyses to improve the organization, financing and delivery of health care in the United States. HSC ceased operations on Dec. 31, 2013, after merging with Mathematica Policy Research, which assumed the HSC contract to complete NIHCR projects.