Journal Articles

Title Date

Accountable Care Organizations 2.0: Linking Beneficiaries

JAMA Internal Medicine

The failure to formally link Medicare beneficiaries to accountable care organizations threatens to undermine efforts to improve care and control costs, according to an invited commentary by economist Paul B. Ginsburg, Ph.D., published online April 21 in JAMA Internal Medicine .

Understanding Differences Between High- and Low-Price Hospitals: Implications for Efforts to Rein In Costs

Health Affairs, Web First

While higher-price hospitals tend to be bigger, have larger market shares and offer expensive specialized services, they don’t necessarily provide better quality of care than lower-price hospitals, according to a study from the nonpartisan, nonprofit National Institute for Health Care Reform (NIHCR) ...

How Do Hospitals Cope with Sustained Slow Growth in Medicare Prices?

Health Services Research, Early View

On average, hospitals do not appear to make up for Medicare cuts by “cost shifting,” but by adjusting their operating expenses over the long run. The Medicare price cuts in the Affordable Care Act will “bend the curve,” that is, significantly slow the growth in hospitals’ ...

Contrary to Cost-Shifting Theory, Lower Medicare Hospital Payment Rates for Inpatient Care Lead to Lower Private Payment Rates

Health Affairs, Vol. 32, No. 5

Contrary to the notion that hospitals charge private payers higher payment rates to offset lower Medicare rates, it turns out the opposite is true—lower Medicare payment rates lead to lower private rates for inpatient care, according to a study by the Center for Studying Health System Change (HSC) ...

Achieving Health Care Cost Containment Through Provider Payment Reform that Engages Patients and Providers

Health Affairs, Vol. 32, No. 5

Scaling up health care payment reform to control costs and improve quality will require both sticks to prod providers from the sidelines and carrots to guide patients to more-efficient, higher-quality doctors and hospitals, according to an article by Paul B. Ginsburg, Ph.D., president of the Center for ...

After-Hours Access to Primary Care Practices Linked with Lower Emergency Department Use and Less Unmet Medical Need

Health Affairs, Web First

Patients with problems reaching their primary care practice after hours are more likely to report ending up in the emergency department and going without needed medical care, according to a study by the Center for Studying Health System Change (HSC) published today as a Web First by Health Affairs ...

Safety-Net Providers in Some U.S. Communities Have Increasingly Embraced Coordinated Care Models

Health Affairs, Vol. 31, No. 8

Safety net clinics, hospitals and other providers that care for uninsured and low-income people increasingly are seeking ways to coordinate services to increase access, improve quality and reduce costs, according to a study by the Center for Studying Health System Change (HSC) published in the August ...

The Growing Power of Some Providers to Win Steep Payment Increases from Insurers Suggests Policy Remedies May be Needed

Health Affairs, Vol. 31, No. 5

Given the negotiating clout of so-called must-have hospitals and physician groups, even dominant health plans are wary of disrupting the status quo by trying to constrain prices, perhaps because insurers can simply pass along higher costs to employers and their workers, according to a study by the Center ...

Hospital Geographic Expansion: The New Medical Arms Race?

Health Affairs, Vol. 31, No. 4

Hospitals’ longstanding competitive focus on cutting-edge technology, niche specialty services and amenities to attract physicians and patients has set the stage for the next chapter in hospital competition—targeted geographic expansion into new markets with well-insured people, according ...

Reforming Provider Payment—The Price Side of the Equation

New England Journal of Medicine, Vol. 365, No. 14

It’s pretty basic economics: spending equals price times quantity. For some time, public health care payers, such as Medicare and Medicaid, have focused much of their cost-containment effort on constraining the prices they pay for health care services, which they set administratively. The Affordable ...

Spending to Save—ACOs and the Medicare Shared Savings Program

New England Journal of Medicine, Vol. 364, No. 22

While criticism that the government set the bar too high for accountable care organizations (ACOs) has been fast and furious, the proposed rule for the Shared Savings Program is a wake-up call that Medicare is serious about achieving better care for individuals, better health for populations and lower ...
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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.