Cost Containment

Title	Date
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) ...	May 2013
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 ...	May 2013
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 ...	April 2013
Few Americans Switch Employer Health Plans for Better Quality, Lower Costs NIHCR Research Brief No. 12 Less than 2.5 percent of nonelderly Americans in 2010 with employer coverage—about the same proportion as in 2003—initiated a change in health plans to reduce their health insurance costs or get a better quality plan, according to a new national study by the Center for Studying Health System ...	January 2013
Employer-Sponsored Insurance and Health Reform: Doing the Math NIHCR Research Brief No. 11 Amid concerns that health reform might hasten the ongoing decline of employer health coverage, the calculus of offering coverage will continue to make economic sense for businesses employing most workers (81%) now offered insurance, according to a new national study for the nonpartisan, nonprofit National ...	December 2012
High-Intensity Primary Care: Lessons for Physician and Patient Engagement NIHCR Research Brief No. 9 If fledgling efforts to improve quality and lower costs by focusing extra primary care attention on patients with complex conditions are to succeed, ensuring physicians and patients are on board will be key, according to a new qualitative study by the Center for Studying Health System Change (HSC) for ...	October 2012
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).	August 2012
Small Employers and Self-Insured Health Benefits: Too Small to Succeed? HSC Issue Brief No. 138 While large firms often assume financial risk for enrollees’ medical care through self-insurance, small firms’ growing interest in the practice may pose challenges for policy makers, according to a new qualitative study by the Center for Studying Health System Change (HSC).	July 2012
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 ...	May 2012
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 ...	May 2012
Limited Options to Manage Specialty Drug Spending HSC Research Brief No. 22 Health insurers and employers have few tools to control rapidly rising spending on high-cost specialty drugs—typically high-cost biologic medications to treat complex medical conditions, according to a new qualitative study from the Center for Studying Health System Change (HSC). The study was ...	April 2012
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 ...	April 2012
Great Recession Accelerated Long-Term Decline of Employer Health Coverage NIHCR Research Brief No. 8 Between 2007 and 2010, the share of U.S. children and working-age adults with employer-sponsored health insurance dropped 10 percentage points from 63.6 percent to 53.5 percent, according to a national study by HSC for the nonpartisan, nonprofit National Institute for Health Care Reform (NIHCR).	March 2012
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 ...	February 2012
Health Status and Hospital Prices Key to Regional Variation in Private Health Care Spending NIHCR Research Brief No. 7 Differences in health status explain much of the regional variation in spending for privately insured people, but differences in provider prices—especially for hospital care—also play a key role, accordingto a new study by the Center for Studying Health System Change (HSC) for the nonpartisan, ...	February 2012
Indianapolis Hospital Systems Compete for Well-Insured, Suburban Patients Community Report No. 12 Indianapolis’ major hospital systems continue to encroach on each other’s traditional territories, engaging in a battle of bricks and mortar in suburban areas to compete for well-insured patients, according to a new Community Report released today by the Center for Studying Health System ...	December 2011
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, ...	November 2011
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 ...	Oct. 6, 2011
Economic Downturn Strains Miami Health Care System Community Report No. 11 Despite the economic downturn’s severe fallout on Miami’s tourism, real estate and construction sectors, some hospitals are expanding beyond their traditional geographic markets to compete for privately insured patients, according to a new Community Report released today by the Center for ...	September 2011
Health Care Provider Market Power Congressional Testimony Statement of Paul B. Ginsburg, Ph.D. President, Center for Studying Health System Change Research Director, National Institute for Health Care Reform (NIHCR). Before the U.S. House of Representatives Ways and Means Committee, Subcommittee on Health. Hearing on "Health Care Industry Consolidation"	Sept. 9, 2011

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Payment Policy and Benefit Design

Title	Date
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 ...	May 2013
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) ...	May 2013
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 ...	April 2013
High-Intensity Primary Care: Lessons for Physician and Patient Engagement NIHCR Research Brief No. 9 If fledgling efforts to improve quality and lower costs by focusing extra primary care attention on patients with complex conditions are to succeed, ensuring physicians and patients are on board will be key, according to a new qualitative study by the Center for Studying Health System Change (HSC) for ...	October 2012
Small Employers and Self-Insured Health Benefits: Too Small to Succeed? HSC Issue Brief No. 138 While large firms often assume financial risk for enrollees’ medical care through self-insurance, small firms’ growing interest in the practice may pose challenges for policy makers, according to a new qualitative study by the Center for Studying Health System Change (HSC).	July 2012
Limited Options to Manage Specialty Drug Spending HSC Research Brief No. 22 Health insurers and employers have few tools to control rapidly rising spending on high-cost specialty drugs—typically high-cost biologic medications to treat complex medical conditions, according to a new qualitative study from the Center for Studying Health System Change (HSC). The study was ...	April 2012
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 ...	April 2012
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 ...	February 2012
Health Status and Hospital Prices Key to Regional Variation in Private Health Care Spending NIHCR Research Brief No. 7 Differences in health status explain much of the regional variation in spending for privately insured people, but differences in provider prices—especially for hospital care—also play a key role, accordingto a new study by the Center for Studying Health System Change (HSC) for the nonpartisan, ...	February 2012
Indianapolis Hospital Systems Compete for Well-Insured, Suburban Patients Community Report No. 12 Indianapolis’ major hospital systems continue to encroach on each other’s traditional territories, engaging in a battle of bricks and mortar in suburban areas to compete for well-insured patients, according to a new Community Report released today by the Center for Studying Health System ...	December 2011
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 ...	Oct. 6, 2011
Rising Hospital Employment of Physicians: Better Quality, Higher Costs? HSC Issue Brief No. 136 While not new, the pace of hospital employment of physicians has quickened in many communities, driven largely by hospitals' quest to increase market share and revenue, according to a study released today by the Center for Studying Health System Change (HSC). The study was funded jointly by the Robert ...	August 2011
Physicians Key to Health Maintenance Organization Popularity in Orange County Community Report No. 10 The extent of health plan delegation of financial risk and utilization management to physicians caring for health maintenance organization (HMO) enrollees makes Orange County stand out from many health care markets, according to a new Community Report released by the Center for Studying Health System ...	August 2011
Key Findings from HSC’s 2010 Site Visits: Health Care Markets Weather Economic Downturn, Brace for Health Reform HSC Issue Brief No. 135 Lingering fallout—loss of jobs and employer coverage—from the great recession slowed demand for health care services but did little to slow aggressive competition by dominant hospital systems for well-insured patients, according to key findings from the Center for Studying Health System Change’s ...	May 2011
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 ...	May 25, 2011
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 ...	April 2011
State Reform Dominates Boston Health Care Market Dynamics Community Report No. 1 Massachusetts’ 2006 landmark health reform law has reverberated throughout the Boston health care market as providers, insurers, employers and consumers adjust and adapt to a post-reform world of nearly universal health insurance coverage, according to a new Community Report released today by the ...	September 2010
Detroit: Motor City to Medical Mecca? Detroit Community Report Despite a weak economic outlook, Detroit area hospital systems plan to spend more than $1.3 billion in the coming years on capital improvements, leading some to hope that medical care can help revitalize the area’s economy, according to a new Community Report released today by the Center for Studying ...	August 2010
Employer Wellness Initiatives Grow Rapidly, but Effectiveness Varies Widely NIHCR Research Brief No. 1 While employer wellness programs have spread rapidly in recent years, few firms implement comprehensive programs likely to make a meaningful difference in employees’ health, according to a new study conducted by the Center for Studying Health System Change (HSC) for the nonpartisan, nonprofit National ...	July 2010
Ginsburg Testifies Before Joint Senate and House Committees in Maryland on Hospital Rate Setting Testimony Paul B. Ginsburg, Ph.D., HSC President and research director of the National Institute for Health Care Reform, testified before a joint hearing of the Maryland Senate Finance Committee and House Health and Government Operations Committee on hospital rate setting.	March 22, 2010

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The Role of Competition

Title	Date
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) ...	May 2013
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 ...	May 2012
Limited Options to Manage Specialty Drug Spending HSC Research Brief No. 22 Health insurers and employers have few tools to control rapidly rising spending on high-cost specialty drugs—typically high-cost biologic medications to treat complex medical conditions, according to a new qualitative study from the Center for Studying Health System Change (HSC). The study was ...	April 2012
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 ...	April 2012
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 ...	February 2012
Health Status and Hospital Prices Key to Regional Variation in Private Health Care Spending NIHCR Research Brief No. 7 Differences in health status explain much of the regional variation in spending for privately insured people, but differences in provider prices—especially for hospital care—also play a key role, accordingto a new study by the Center for Studying Health System Change (HSC) for the nonpartisan, ...	February 2012
Indianapolis Hospital Systems Compete for Well-Insured, Suburban Patients Community Report No. 12 Indianapolis’ major hospital systems continue to encroach on each other’s traditional territories, engaging in a battle of bricks and mortar in suburban areas to compete for well-insured patients, according to a new Community Report released today by the Center for Studying Health System ...	December 2011
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, ...	November 2011
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 ...	Oct. 6, 2011
Economic Downturn Strains Miami Health Care System Community Report No. 11 Despite the economic downturn’s severe fallout on Miami’s tourism, real estate and construction sectors, some hospitals are expanding beyond their traditional geographic markets to compete for privately insured patients, according to a new Community Report released today by the Center for ...	September 2011
Health Care Provider Market Power Congressional Testimony Statement of Paul B. Ginsburg, Ph.D. President, Center for Studying Health System Change Research Director, National Institute for Health Care Reform (NIHCR). Before the U.S. House of Representatives Ways and Means Committee, Subcommittee on Health. Hearing on "Health Care Industry Consolidation"	Sept. 9, 2011
Rising Hospital Employment of Physicians: Better Quality, Higher Costs? HSC Issue Brief No. 136 While not new, the pace of hospital employment of physicians has quickened in many communities, driven largely by hospitals' quest to increase market share and revenue, according to a study released today by the Center for Studying Health System Change (HSC). The study was funded jointly by the Robert ...	August 2011
Physicians Key to Health Maintenance Organization Popularity in Orange County Community Report No. 10 The extent of health plan delegation of financial risk and utilization management to physicians caring for health maintenance organization (HMO) enrollees makes Orange County stand out from many health care markets, according to a new Community Report released by the Center for Studying Health System ...	August 2011
Syracuse Health Care Market Works to Right-Size Hospital Capacity Community Report No. 9 Largely stable over the last three years, the Syracuse health care market continues to grapple with the challenge of finding the right level and mix of hospital capacity, according to a new Community Report by the Center for Studying Health System Change (HSC). The study was funded jointly by the Robert ...	August 2011
Economic Downturn Slows Phoenix’s Once-Booming Health Care Market Community Report No. 8 After more than a decade of rapid population growth and a thriving economy, Phoenix’s once-booming health care market has adopted a more cautious outlook amid the lingering effects of the great recession, according to a new Community Report by the Center for Studying Health System Change (HSC). ...	July 2011
Key Findings from HSC’s 2010 Site Visits: Health Care Markets Weather Economic Downturn, Brace for Health Reform HSC Issue Brief No. 135 Lingering fallout—loss of jobs and employer coverage—from the great recession slowed demand for health care services but did little to slow aggressive competition by dominant hospital systems for well-insured patients, according to key findings from the Center for Studying Health System Change’s ...	May 2011
Health Care Certificate-of-Need (CON) Laws: Policy or Politics? NIHCR Research Brief No. 4 Originally intended to ensure access to care, maintain or improve quality, and control capital expenditures on health care services and facilities, the certificate-of-need (CON) process has evolved into an arena where providers often battle for service-line dominance and market share, according to a ...	May 2011
Lansing’s Dominant Hospital, Health Plan Strengthen Market Positions Community Report No. 7 In an insular market wary of outsiders, Lansing’s dominant hospital system—Sparrow Health System—and health plan—Blue Cross Blue Shield of Michigan—have reinforced their already-strong market positions, according to a Community Report by the Center for Studying Health System ...	March 2011
Greenville & Spartanburg: Surging Hospital Employment of Physicians Poses Opportunities and Challenges Community Report No. 6 In an area already notable for high rates of physician employment, the two largest hospital systems in Greenville and Spartanburg, S.C., have greatly increased employment of physicians with an eye toward capturing more referrals and admissions, according to a new Community Report released today by the ...	February 2011
Little Rock Health Care Safety Net Stretched by Economic Downturn Community Report No. 5 The economic downturn has been milder in Little Rock than elsewhere, but increased unemployment and an almost 15 percent uninsurance rate have strained the area’s fragmented health care safety net, according to a new Community Report released today by the Center for Studying Health System Change ...	January 2011

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Regulatory Policy

Title	Date
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) ...	May 2013
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 ...	May 2013
Small Employers and Self-Insured Health Benefits: Too Small to Succeed? HSC Issue Brief No. 138 While large firms often assume financial risk for enrollees’ medical care through self-insurance, small firms’ growing interest in the practice may pose challenges for policy makers, according to a new qualitative study by the Center for Studying Health System Change (HSC).	July 2012
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 ...	May 2012
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 ...	May 2012
Limited Options to Manage Specialty Drug Spending HSC Research Brief No. 22 Health insurers and employers have few tools to control rapidly rising spending on high-cost specialty drugs—typically high-cost biologic medications to treat complex medical conditions, according to a new qualitative study from the Center for Studying Health System Change (HSC). The study was ...	April 2012
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 ...	February 2012
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, ...	November 2011
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 ...	Oct. 6, 2011
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 ...	May 25, 2011
Health Care Certificate-of-Need (CON) Laws: Policy or Politics? NIHCR Research Brief No. 4 Originally intended to ensure access to care, maintain or improve quality, and control capital expenditures on health care services and facilities, the certificate-of-need (CON) process has evolved into an arena where providers often battle for service-line dominance and market share, according to a ...	May 2011
Ginsburg Testifies Before Joint Senate and House Committees in Maryland on Hospital Rate Setting Testimony Paul B. Ginsburg, Ph.D., HSC President and research director of the National Institute for Health Care Reform, testified before a joint hearing of the Maryland Senate Finance Committee and House Health and Government Operations Committee on hospital rate setting.	March 22, 2010
Ginsburg Testifies Before the Massachusetts Division of Health Care Finance and Policy Paul B. Ginsburg, Ph.D., HSC president and research director of the National Institute for Health Care Reform, testified before the Massachusetts Office of Health and Human Services, Division of Health Care Finance and Policy, on health care spending trends.	March 18, 2010
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.	January 2010

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The National Institute for Health Care Reform contracts with the Center for Studying Health System Change (HSC) to conduct health policy research and analyses to improve the organization, financing and delivery of health care in the United States.

National Institute for Health Care Reform

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

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

Health Affairs, Vol. 32, No. 5

Hospital Quality Reporting: Separating the Signal from the Noise

NIHCR Policy Analysis No. 11

Few Americans Switch Employer Health Plans for Better Quality, Lower Costs

NIHCR Research Brief No. 12

Employer-Sponsored Insurance and Health Reform: Doing the Math

NIHCR Research Brief No. 11

High-Intensity Primary Care: Lessons for Physician and Patient Engagement

NIHCR Research Brief No. 9

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

NIHCR Policy Analysis No. 10

Small Employers and Self-Insured Health Benefits: Too Small to Succeed?

HSC Issue Brief No. 138

Addressing Hospital Pricing Leverage through Regulation: State Rate Setting

NIHCR Policy Analysis No. 9

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

Limited Options to Manage Specialty Drug Spending

HSC Research Brief No. 22

Hospital Geographic Expansion: The New Medical Arms Race?

Health Affairs, Vol. 31, No. 4

Great Recession Accelerated Long-Term Decline of Employer Health Coverage

NIHCR Research Brief No. 8

State Benefit Mandates and National Health Reform

NIHCR Policy Analysis No. 8

Health Status and Hospital Prices Key to Regional Variation in Private Health Care Spending

NIHCR Research Brief No. 7

Indianapolis Hospital Systems Compete for Well-Insured, Suburban Patients

Community Report No. 12

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

NIHCR Policy Analysis No. 6

Reforming Provider Payment—The Price Side of the Equation

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

Economic Downturn Strains Miami Health Care System

Community Report No. 11

Health Care Provider Market Power

Congressional Testimony

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

Health Affairs, Vol. 32, No. 5

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

Hospital Quality Reporting: Separating the Signal from the Noise

NIHCR Policy Analysis No. 11

High-Intensity Primary Care: Lessons for Physician and Patient Engagement

NIHCR Research Brief No. 9

Small Employers and Self-Insured Health Benefits: Too Small to Succeed?

HSC Issue Brief No. 138

Limited Options to Manage Specialty Drug Spending

HSC Research Brief No. 22

Hospital Geographic Expansion: The New Medical Arms Race?

Health Affairs, Vol. 31, No. 4

State Benefit Mandates and National Health Reform

NIHCR Policy Analysis No. 8

Health Status and Hospital Prices Key to Regional Variation in Private Health Care Spending

NIHCR Research Brief No. 7

Indianapolis Hospital Systems Compete for Well-Insured, Suburban Patients

Community Report No. 12

Reforming Provider Payment—The Price Side of the Equation

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

Rising Hospital Employment of Physicians: Better Quality, Higher Costs?

HSC Issue Brief No. 136

Physicians Key to Health Maintenance Organization Popularity in Orange County

Community Report No. 10

Key Findings from HSC’s 2010 Site Visits: Health Care Markets Weather Economic Downturn, Brace for Health Reform

HSC Issue Brief No. 135

Spending to Save—ACOs and the Medicare Shared Savings Program

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

Geographic Variation in Health Care:Changing Policy Directions

NIHCR Policy Analysis No. 4

State Reform Dominates Boston Health Care Market Dynamics

Community Report No. 1

Detroit: Motor City to Medical Mecca?

Detroit Community Report

Employer Wellness Initiatives Grow Rapidly, but Effectiveness Varies Widely

NIHCR Research Brief No. 1

Ginsburg Testifies Before Joint Senate and House Committees in Maryland on Hospital Rate Setting

Geographic Variation in Health Care:
Changing Policy Directions