Improving Care Delivery

Title Date

Patient Engagement During Medical Visits and Smoking Cessation Counseling

JAMA Internal Medicine

Physicians who skip counseling patients to stop smoking are missing an opportunity to help their patients quit—even if those patients are less engaged during medical visits, according to a new study from the nonpartisan, nonprofit National Institute for Health Care Reform (NIHCR) published online ...

Privately Insured People’s Use of Emergency Departments: Perception of Urgency is Reality for Patients

HSC Research Brief No. 31

Contrary to the idea that convenience prompts many privately insured people to seek care in emergency departments (EDs), the people most likely to use EDs believe they urgently need medical attention, according to a new study by the Center for Studying Health System Change (HSC) for the nonpartisan, ...

The Surge in Urgent Care Centers: Emergency Department Alternative or Costly Convenience?

HSC Research Brief No. 26

Consumer demand for more convenient and timely access to care for illnesses and injuries is a major driver of the rapid growth of urgent care centers across the country, according to a new qualitative study by the Center for Studying Health System Change (HSC) for the nonpartisan, nonprofit National ...

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 ...

Primary Care Workforce Shortages: Nurse Practitioner Scope-of-Practice Laws and Payment Policies

NIHCR Research Brief No. 13

While state scope-of practice laws don’t typically restrict what primary care services nurse practitioners (NPs) can provide to patients, the laws do affect practice opportunities for NPs and appear to influence payer policies, according to a new qualitative study by the Center for Studying Health ...

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 ...

Local Public Hospitals: Changing with the Times

HSC Research Brief No. 25

In recent years, local public hospitals have stayed afloat financially without abandoning their mission to care for low-income people by expanding access to primary care, attracting privately insured patients and paying closer attention to collection of patient revenues, among other strategies, according ...

U.S. Families’ Use of Workplace Health Clinics, 2007-2010

NIHCR Research Brief No. 10

Despite heightened employer interest in workplace clinics as a cost-containment tool, only 4 percent of American families in 2010 reported visiting a workplace clinic in the previous year--the same proportion as in 2007, according to a new national study by the Center for Studying Health System Change ...

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 ...

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 ...

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 ...

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 ...

Physician Visits After Hospital Discharge: Implications for Reducing Readmissions

NIHCR Research Brief No. 6

One in three adult patients—aged 21 and older—discharged from a hospital to the community does not see a physician within 30 days of discharge, according to a new national study by the Center for Studying Health System Change (HSC) for the nonpartisan, nonprofit National Institute for Health ...

A Long and Winding Road: Federally Qualified Health Centers, Community Variation and Prospects Under Reform

HSC Research Brief No. 21

Tracing their roots to the civil rights movement and the 1960s’ War on Poverty, federally qualified health centers (FQHCs) have grown from fringe providers to mainstays of many local health care system safety nets, according to a study released today by the Center for Studying Health System Change ...

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 ...

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 ...

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 ...

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 ...

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). ...

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 ...
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Title Date

Patient Engagement During Medical Visits and Smoking Cessation Counseling

JAMA Internal Medicine

Physicians who skip counseling patients to stop smoking are missing an opportunity to help their patients quit—even if those patients are less engaged during medical visits, according to a new study from the nonpartisan, nonprofit National Institute for Health Care Reform (NIHCR) published online ...

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 .

Privately Insured People’s Use of Emergency Departments: Perception of Urgency is Reality for Patients

HSC Research Brief No. 31

Contrary to the idea that convenience prompts many privately insured people to seek care in emergency departments (EDs), the people most likely to use EDs believe they urgently need medical attention, according to a new study by the Center for Studying Health System Change (HSC) for the nonpartisan, ...

The Potential of Reference Pricing to Generate Health Care Savings: Lessons from a California Pioneer

HSC Research Brief No. 30

Along with steering patients to lower-price hospitals, a California Public Employees Retirement System (CalPERS) reference pricing initiative influenced market dynamics by motivating other hospitals to reduce prices for hip and knee replacements, according to a qualitative study by the Center for Studying ...

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 ...

U.S. Families’ Use of Workplace Health Clinics, 2007-2010

NIHCR Research Brief No. 10

Despite heightened employer interest in workplace clinics as a cost-containment tool, only 4 percent of American families in 2010 reported visiting a workplace clinic in the previous year--the same proportion as in 2007, according to a new national study by the Center for Studying Health System Change ...

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 ...

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 ...

Lessons from the Field: Making Accountable Care Organizations Real

NIHCR Research Brief No. 2

An examination of provider efforts to improve patient care illustrates that changing care delivery requires substantial investments—both time and money—even among groups of providers affiliated with one another for many years, according to a new study conducted by the Center for Studying ...

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).

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 ...
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Title Date

Patient Engagement During Medical Visits and Smoking Cessation Counseling

JAMA Internal Medicine

Physicians who skip counseling patients to stop smoking are missing an opportunity to help their patients quit—even if those patients are less engaged during medical visits, according to a new study from the nonpartisan, nonprofit National Institute for Health Care Reform (NIHCR) published online ...

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 .

Primary Care Workforce Shortages: Nurse Practitioner Scope-of-Practice Laws and Payment Policies

NIHCR Research Brief No. 13

While state scope-of practice laws don’t typically restrict what primary care services nurse practitioners (NPs) can provide to patients, the laws do affect practice opportunities for NPs and appear to influence payer policies, according to a new qualitative study by the Center for Studying Health ...

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 ...

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 ...

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 ...

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 ...

Physician Visits After Hospital Discharge: Implications for Reducing Readmissions

NIHCR Research Brief No. 6

One in three adult patients—aged 21 and older—discharged from a hospital to the community does not see a physician within 30 days of discharge, according to a new national study by the Center for Studying Health System Change (HSC) for the nonpartisan, nonprofit National Institute for Health ...

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 ...

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 ...

Fostering Health Information Technology in Small Physician Practices: Lessons from Independent Practice Associations

NIHCR Research Brief No. 5

As policy makers try to jumpstart health information technology (HIT) in small physician practices, lessons from independent practice associations—networks of small medical practices—can offer guidance in overcoming barriers to HIT adoption and use, according to a new study by the Center ...

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 ...

Coordination Between Emergency and Primary Care Physicians

NIHCR Research Brief No. 3

An examination of emergency and primary care physicians’ ability—and willingness—to communicate found that haphazard communication and poor coordination can undermine effective care, accordingto a new study conducted by the Center for Studying Health System Change (HSC) for the nonpartisan, ...

Lessons from the Field: Making Accountable Care Organizations Real

NIHCR Research Brief No. 2

An examination of provider efforts to improve patient care illustrates that changing care delivery requires substantial investments—both time and money—even among groups of providers affiliated with one another for many years, according to a new study conducted by the Center for Studying ...

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 ...
« 1 »
Title Date

Patient Engagement During Medical Visits and Smoking Cessation Counseling

JAMA Internal Medicine

Physicians who skip counseling patients to stop smoking are missing an opportunity to help their patients quit—even if those patients are less engaged during medical visits, according to a new study from the nonpartisan, nonprofit National Institute for Health Care Reform (NIHCR) published online ...

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 ...

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 ...

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 ...

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).

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 ...
« 1 »
Title Date

Patient Engagement During Medical Visits and Smoking Cessation Counseling

JAMA Internal Medicine

Physicians who skip counseling patients to stop smoking are missing an opportunity to help their patients quit—even if those patients are less engaged during medical visits, according to a new study from the nonpartisan, nonprofit National Institute for Health Care Reform (NIHCR) published online ...

Cutting Medicare Hospital Prices Leads to a Spillover Reduction in Hospital Discharges for the Nonelderly

Health Services Research

When Medicare keeps a tight rein on inpatient hospital payments, hospitals scale back overall capacity, resulting in less hospital use by nonelderly patients—not just elderly patients, according to a study from the nonpartisan, nonprofit National Institute for Health Care Reform (NIHCR) published ...

Privately Insured People’s Use of Emergency Departments: Perception of Urgency is Reality for Patients

HSC Research Brief No. 31

Contrary to the idea that convenience prompts many privately insured people to seek care in emergency departments (EDs), the people most likely to use EDs believe they urgently need medical attention, according to a new study by the Center for Studying Health System Change (HSC) for the nonpartisan, ...

The Surge in Urgent Care Centers: Emergency Department Alternative or Costly Convenience?

HSC Research Brief No. 26

Consumer demand for more convenient and timely access to care for illnesses and injuries is a major driver of the rapid growth of urgent care centers across the country, according to a new qualitative study by the Center for Studying Health System Change (HSC) for the nonpartisan, nonprofit National ...

Primary Care Workforce Shortages: Nurse Practitioner Scope-of-Practice Laws and Payment Policies

NIHCR Research Brief No. 13

While state scope-of practice laws don’t typically restrict what primary care services nurse practitioners (NPs) can provide to patients, the laws do affect practice opportunities for NPs and appear to influence payer policies, according to a new qualitative study by the Center for Studying Health ...

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 ...

Local Public Hospitals: Changing with the Times

HSC Research Brief No. 25

In recent years, local public hospitals have stayed afloat financially without abandoning their mission to care for low-income people by expanding access to primary care, attracting privately insured patients and paying closer attention to collection of patient revenues, among other strategies, according ...

U.S. Families’ Use of Workplace Health Clinics, 2007-2010

NIHCR Research Brief No. 10

Despite heightened employer interest in workplace clinics as a cost-containment tool, only 4 percent of American families in 2010 reported visiting a workplace clinic in the previous year--the same proportion as in 2007, according to a new national study by the Center for Studying Health System Change ...

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).

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 ...

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 ...

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 ...

Physician Visits After Hospital Discharge: Implications for Reducing Readmissions

NIHCR Research Brief No. 6

One in three adult patients—aged 21 and older—discharged from a hospital to the community does not see a physician within 30 days of discharge, according to a new national study by the Center for Studying Health System Change (HSC) for the nonpartisan, nonprofit National Institute for Health ...

A Long and Winding Road: Federally Qualified Health Centers, Community Variation and Prospects Under Reform

HSC Research Brief No. 21

Tracing their roots to the civil rights movement and the 1960s’ War on Poverty, federally qualified health centers (FQHCs) have grown from fringe providers to mainstays of many local health care system safety nets, according to a study released today by the Center for Studying Health System Change ...

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 ...

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 ...

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 ...

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). ...

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 ...

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 ...
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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.