Patient Engagement and Shared Decision-making

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 ...

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 in ...

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 Health System ...

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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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.