Title Date

Balancing Access and Costs: Health Benefit Structures for Privately Insured People

NIHCR Research Brief No. 21

Along with increased spending on physician services, expanded coverage of outpatient physician visits contributed to higher spending on advanced imaging, diagnostic tests, minor procedures and prescription drugs, according to a new study from the nonprofit, nonpartisan National Institute for Health Care ...

Limiting Tax Breaks for Employer-Sponsored Health Insurance: Cadillac Tax vs. Capping the Tax Exclusion

NIHCR Research Brief No. 20

The so-called Cadillac tax on high-cost health benefits is only slightly less progressive than capping the tax exclusion on the $250-billion annual tax break for employer health coverage because employers are likely to try and avoid paying either tax by restructuring health benefits, especially under ...

Interspecialty Communication Supported by Health Information Technology Associated with Lower Hospitalization Rates for Ambulatory Care-Sensitive Conditions

Journal of the American Board of Family Medicine

Greater primary care and specialist communication is associated with reduced hospitalizations for ambulatory care-sensitive conditions. This effect was magnified by the use of health information technology, according to a new study from the nonpartisan, nonprofit National Institute for Health Care Reform ...

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 ...

Reference Pricing: A Small Piece of the Health Care Price and Quality Puzzle

NIHCR Research Brief No. 18

Despite heightened interest in reference pricing--or capping payment for a particular medical service--potential savings to health plans and purchasers are modest, according to a new study from the nonpartisan, nonprofit National Institute for Health Care Reform (NIHCR).

Hospital Experiences Using Electronic Health Records to Support Medication Reconciliation

NIHCR Research Brief No. 17

While electronic health records (EHRs) can help standardize medication reconciliation for hospitalized patients, data quality, technical problems and workflow issues continue to pose challenges, according to a new qualitative study from the nonpartisan, nonprofit National Institute for Health Care Reform ...

Location, Location, Location: Hospital Outpatient Prices Much Higher than Community Settings for Identical Services

NIHCR Research Brief No. 16

Average hospital outpatient department prices for common imaging, colonoscopy and laboratory services can be double the price or more for identical services provided in a physician’s office or other community-based setting, according to a study from the nonpartisan, nonprofit National Institute for ...

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 online ...

Inpatient Hospital Prices Drive Spending Variation for Episodes of Care for Privately Insured Patients

NIHCR Research Brief No. 14

When including all care related to a hospitalization--for a knee or hip replacement, for example--the price of the initial inpatient stay explains almost all of the wide spending variation from hospital to hospital on so-called episodes of care, according to a study from the nonpartisan, nonprofit National ...

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) ...

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 ...

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’ total revenues and ...

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 ...

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 ...

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 Change ...

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 ...

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 ...
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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.