National Institute for Health Care Reform
About the Institute
Policy Research & Analysis
Payment Policy and Benefit Design
The Role of Competition
Improving Care Delivery
Patient Engagement and Shared Decision-making
Care Coordination and Management
Prevention and Improving Health
Access to Medical Providers
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’ ...
Contrary to Cost-Shifting Theory, Lower Medicare Hospital Payment Rates for Inpatient Care Lead to Lower Private Payment Rates
, 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 truelower 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
, 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 ...
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
, 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 ...
Dec. 12, 2012
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 ...
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
, 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 ...
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).
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 ...
The Growing Power of Some Providers to Win Steep Payment Increases from Insurers Suggests Policy Remedies May be Needed
, 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 ...
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 ...
Hospital Geographic Expansion: The New Medical Arms Race?
, 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 competitiontargeted geographic expansion into new markets with well-insured people, according ...
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 ...
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, nonprofit ...
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.
© 2012 National Institute for Health Care Reform.
National Institute for Health Care Reform
c/o Center for Studying Health System Change
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