Mission Statement

The mission of the National Institute for Health Care Reform is to conduct high-quality, objective research and policy analyses of the organization, financing and delivery of health care in the United States. The Institute works to identify key health policy issues, explore policy options, and assess the advantages and disadvantages of policy options to help inform policy makers and other decision makers about how to expand access to high-quality, affordable health care to all Americans.

What's New

Indianapolis Hospital Systems Compete for Well-Insured, Suburban Patients
Dec. 30, 2011
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 Change (HSC). The study was funded jointly by the Robert Wood Johnson Foundation and NIHCR.

Community Report No. 12
News Release

Matching Supply to Demand: Addressing the U.S. Primary Care Workforce Shortage
Dec. 20, 2011
While there’s little debate about a growing primary care workforce shortage in the United States, it’s less clear whether existing workforce policies—such as educational loan forgiveness or scholarships and higher payment rates—can boost the supply of practitioners quickly enough, according to a new Policy Analysis from the nonprofit, nonpartisan National Institute for Health Care Reform (NIHCR).

NIHCR Policy Analysis No. 7
Media Advisory

A Third of Adults Discharged from a Hospital Don’t See a Doctor Within 30 Days
Dec. 8, 2011
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 Care Reform (NIHCR).

NIHCR Research Brief No. 6
News Release

Federally Qualified Health Centers Poised for Significant Role in Reform
Nov. 10, 2011
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 (HSC). The study was funded jointly by the Robert Wood Johnson Foundation and NIHCR.

HSC Research Brief No. 21
News Release

Promoting Healthy Competition in Health Insurance Exchanges:
Options and Trade-offs
Nov. 9, 2011
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, according to a new Policy Analysis from the nonprofit, nonpartisan National Institute for Health Care Reform (NIHCR).

NIHCR Policy Analysis No. 6
Media Advisory

Employer-Sponsored Health Insurance: Down but Not Out
Oct. 27, 2011
Rising costs and the lingering fallout from the great recession are altering the calculus of employer approaches to offering health benefits, according to a study released today by the Center for Studying Health System Change (HSC). The study was funded jointly by the Robert Wood Johnson Foundation and NIHCR.

HSC Issue Brief No. 137
News Release

Reforming Provider Payment—The Price Side of the Equation
Oct. 6, 2011
Unless public and private health care payers send consistent signals to providers through payment reform about controlling both the price and quantity of care, they risk working at cross purposes, according to a perspective by Paul B. Ginsburg, president of the Center for Studying Health System Change (HSC), published online today in the New England Journal of Medicine. Ginsburg also serves as research director of NIHCR.

Journal Article - (Free access)
Media Advisory

Economic Downturn Strains Miami Health Care System
Sept. 29, 2011
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 Studying Health System Change (HSC). The study was funded jointly by the Robert Wood Johnson Foundation and NIHCR.

Community Report No. 11
News Release

Adding Patients to the Decision Equation
Sept. 20, 2011
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 to a new Policy Analysis from the nonprofit, nonpartisan National Institute for Health Care Reform (NIHCR).

NIHCR Policy Analysis No. 5
Media Advisory

Ginsburg Testifies at Ways & Means Health Panel on Provider Market Power
Sept. 9, 2011
While consolidation contributes to dominant hospitals’ upper hand in negotiating higher payment rates from private insurers, other factors, including consumer perceptions of quality and desire for broad provider choice, provision of highly specialized services, and geographic niches, contribute to providers’ market power, economist Paul B. Ginsburg, Ph.D., research director of NIHCR and president of the Center for Studying Health System Change (HSC), told Congress today.

Congressional Testimony
News Release

Hospitals Rush to Employ Physicians to Shore Up Referrals, Admissions
Aug. 18, 2011
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 Wood Johnson Foundation and NIHCR.

HSC Issue Brief No. 136
News Release

Physicians Key to Health Maintenance Organization Popularity in Orange County
Aug. 11, 2011
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 today by the Center for Studying Health System Change (HSC). The study was funded jointly by the Robert Wood Johnson Foundation and NIHCR.

Community Report No. 10
News Release

Syracuse Health Care Market Works to Right-Size Hospital Capacity
Aug. 4, 2011
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 released today by the Center for Studying Health System Change (HSC). The study was funded jointly by the Robert Wood Johnson Foundation and NIHCR.

Community Report No. 9
News Release

Economic Downturn Slows Phoenix’s Once-Booming Health Care Market
July 21, 2011
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 released today by the Center for Studying Health System Change (HSC). The study was funded jointly by the Robert Wood Johnson Foundation and NIHCR.

Community Report No. 8
News Release

Health Information Technology and Small Physician Practices
June 30, 2011
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 for Studying Health System Change (HSC) for the nonpartisan, nonprofit National Institute for Health Care Reform (NIHCR).

NIHCR Research No. 5
News Release

Health Care Markets Weather Economic Downturn, Brace for Health Reform
May 26, 2011
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 (HSC) 2010 site visits to 12 nationally representative metropolitan communities. The site visits were jointly funded by the Robert Wood Johnson Foundation and the National Institute for Health Care Reform.

HSC Issue Brief No. 135
News Release

Spending to Save—Accountable Care Organizations and the Medicare Shared Savings Program
May 25, 2011
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 growth in expenditures, according to a perspective by HSC President Paul B. Ginsburg, published online today in the New England Journal of Medicine.

Journal Article Abstract
Media Advisory

Health Care Certificate-of-Need (CON) Laws: Policy or Politics?
May 19, 2011
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 new study conducted by the Center for Studying Health System Change (HSC) for the nonpartisan, nonprofit National Institute for Health Care Reform (NIHCR).

NIHCR Research Brief No. 4
News Release

Geographic Variation in Health Care: Changing Policy Directions
April 12, 2011
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 from the nonprofit, nonpartisan National Institute for Health Care Reform (NIHCR).

NIHCR Policy Analysis No. 4
Media Advisory

Lansing's Dominant Hospital, Health Plan Strengthen Market Positions
March 22, 2011
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 new Community Report released today by the Center for Studying Health System Change (HSC).

Community Report No. 7
News Release

Hospital Employment of Physicians Surges in Greenville-Spartanburg, S.C.
Feb. 28, 2011
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 Center for Studying Health System Change (HSC).

Community Report No. 6
News Release

Coordination Between Emergency and Primary Care Physicians
Feb. 24, 2011
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, nonprofit National Institute for Health Care Reform (NIHCR).

NIHCR Research Brief No. 3
News Release

Little Rock Health Care Safety Net Stretched by Economic Downturn
Jan. 27, 2011
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 (HSC).

Community Report No. 5
News Release

Lessons from the Field: Making Accountable Care Organizations Real
Jan. 20, 2011
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 Change (HSC) for the National Institute for Health Care Reform (NIHCR).

NIHCR Research Brief No. 2
News Release

Northern New Jersey Health Care Market Refects Urban-Suburban Conrasts
Dec. 23, 2010
Northern New Jersey is a community of contrasts with affluent suburbs and financially strong health care providers juxtaposed against the fragile health care safety net of impoverished inner-city Newark, according to a new Community Report released today by the Center for Studying Health System Change (HSC).

Community Report No. 4
News Release

Seattle Hospital Competition Heats Up, Raising Cost Concerns
Dec. 2, 2010
Known as a market where hospital systems focus on particular niches rather than head-to-head competition, Seattle now faces growing competition as hospital systems vie for market share in the city and seek new affiliations and growth in affluent suburbs, according to a new Community Report released today by the Center for Studying Health System Change (HSC).

Community Report No. 3
News Release

Comparative Effectiveness Research and Medical Innovation
Oct. 5, 2010
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).

NIHCR Policy Analysis No. 3
Media Advisory

Cleveland Hospital Systems Expand Despite Weak Economy
Sept. 29, 2010
Attracting well-insured suburban patients, expanding profitable specialty-service lines and winning physician loyalty are the main fields of competition between the two dominant Cleveland health systems, leading to ever-more consolidation of the hospital and physician sectors, according to a new Community Report released today by HSC.

Community Report No. 2
News Release

State Health Reform Dominates Boston Health Care Market
Sept. 2, 2010
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 Center for Studying Health System Change (HSC). Boston is one of 12 communities across the country tracked intensively as part of the Community Tracking Study site visits, which are jointly funded by the Robert Wood Johnson Foundation and the National Institute for Health Care Reform.

Community Report No. 1
News Release

Detroit: Motor City to Medical Mecca?
Aug. 26, 2010
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 Health System Change (HSC) and the nonpartisan, nonprofit National Institute for Health Care Reform (NIHCR).

Detroit Community Report
News Release

Employer Wellness Initiatives Grow Rapidly, but Effectiveness Varies Widely
July 29, 2010
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 Institute for Health Care Reform (NIHCR).

NIHCR Research Brief No. 1
News Release

Health Coverage for the High-Risk Uninsured: Policy Options for Design of the Temporary High-Risk Pool
May 27, 2010
While 5.6-million to 7-million Americans may qualify for health coverage through the new temporary national high-risk pool program, the $5 billion allocated until 2014 will cover only a small fraction of those in need, according to a new Policy Analysis from the National Institute for Health Care Reform (NIHCR). Policy makers will face hard choices to stretch the funding to cover uninsured people with pre-existing medical conditions, and the analysis reviews key issues that must be resolved as the high-risk program is implemented.

NIHCR Policy Analysis No. 2
News Release

Ginsburg Testifies Before Joint Senate and House Committees in Maryland on Hospital Rate Setting
March 22, 2010
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.

Click Here for Ginsburg's testimony. (.pdf)

Ginsburg Testifies Before the Massachusetts Division of Health Care Finance and Policy
March 18, 2010
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.

Click Here for Ginsburg's testimony. (.pdf)

Episode-Based Payments: Charting a Course for Health Care Payment Reform
Policy Analysis Explores Key Considerations in Moving Away from Fee-for-Service Payment
Jan. 14, 2010
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, according to a new Policy Analysis from the National Institute for Health Care Reform.

NIHCR Policy Analysis No. 1
Media Advisory

Center for Studying Health System Change (HSC) President Paul B. Ginsburg Named Research Director of the National Institute for Health Care Reform
Union-Automaker-Backed Institute Will Fund Health Policy Research and Analyses
December 10, 2009
HSC President Paul B. Ginsburg will serve as research director of the nonpartisan, nonprofit National Institute for Health Care Reform—an initiative of the International Union, UAW; Chrysler Group LLC; Ford Motor Company; and General Motors to conduct high-quality, objective health policy research and analyses to improve the organization, financing and delivery of U.S. health care.

News Release

Policy Perspective: Affordable Health Coverage for Near-Elderly Americans
Sept. 30, 2009
Among the policy options to expand health coverage for Americans aged 55 to 64—the near elderly—comprehensive reform of the individual insurance market, coupled with a Medicaid expansion for those with very low incomes, would be the most effective and far-reaching approach, according to a new Policy Perspective from HSC.

Policy Perspective
Media Advisory