Search Results

NIHCR Policy Analysis No. 11

Gaps in hospital safety and quality have prompted public and private payers to push for greater accountability through clinical quality measurement and reporting initiatives, which have grown rapidly in the past two decades. With U.S. health care costs high and rising, purchasers increasingly are seeking to identify high-value hospitals that…

Rising health care prices have increased concerns about hospital and health system consolidation among policymakers, regulators, employers, and other purchasers of health coverage. Although merging hospitals and health systems claim they can achieve greater efficiencies through their consolidation, the economic literature almost universally finds that hospitals that merge have prices…

Rising health care prices have increased concerns about hospital and health system consolidation among policymakers, regulators, employers, and other purchasers of health coverage. Although merging hospitals and health systems claim they can achieve greater efficiencies through their consolidation, the economic literature almost universally finds that hospitals that merge have prices…

Rising health care prices have increased concerns about hospital and health system consolidation among policymakers, regulators, employers, and other purchasers of health coverage. Although merging hospitals and health systems claim they can achieve greater efficiencies through their consolidation, the economic literature almost universally finds that hospitals that merge have prices…

Rising health care prices have increased concerns about hospital and health system consolidation among policymakers, regulators, employers, and other purchasers of health coverage. Although merging hospitals and health systems claim they can achieve greater efficiencies through their consolidation, the economic literature almost universally finds that hospitals that merge have prices…

Introduction In 2013, the city of Detroit had fewer than 10 working ambulances. A 911 caller with a medical emergency was likely to wait 20 minutes or more for help to arrive, and there was no consistent assessment of data. Emergency medical services (EMS) response and firefighting were completely separate…

A key element of the Affordable Care Act has been promoting changes in the way Medicare, Medicaid, and private insurers pay hospitals, physicians, and others for the health care services they provide. When the era of managed care began more than 30 years ago, health insurers moved away from the…

The authors would like to thank: current and past program leadership and support staff; the outstanding team of Community Health Workers who serve as Community Neighborhood Navigators; and the WIN Network program participants who freely and enthusiastically shared their experiences. Detroit has a serious infant mortality problem. Infants die there…

NIHCR Research Brief No. 17

Hospitals face increasing pressure to implement medication reconciliation—a systematic way to ensure accurate patient medication lists at admission, during a hospitalization and at discharge—to reduce errors and improve patient outcomes. Electronic health records (EHRs) can help standardize medication reconciliation, but data quality and technical and workflow issues continue to pose…

HSC Research Brief No. 30

In the context of high health care costs and wide variation in hospital prices, purchasers are seeking ways to encourage consumers to make more price-conscious choices of providers. The California Public Employees’ Retirement System (CalPERS) in 2011 adopted a strategy—known as reference pricing—to guide enrollees to hospitals that provide hip…

NIHCR Research Brief No. 9

WASHINGTON, DC—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, accordingto a new qualitative study by the Center for Studying Health System Change (HSC) for the…

NIHCR Research Brief No. 9

To prevent costly emergency department visits and hospitalizations, a handful of care-delivery models offer high-intensity primary care to a subset of patients with complex or multiple chronic conditions, such as diabetes, congestive heart failure, obesity and depression. Early assessments of high-intensity primary care programs show promise, but these programs’ success…

NIHCR Policy Analysis No. 10

Outpatient prescription drugs account for about 10 percent—$259 billion in 2010—of total U.S. health spending. Expiring patents on many of the most commonly prescribed drugs have helped slow the rate of spending growth in recent years, but drug spending is likely to accelerate again as new drugs come to market.…

NIHCR Research Brief No. 6

Public and private payers view reducing avoidable hospital readmissions as a way to improve quality and reduce unnecessary costs. While policy makers have targeted readmissions stemming from poor quality of care during an initial hospital stay, readmissions also can occur when patients don’t receive appropriate follow-up care or ongoing outpatient…

NIHCR Policy Analysis No. 5

Major discrepancies exist between patient preferences and the medical care they receive for many common conditions. Shared decision making (SDM) is a process where a patient and clinician faced with more than one medically acceptable treatment option jointly decide which option is best based on current evidence and the patient’s…

Community Report No. 9

In October 2010, a team of researchers from the Center for Studying Health System Change (HSC), as part of the Community Tracking Study (CTS), visited the Syracuse metropolitan area to study how health care is organized, financed and delivered in that community. Researchers interviewed more than 40 health care leaders,…

NIHCR Research Brief No. 5

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

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 new qualitative research study from the Center…

Community Report No. 7

In August 2010, a team of researchers from the Center for Studying Health System Change (HSC), as part of the Community Tracking Study (CTS), visited the Lansing metropolitan area to study how health care is organized, financed and delivered in that community. Researchers interviewed more than 40 health care leaders,…

Community Report No. 6

In July 2010, a team of researchers from the Center for Studying Health System Change (HSC), as part of the Community Tracking Study (CTS), visited the Greenville-Spartanburg metropolitan area to study how health care is organized, financed and delivered in that community. Researchers interviewed more than 45 health care leaders,…

NIHCR Research Brief No. 2

Policy makers hope that the development of accountable care organizations (ACOs)—organized groups of physicians, hospitals or other providers jointly accountable for caring for a defined patient population—can improve health care quality and efficiency. An examination of existing provider efforts to improve care delivery illustrates that substantial financial and time investments…

Community Report No. 4

In May 2010, a team of researchers from the Center for Studying Health System Change (HSC), as part of the Community Tracking Study (CTS), visited the northern New Jersey metropolitan area to study how health care is organized, financed and delivered in that community. Researchers interviewed more than 40 health…

Community Report No. 3

In April 2010, a team of researchers from the Center for Studying Health System Change (HSC), as part of the Community Tracking Study (CTS), visited the Seattle metropolitan area to study how health care is organized, financed, and delivered in that community. Researchers interviewed more than 50 health care leaders,…

NIHCR Policy Analysis No. 3

Many believe the renewed U.S. public investment in determining what treatments work best for which patients in real-world settings—known as comparative effectiveness research (CER)—will improve patient care by strengthening the evidence base for medical decisions. A major goal of CER is to encourage the use of effective therapies and discourage…

Detroit Community Report

In February 2010, a team of researchers from the Center for Studying Health System Change (HSC) visited the Detroit metropolitan area on behalf of the National Institute for Health Care Reform to study how health care is organized, financed and delivered in that community. Researchers interviewed more than 55 health…

NIHCR Research Brief No. 1

While employer wellness programs have spread rapidly in recent years, few employers implement programs likely to make a meaningful difference in employees’ health—customized, integrated, comprehensive, diversified programs strongly linked to a firm’s business strategy and strongly championed by senior leadership and managers throughout the company. Employers that lack the ability…

NIHCR Policy Analysis No. 1

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. An episode-based payment approach would essentially bundle payment for some or all services delivered to…