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. Beginning in 2014, NIHCR has contracted with Altarum Institute’s Center for Sustainable Health Spending and others, with a focus on research to improve health in Detroit.

James D. Reschovsky

Documents & Publications

Title	Date
Balancing Access and Costs: Health Benefit Structures for Privately Insured People Health insurance benefit structures, particularly cost-sharing amounts, can either encourage or discourage patients from seeking care. The goal is to strike the right balance so out-of-pocket costs don’t discourage people from getting needed care but do prompt them to consider costs before seeking discretionary care. In 2011, contracts between the…	March 1, 2016
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 Background: Practice tools, such as health information technology (HIT), can potentially support care processes, such as communication between health care providers, and influence care for so-called ambulatory care-sensitive conditions (ACSCs). Good outpatient care can potentially prevent the need for hospitalization of patients with ACSCs. To date, associations between primary care…	May 15, 2015
Bridging the Disconnect Between Patient Wishes and Care at the End of Life NIHCR Policy Analysis No. 12 Most Americans want to die at home, but most die in hospitals or other facilities. Most people care more about quality of life than prolonging life as long as possible, but many receive invasive, life-sustaining treatments that diminish quality of life. Often, the disconnect between patient wishes and actual care…	March 19, 2015
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 for identical services provided in a physician’s office or other community-based setting, according to a study by researchers at the former Center for Studying Health System Change (HSC). Using private insurance claims data…	June 26, 2014
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 example, a knee or hip replacement—the price of the initial inpatient stay explains almost all of the wide variation from hospital to hospital in spending on so-called episodes of care, according to a study by researchers at the former Center for Studying…	February 27, 2014
Understanding Differences Between High- and Low-Price Hospitals: Implications for Efforts to Rein In Costs Health Affairs, Web First Private insurers pay widely varying prices for inpatient care across hospitals. Previous research indicates that certain hospitals use market clout to obtain higher payment rates, but there have been few in-depth examinations of the relationship between hospital characteristics and pricing power. This study used private insurance claims data to identify…	January 29, 2014
High and Varying Prices for Privately Insured Patients Underscore Hospital Market Power HSC Research Brief No. 27 Across 13 selected U.S. metropolitan areas, hospital prices for privately insured patients are much higher than Medicare payment rates and vary widely across and within markets, according to a study by the Center for Studying Health System Change (HSC) based on claims data for about 590,000 active and retired nonelderly…	September 4, 2013
Great Recession Accelerated Long-Term Decline of Employer Health Coverage NIHCR Research Brief No. 8 Between 2007 and 2010, the share of children and working-age adults in the United States with employer-sponsored health insurance dropped 10 percentage points from 63.6 percent to 53.5 percent, according to a new national study by the Center for Studying Health System Change (HSC). The key factor driving the sharp…	March 15, 2012
Geographic Variation in Health Care: Changing Policy Directions NIHCR Policy Analysis No. 4 Dating back more than 40 years, a large body of research has identified wide geographic variation in fee-for-service Medicare spending and service utilization. A major early conclusion of geographic variation research was that care is provided much more efficiently in some areas of the United States than in others, with…	April 12, 2011