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.

Jon B. Christianson

Documents & Publications

Title	Date
Small Employers and Self-Insured Health Benefits: Too Small to Succeed? HSC Issue Brief No. 138 Over the past decade, large employers increasingly have bypassed traditional health insurance for their workers, opting instead to assume the financial risk of enrollees’ medical care through self-insurance. Because self-insurance arrangements may offer advantages—such as lower costs, exemption from most state insurance regulation and greater flexibility in benefit design—they are…	July 19, 2012
The Growing Power of Some Providers to Win Steep Payment Increases from Insurers Suggests Policy Remedies May be Neededuggests Policy Remedies May be Needed Health Affairs, Vol. 31, No. 5 In the constant attention paid to what drives health care costs, only recently has scrutiny been applied to the power that some health care providers, particularly dominant hospital systems, wield to negotiate higher payment rates from insurers. Interviews in twelve US communities indicated that so-called must-have hospital systems and large…	May 7, 2012
Economic Downturn Strains Miami Health Care System Community Report No. 11 In September 2010, a team of researchers from the Center for Studying Health System Change (HSC), as part of the Community Tracking Study (CTS), visited Miami to study how health care is organized, financed and delivered in that community. Researchers interviewed more than 45 health care leaders, including representatives of…	September 29, 2011
Little Rock Health Care Safety Net Stretched by Economic Downturn Community Report No. 5 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 Little Rock metropolitan area to study how health care is organized, financed and delivered in that community. Researchers interviewed more than 40 health care…	January 24, 2011
Seattle Hospital Competition Heats Up, Raising Cost Concerns 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,…	December 10, 2010
Detroit: Motor City to Medical Mecca? 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…	August 26, 2010