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.

Lucy B. Stark

Documents & Publications

Title	Date
Local Public Hospitals: Changing with the Times HSC Research Brief No. 25 Over the last 15 years, public hospitals have pursued multiple strategies to help maintain financial viability without abandoning their mission to care for low-income people, according to findings from the Center for Studying Health System Change’s (HSC) site visits to 12 nationally representative metropolitan communities. Local public hospitals serve as…	November 29, 2012
Safety-Net Providers in Some U.S. Communities Have Increasingly Embraced Coordinated Care Models Health Affairs, Vol. 31, No. 8 Safety net organizations, which provide health services to uninsured and low-income people, increasingly are looking for ways to coordinate services among providers to improve access to and quality of care and to reduce costs. This analysis, a part of the Community Tracking Study, examined trends in safety net coordination activities…	August 6, 2012
Indianapolis Hospital Systems Compete for Well-Insured, Suburban Patients Community Report No. 12 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…	December 30, 2011
Matching Supply to Demand: Addressing the U.S. Primary Care Workforce Shortage NIHCR Policy Analysis No. 7 While there is little debate about a growing primary care workforce shortage in the United States, precise estimates of current and projected need vary. A secondary problem contributing to addressing capacity shortfalls is that the distribution of primary care practitioners often is mismatched with patient needs. For example, patients in…	December 10, 2011
A Long and Winding Road: Federally Qualified Health Centers, Community Variation and Prospects Under Reform HSC Research Brief No. 21 Community health centers have evolved from fringe providers to mainstays of many local health care systems. Those designated as federally qualified health centers (FQHCs), in particular, have largely established themselves as key providers of comprehensive, efficient, high-quality primary care services to low-income people, especially Medicaid and uninsured patients. The Center…	November 10, 2011
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
Health Care Certificate-of-Need (CON) Laws: Policy or Politics? 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…	May 19, 2011
Lansing’s Dominant Hospital, Health Plan Strengthen Market Positions 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,…	March 22, 2011
Greenville & Spartanburg: Surging Hospital Employment of Physicians Poses Opportunities and Challenges 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,…	February 24, 2011