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.

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Documents & Publications

Title	Date
Small Employers and Self-Insured Health Benefits: Too Small to Succeed? HSC Issue Brief No. 138 While large firms often assume financial risk for enrollees’ medical care through self-insurance, small firms’ growing interest in the practice may pose challenges for policy makers, according to a new qualitative study by the Center for Studying Health System Change (HSC). Self-insured firms typically purchase stop-loss insurance to cover medical…	July 19, 2012
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
Adding Patients to the Decision Equation NIHCR Policy Analysis No. 5 WASHINGTON, D.C. –– 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…	September 20, 2011
Hospitals Rush to Employ Physicians to Shore Up Referrals, Admissions HSC Issue Brief No. 136 WASHINGTON , DC—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). To date, hospitals’ primary motivation for employing…	August 18, 2011
Rising Hospital Employment of Physicians: Better Quality, Higher Costs? HSC Issue Brief No. 136 In a quest to gain market share, hospital employment of physicians has accelerated in recent years to shore up referral bases and capture admissions, according to the Center for Studying Health System Change’s (HSC) 2010 site visits to 12 nationally representative metropolitan communities. Stagnant reimbursement rates, coupled with the rising…	August 18, 2011
Health Care Markets Weather Economic Downturn, Brace for Health Reform HSC Issue Brief No. 135 WASHINGTON , DC—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…	May 26, 2011
Key Findings from HSC’s 2010 Site Visits: Health Care Markets Weather Economic Downturn, Brace for Health Reform HSC Issue Brief No. 135 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…	May 26, 2011
Center for Studying Health System Change (HSC) President Paul B. Ginsburg Named Research Director of the National Institute for Health Care Reform WASHINGTON, D.C. —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,…	December 10, 2009