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Consumer-Directed Health Care: Promise and Performance

The performance of consumer-driven health care has fallen short of both the aspirations of its proponents and the fears of its critics, according to a study released today as a Web exclusive in the journal Health Affairs. Growth of the organizational forms favored by advocates of consumer-driven health care, such as high-deductible health plans and individually purchased insurance, has been anemic.

Access to Prescription Drugs Declines Among Nonelderly Americans

The proportion of children and working-age Americans who went without a prescription drug because of cost jumped to one in seven in 2007, up from one in 10 in 2003, according to a national study released today be HSC and funded by the Robert Wood Johnson Foundation.

Studies Examine Patient Trust in Physicians and Patient Views of Care Coordination

Patients with high medical costs are less likely to trust that their physician will put their interests first, while less than half of patients reported that their primary care physician always seemed informed about specialist care received, according to two studies by the Center for Studying Health System Change (HSC) published online in The Journal of General Internal Medicine.

Living on the Edge: Health Care Expenses Strain Family Budgets

Financial pressures on families from medical bills increase sharply when out-of-pocket spending for medical care exceeds 2.5 percent of family income, according to a new national study by HSC.

American Families' Use of Retail-Based Health Clinics Remains Modest

Despite rapid growth of retail clinics, only a tiny fraction of American families in 2007 had ever used the in-store clinics, typically located in pharmacies, supermarkets and big-box retailers, according to a national study released today by the Commonwealth Fund and conducted by HSC.

Making Medical Homes Work: Moving from Concept to Practice

Key operational issues facing medical home initiatives include how to qualify physician practices as medical homes; how to match patients to their medical homes; how to engage patients and other providers to work with medical homes in care coordination; and how to pay practices that serve as medical homes, according to a new Policy Perspective from researchers at the Center for Studying Health System Change (HSC) and Mathematica Policy Research (MPR).

Word of Mouth and Physician Referrals Still Drive Health Care Provider Choice

Despite myriad initiatives to encourage people to use health care price and quality information, most Americans still rely on word-of-mouth and physician recommendations to choose health providers, according to a new HSC study funded by the California HealthCare Foundation.

The Fraying Link Between Work and Health Insurance

Most nonelderly Americans still obtain health insurance coverage through an employer, but the percentage of nonelderly persons with employer-sponsored insurance coverage has declined steadily since 2000, according to a study released today by the Kaiser Family Foundation (KFF). The research, conducted by HSC Senior Fellow Peter J. Cunningham, Ph.D., and KFF Senior Policy Analysts Samantha Artiga and Karyn Schwartz, examines the factors driving the decrease in employer-sponsored insurance since 2000.

Medicaid Payment Delays Deter Physician Participation

Although low fees discourage physicians from treating Medicaid patients, payment delays also play an important role in physician decisions to avoid Medicaid patients, according to an HSC study published as a Web exclusive in the journal Health Affairs.

Massachusetts Health Reform: High Costs and Expanding Expectations May Weaken Employer Support

While employer support was key to enacting Massachusetts' landmark law to gain near-universal health coverage, high costs and expanding expectations may dampen employer support as the reform plays out, according to a new study by HSC.

How Engaged Are American Consumers in Their Health and Health Care?

The level of patient activation—a person's ability to manage their health and health care—varies considerably in the U.S. population, with less than half of adults (41.4%) at the highest level, according to a new national study by HSC.

High and Rising Health Care Costs: Demystifying U.S. Health Care Spending

Concern about high and rising health care costs in the U.S. has increased sharply in recent years. With the increase in costs and the lack of affordability of health insurance for many Americans, health policy experts are discussing whether steps can be taken to expand insurance coverage while keeping costs down. The Robert Wood Johnson Foundation today released a report written by HSC President Paul B. Ginsburg, Ph.D., that synthesizes research on health care costs.

Problems Paying Medical Bills Increase for U.S. Families Between 2003 and 2007

The proportion of Americans in families with problems paying medical bills increased to 19.4 percent in 2007, up from 15.1 percent in 2003, according to a new national study released today by HSC and funded by The Commonwealth Fund.

The growth translates to more than 57 million Americans in families with medical bill problems in 2007—an increase of 14 million people since 2003.

Hospitals Cautious in Helping Physicians Purchase Electronic Medical Records

Despite regulatory changes allowing hospitals to help physicians purchase electronic medical records (EMRs), hospitals are proceeding cautiously, according to a study released today by HSC.

Three HSC Studies Appear in September/October Health Affairs

Studies from the Center for Studying Health System Change (HSC) in the September/October edition of Health Affairs explore the impact of hospitalists on care coordination, the current state of hospital-physician relations and the transition from managed care to consumerism at the community level.

Health Plans Ramp Up Hospital-Physician Price and Quality Transparency Tools

While health plans are developing tools to help consumers compare price and quality information across hospitals and physicians, the tools' pervasiveness and usefulness are limited, according to a study released today by HSC.

Ginsburg Named Among 100 Most Powerful in Health Care

HSC President Paul B. Ginsburg was named to Modern Healthcare's 100 Most Powerful in Health Care list. To view the complete list click here.

More Americans Seeking Health Information, Especially on the Internet

In 2007, 56 percent of American adults—more than 122 million people—sought information about a personal health concern from a source other than their doctor, up from 38 percent, or 72 million people, in 2001, according to a national study released today by HSC.

Safety-Net Providers Caught in the Competitive Crossfire

As private physicians and hospitals shed unprofitable patients and services, safety net providers are balancing their mission to serve the needy with steps to attract higher-paying patients to shore up their margins, according to a study by HSC published today as a Web Exclusive in the journal Health Affairs.

Rising Rates of Chronic Health Conditions: What Can Be Done?

HSC held its Rising Rates of Chronic Conditions: What Can Be Done? conference on July 31, 2008. A transcript of the conference is now available.

Community Efforts to Expand Dental Services for Low-Income People

Recognizing the difficulties low-income people face in getting dental care, many communities are attempting to provide more dental services to vulnerable residents, according to a study released today by the Center for Studying Health System Change (HSC).

HSC's Wall Street Comes to Washington Conference

HSC held its 13th annual Wall Street Comes to Washington Conference on July 9, 2008. A transcript of the conference is now available. A webcast of the conference is also available, courtesy of kaisernetwork.org.

Innovations Lacking in Provider Payment Reform for Chronic Disease Care

Despite wide recognition that existing physician and hospital payment methods do not foster high-quality and efficient care for people with chronic conditions, little innovation in provider payment strategies is occurring, according to a new study by HSC commissioned by the California HealthCare Foundation.

Americans' Access to Medical Care Deteriorates, 2003-2007

More than 20 percent of the U.S. population in 2007—one in five people—reported not getting or delaying needed medical care in the previous 12 months, up significantly from 14 percent—one in seven people—in 2003, according to a national study released today by HSC.

Progress on Health System Disaster Surge Capacity at Risk

Communities fear waning attention to health system surge capacity—the space, supplies, people and command structure to care for many injured or ill people—could jeopardize progress to respond in a terrorist attack, natural disaster or infectious disease pandemic, according to a study released today by HSC.

Employers and Health Plans Bet on Health and Wellness Initiatives to Stem Costs

Health plan initiatives to promote health and wellness among workers are now commonplace, despite an acknowledged lack of evidence of an investment payoff, according to a study released today by HSC.

Ginsburg Testifies Before U.S. Senate Finance Committee

How the United States finances health care and our pervasive unwillingness to confront the difficult trade-offs inherent in containing costs, improving quality and expanding coverage contribute to the seemingly intractable problem of stemming rising health care costs, HSC President Paul Ginsburg told the U.S. Senate Finance Committee today.

Caution Urged Before Abandoning Employer Health Coverage in Favor of Individual Coverage

In an article published in the May/June Health Affairs, HSC President Paul B. Ginsburg, Ph.D., discusses the advantages and shortcomings of employer-based health coverage, how individual health insurance could be a viable alternative to employer-based coverage, and why care should be taken not to undermine employers’ role in providing coverage.

Safety Net Emergency Departments: Creating Safety Valves for Non-Urgent Care

Faced with more patients seeking care for non-emergencies, safety net hospital emergency departments are working to redirect patients to outpatient clinics, community health centers and private physicians, with varied results, according to a study released today by HSC.

Racial and Ethnic Health Disparities Linked to Physician Practice Resources

Primary care physicians treating a disproportionate share of black and Latino patients typically earn less, see more patients, provide more charity care, treat more Medicaid patients and receive lower private insurance payments, according to a national study funded by the Commonwealth Fund and published today as a Web exclusive in the journal Health Affairs.

Public Health Workforce Shortages Imperil the Nation's Health

As the post-9/11 spotlight on shoring up the nation's public health system fades, local health departments face a mounting workforce crisis as they struggle to recruit, train and retain qualified workers ranging from nurses to epidemiologists, according to a study released today by HSC.

Ginsburg Presentation: Health Care Costs 101

HSC President Paul B. Ginsburg, Ph.D., delivered a presentation titled "Health Care Costs 101" at the Association of Health Care Journalists annual meeting in Washington, D.C. Click here to access the slides used in the presentation.

Lots of Window Shopping, But Modest Consumer-Driven Health Plan Adoption

While adoption of high-deductible health plans coupled with spending accounts remains modest, supporters believe consumer-directed health plans will take hold as part of a larger employer strategy to confer more responsibility on workers for health care costs, lifestyle choices and treatment decisions, according to a new study released by HSC.

Demands on Nurses Grow as Hospital Quality Improvement Activities Increase

Hospitals face growing tensions and trade-offs when allocating nurses between the competing priorities of direct patient care and quality improvement efforts, according to a new study by HSC.

Milbank Quarterly Article Examines Decline in Physician Charity Care

Changes in physicians' income, practice ownership and practice size play a large role in their decisions to start or stop treating charity care and Medicaid patients, according to an HSC study published in the March edition of the Milbank Quarterly.

Connecting the Electronic Dots Among Disparate Health Providers

Barriers to sharing patient clinical data electronically among rival hospitals, doctors and health plans remain high as concerns about loss of competitive advantage and data misuse hamper participation in local health information exchanges, according to a new study released by HSC and the National Institute for Health Care Management Foundation.

Rapid Growth Prompts Health Plans to Target Advanced Imaging Services

Faced with double-digit annual increases in the use of advanced imaging services, such as CT and PET scans, health plans are stepping up efforts to slow the proliferation of advanced imaging services, according to a new study by HSC.

Missing Price Information Hampers Usefulness of State Prescription Drug Web Sites

Extensive gaps in price information seriously hamper the effectiveness of state drug price comparison Web sites, according to a study released today by HSC.

State Budget Cycles Hinder Health Care Safety Net Stability

The sensitivity of state budgets to economic cycles contributes to instability in public health insurance eligibility, benefits and provider payments, as well as support for safety net hospitals and community health centers, according to a study released today by HSC.

HSC Researchers Win ACHE Award

HSC Consulting Researchers Robert Berenson, M.D., and Thomas Bodenheimer, M.D., and HSC Senior Researcher Mai Pham, M.D., have been named the winners of the American College of Healthcare Executives 2008 Dean Conley Award for their article "Specialty-Services Lines: Salvos in the New Medical Arms Race," published in the July/August 2006 edition of Health Affairs.

Higher Costs and Stagnant Incomes Increase Financial Burden of Health Care

Rising out-of-pocket expenses and stagnant incomes increased the financial burden of health care for more Americans between 2001 and 2004, especially for the privately insured, according to a national study supported in part by the Commonwealth Fund and published in the January/February edition of Health Affairs.

Don't Break Out the Champagne: Slowdown in Health Spending Growth Unlikely to Last

The continued slowdown in personal health care spending growth in 2006 reported by government economists is unlikely to last, according to a perspective by HSC President Paul B. Ginsburg, Ph.D., published in the January/February Health Affairs.

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