Center for Studying Health System Change

The Community Tracking Study

The Community Tracking Study is national in scope, but is focused on the community level, where health care is organized and delivered. The study consists of national surveys every other year of those involved in or affected by changes in the health system-namely households, physicians and employers-as well as visits to 12 communities. The surveys, conducted by telephone, are concentrated in 60 communities and have a panel of respondents who are carried over from the previous round for tracking purposes. The third round of site visits began this June, and the third round of the surveys in August.

• HOUSEHOLD SURVEY. Sixty thousand individuals in 33,000 families comprise the Household Survey, which focuses on assessing whether consumer access to the health care system is improving or declining over time, nationally and at the community level. Particular areas of inquiry include access, satisfaction, use of services and insurance coverage. Information about health status and sociodemographic characteristics is also collected. An Insurance Followback Survey of the plans that household respondents are in is conducted to enhance information reliability, particularly as it relates to plan type and attributes-e.g., degree of plan management. Mathematica Policy Research, Inc. (MPR), conducts the Household Survey and the Followback Survey for HSC.
• PHYSICIAN SURVEY. Twelve thousand practicing physicians across the country provide perspective on how health care delivery is changing. Physicians respond to a series of questions about whether they are able to provide needed services for patients, how they are compensated and what effect various care management strategies have on their practices, as well as questions about their practice arrangements. The Gallup Organization conducts the Physician Survey for HSC.
• EMPLOYER SURVEY. Twenty-two thousand public and private employers are interviewed to understand how they are shaping the health system nationally and locally. These employers, which span size and industry sector, are asked questions about the choice of plans they offer, how much their employees contribute to paying for their coverage, whether they participate in a purchasing alliance and whether they provide quality information to their employees. HSC collaborates with RAND on the Employer Survey, which was last conducted in 1997 and will not be fielded this year.
• SITE VISITS. Researchers examine the forces affecting health care organizations and how they are responding by interviewing 40 to 60 health care leaders in 12 sites: Boston, Mass; Cleveland, Ohio; Greenville, S.C.; Indianapolis, Ind.; Lansing, Mich; Little Rock, Ark; Miami, Fla; Northern New Jersey; Orange County, Calif; Phoenix, Ariz; Seattle, Wash.; and Syracuse, N.Y. HSC conducts and manages the site visits, with involvement of outside researchers.