HSC's Mission and Vision
Shedding Light on
Health Care Markets with Research
by Len M. Nichols
very research organization continually asks itself two
fundamental questions: which topics should it study, and how should it commu-nicate
the findings to the outside world? Indeed, research organizations define themselves
as distinct types by the way they answer these questions. At HSC, we answer
both questions in a way that maximizes the objective insights we contribute
to current and future health policy discussions.
Each year we carefully survey the policy environment before we select our research topics. This review includes consultations with our advisory committee members; ongoing conversations with senior federal and state policy staff; feedback HSC researchers receive when they speak at meetings, participate in advisory panels and referee journal articles; and ongoing monitoring of the key players in our 12 site visit communities. Senior management prepares a memo summarizing the near- and intermediate-term policy environment to help HSC researchers frame their research proposals. Additional research is initiated by management in response to unique opportunities our data or insights have for contributing to emerging policy issues. For example, in early 2002 Paul Ginsburg testified before Congress as lawmakers debated the impact of a reduction in Medicare physician fees. HSC was able to use data from our 2000-01 Household and Physician Surveys to identify signs of tightened capacity and access problems for seniors that occurred just before the payment cut.
By tracking these changes across the six years of our surveys, we could identify trends and put this result in context by reporting on similar access problems experienced by the near-elderly population. Underlying all of this is our policy that all intellectual work at HSC is designed to improve understanding so policy decisions can be made with less uncertainty and rhetorical heat and more analytical light.
Of course, no matter how rigorous, pertinent and timely the research is, actually improving the information and policy makers' understanding of it requires an effective communication strategy. Here, HSC has two guiding principles:
 Researchers themselves—after
an extensive internal and (where appropriate) external review process—draw
policy inferences and explain the limits of the analysis; and Multiple product
types—e.g., refereed journal articles, HSC publications (Issue
Briefs and Data Bulletins) that draw from published research and HSC publications
that represent original research—combine to enhance the power of
any communication effort to inform policy makers. |
Adherence to these principles empowers our audiences to make their own judgments and to avoid dependence on subjective translators (i.e., lobbyists). In this way, HSC's publications provide an independent source of information our readers can rely on. To clarify the message, implications and limits of our research findings, we also offer briefings to small groups of policy makers, researchers and others.
In the short term, policy makers—public and private—are our primary audience, and we design much of our research to provide them with timely and unbiased data and analyses to inform their deliberations on everything from public policy choices to private decisions that affect people's access to care and coverage opportunities. The media serve as an important conduit to policy makers, so we try to make our research findings and products as accessible to them as possible.
Our ultimate audience is fellow researchers. Their peer review of our research allows policy makers and the media to be confident that they can depend on our objectivity and rigor, serving as both a filter for and validator of our work. By enriching our knowledge of the way the health care system operates, we make an immediate contribution to current debates and help to shape the nature of future ones. Only by meeting both of these tests—rigor and relevance—can we succeed in either area. Thus, in our view, HSC's policy focus motivates the research process and improves our products because our results really matter, even as the rigor of the research makes our contribution to policy debates respected and appreciated by all sides.
The following illustrate ways in which our research has been relevant to policy makers in three key policy areas: insurance coverage and costs; access to care; and local markets and managed care.
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