General Information

Mission Statement

he mission of the Center for Studying Health System Change (HSC) is to inform policy makers and private decision makers about how local and national changes in the financing and delivery of health care affect people. HSC strives to provide high-quality, timely and objective research and analysis that leads to sound policy decisions, with the ultimate goal of improving the health of the American public.

	About HSC
	Research Funding
	HSC Staff
	Advisory Committee
	HSC and Mathematica
	Career Opportunities

About HSC

he Center for Studying Health System Change (HSC) is a nonpartisan policy research organization located in Washington, D.C. HSC designs and conducts studies focused on the U.S. health care system to inform the thinking and decisions of policy makers in government and private industry. In addition to this applied use, HSC studies contribute more broadly to the body of health care policy research that enables decision makers to understand change and the national and local market forces driving that change.

Based on rigorous surveys and in-depth case studies, HSC President Paul B. Ginsburg and his fellow researchers are committed to chronicling trends in the health care system and drawing implications that are devoid of bias. HSC then disseminates this research to inform public debate. Release of such well-formed research without editorial comment makes HSC unique in Washington. HSC is funded in part by the Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research.

Additionally, the National Institute for Health Care Reform, a nonpartisan, nonprofit organization established by the International Union, UAW; Chrysler Group LLC; Ford Motor Company; and General Motors, has contracted with HSC to conduct health policy research and analyses, which will meet HSC's rigorous standards for quality and objectivity. HSC's Ginsburg serves as the Institute's research director.

HSC does not take policy positions, but is a resource for decision makers on all sides of the issues because of its reliable data and objective analysis. Through an advisory committee made up of top public and private health care leaders, formal and informal briefings, and a staff with extensive Washington experience, HSC has developed a research agenda to guide those crafting health care policy in government and private industry.

HSC’s core research effort is the Community Tracking Study (CTS). While the CTS is national in scope, it focuses on the community level, where care is organized and delivered. The study consists of biennial visits to 12 communities and periodic national surveys of those involved in or affected by changes in the health system — namely households and physicians.

The community-based design was replaced by a national sample design for the 2007 Household Survey and 2008 Physician Survey, although site visits continue to be focused on the 12 communities. Because the latest samples are no longer clustered in communities, the surveys have been renamed the HSC Health Tracking Household and Physician surveys.

Household Survey. 17,800 individuals in 9,400 families comprise the sample for the most recent Household Survey in 2007, which focuses on tracking changes in health care access, utilization, insurance, perceptions of care quality and problems paying medical bills. The response rate was 43% in 2007. The survey is nationally representative. Particular areas of inquiry include access, satisfaction, use of services and insurance coverage. Information about health status, sociodemographic characteristics and employment is also collected. Mathematica Policy Research conducts the Household Survey for HSC. The first four household surveys were conducted in 1996-97, 1998-99, 2000-01, and 2003. The fourth survey was conducted primarily in calendar year 2007.

Physician Survey. Practicing physicians across the country provide perspectives on how health care delivery is changing. Physicians respond to a series of questions about source of practice revenue, problems they face in practicing medicine, quality of care, access to services, information technology, sources of practice revenue and compensation, as well as questions about their practice arrangements and care practices. More than twelve thousand practicing physicians across the country provided perspectives on how health care delivery is changing in the first three rounds of the survey (1996-97, 1998-99, 2000-01), while more than 6,600 physicians were interviewed in round four (2004-05), and more than 4,700 physicians were interviewed for the 2008 survey. Unlike previous rounds that were administered over the telephone, the 2008 survey used a mail questionnaire. It was conducted by Westat, while the Gallup Organization conducted previous rounds of the survey. The 2008 survey included questions in new topic areas, such as coordination of care, malpractice, and physician ownership of equipment and hospitals.

Site Visits. Researchers examine the forces affecting health care organizations and how they are responding by interviewing 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 the involvement of outside researchers.