Center for Studying Health System Change

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Community Tracking Study Site Visits


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As part of the Community Tracking Study (CTS), HSC studies how local health systems are changing through site visits to 12 randomly selected U.S. communities.

CTS Community Reports CTS Community Reports CTS Community Reports CTS Community Reports CTS Community Reports CTS Community Reports CTS Community Reports CTS Community Reports CTS Community Reports CTS Community Reports CTS Community Reports CTS Community Reports

Since 1996, researchers have visited the 12 communities approximately every two-three years to conduct in-depth interviews with leaders of the local health system. HSC explores how the organization, financing and delivery of health care are changing and the impact of these changes on people. Researchers interview representatives of local hospitals, health plans, physician organizations, safety net providers, employers, benefits consultants and insurance brokers, government agencies, policy makers, and others. [Site Visit Methodology]

In 2010, HSC completed the seventh round of site visits. HSC has published Community Reports from each site and cross-site analyses identifying emerging trends across the communities. The 2010 site visits were funded jointly by the Robert Wood Johnson Founation and the National Institute for Health Care Reform (NIHCR). In addition to the 12 CTS sites, an August 2010 Detroit Community Report, funded by NIHCR, was published.

Previous site visits were fielded in 1996-97, 1998-99, 2000-01, 2002-03, 2005 and 2007.

2010 CTS Site Visit Products

Cross-Site Analyses

Issue Brief No. 138 - Small Employers and Self Insured Health Benefits: Too Small to Succeed?
Issue Brief No. 137 - Employer-Sponsored Health Insurance: Down but Not Out
Issue Brief No. 136 - Rising Hospital Employment of Physicians: Better Quality, Higher Costs?
Issue Brief No. 135 - Key Findings from HSC's 2010 Site Visits: Health Care Markets Weather Economic Downturn, Brace for Health Reform

Research Brief No. 25 - Local Public Hospitals: Changing with the Times
Research Brief No. 21 - A Long and Winding Road: Federally Qualified Health Centers, Community Variation and Prospects Under Reform

Journal Article - Health Plan-Provider Price Negotiations: Passing the Buck to Employers
Journal Article - Hospitals' Geographic Expansion in Quest of Well-Insured Patients: Will the Outcome be Better Care, More Cost, or Both?

Community Reports

Boston Community Report - State Reform Dominates Boston Health Care Market Dynamics
Cleveland Community Report - Cleveland Hospital Systems Expand Despite Weak Economy
Greenville Community Report - Greenville & Spartanburg: Surging Hospital Employment of Physicians Poses Opportunities and Challenges
Indianapolis Community Report - Indianapolis Hospital Systems Compete for Well-Insured, Suburban Patients
Lansing Community Report - Lansing's Dominant Hospital, Health Plan Strengthen Market Positions
Little Rock Community Report - Little Rock Health Care Safety Net Stretched by Economic Downturn
Miami Community Report - Economic Downturn Strains Miami Health Care System
Northern New Jersey Community Report - Northern New Jersey Health Care Market Reflects Urban-Suburban Contrasts
Orange County Community Report - Physicians Key to Health Maintenance Organization Popularity in Orange County
Phoenix Community Report - Economic Downturn Slows Phoenix's Once-Booming Health Care Market
Seattle Community Report - Seattle Hospital Competition Heats Up, Raising Cost Concerns
Syacuse Community Report - Syracuse Health Care Market Works to Right-Size Hospital Capacity



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The Center for Studying Health System Change Ceased operation on Dec. 31, 2013.