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HCFO Year in Review

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Publication Date: 
January 15, 2014

The past year saw significant changes in the health care system as implementation of the Affordable Care Act (ACA) continued and marketplaces evolved.  For policymakers and health care leaders trying to make decisions in the midst of this changing environment, the critical need for evidence remained a constant. As it has for over two decades, HCFO made new grant investments, helped researchers better understand data available to study questions of health care financing and organization, brought researchers and policymakers together to consider pressing issues, and disseminated work we previously funded. HCFO’s activities in 2013 addressed a variety of topics, including quality of care, payment, access, costs, and price transparency.

Supporting Researchers

Grantmaking

The work starts here with those who produce timely, policy-relevant research. A number of the seven grants funded in 2013 address important issues stemming from the implementation and roll-out of health reform.

Special Topic Solicitation

On March 15, 2013, HCFO released a special topic solicitation, Understanding the Impact of Price Data in Health Care. The solicitation was designed to solicit studies that will provide reliable and generalizable evidence to inform policymakers and delivery system representatives and help accelerate progress toward using price and quality information effectively. Researchers submitted 67 brief proposals from which 27 full proposals were invited. Six grants were funded in early December 2013.  A key requirement of these studies is the ability to create or inform brief and timely deliverables for wide dissemination, based on preliminary findings and throughout the life of the grant. HCFO staff also intend to connect the grantees with policymakers and other end-users of the research in early 2014.

Webinars

We believe strongly in our commitment to supporting the field, including professional development offerings for new and established researchers. Our webinars are designed to disseminate the work of HCFO-funded researchers and provide information on the use of traditional and new data sources and tools important to research on health care financing and organization topics.  We conducted four webinars in 2013.

  • Examining Employers’ Use of Massachusetts’ Health Insurance Exchange to Inform Best Strategies Nationally Under the Affordable Care Act.  As part of a HCFO-funded study, Mark Hall, J.D. of Wake Forest University used key informant interviews and document review to investigate employers’ use of the Massachusetts Health Connector. In this webinar, Professor Hall reviewed his findings and their implications for other states designing and operating SHOP exchanges. Three discussants provided additional perspectives on the results. Katherine Swartz, Ph.D., from the Harvard School of Public Health, drew on her familiarity with the Massachusetts experience; Rex Cowdry, M.D., provided comments based on his experience at the CMS Center for Consumer Information and Insurance Oversight (CCIIO); and Eileen Hayes from the New York State Department of Financial Services provided her perspective from a state currently setting up a SHOP exchange. The webinar recording can be accessed online. 
  • Using the American Community Survey (ACS) for Health Services Research: Opportunities, Best Practices and Expert Advice.  The American Community Survey (ACS) is an annual, general household survey conducted by the U.S. Census Bureau. ACS data can provide useful estimates at the national, state, and local levels, including insurance coverage and other demographic indicators such as income, poverty, disability, marital status, education, and occupation. The webinar provided an overview of the data source, offered experienced user insights and illustrated how the data can be used to explore issues related to health care coverage. Joanna Turner and Elizabeth Lukanen from SHADAC provided background on the ACS, including how to access and use ACS data and advantages and disadvantages relative to other data sources. Genevieve Kenney and Victoria Lynch from the Urban Institute then provided the user perspective. The webinar recording can be accessed online. 
  • Getting and Using the Medicare Current Beneficiary Survey for HSR: Guidance from the Experts. The Medicare Current Beneficiary Survey (MCBS) represents an important resource for researchers studying the Medicare program and its enrolled populations. It is a continuous survey of a nationally representative sample of the Medicare population conducted by Centers for Medicare & Medicaid Services (CMS) through a contract with Westat. Among its uses, MCBS allows researchers to determine expenditures and sources of payment—including non-Medicare insurance and out-of-pocket spending—for all health care services used by Medicare beneficiaries. The webinar provided an overview of the data source by staff from ResDAC and insights from experienced researchers, Bruce Stuart from the University of Maryland, Baltimore and Timothy Waidmann from the Urban Institute, who illustrated how the data can be used to explore issues related to health care financing and organization. The webinar recording can be accessed online.
  • New Hospital Pricing Data: What it Says and What it Means.  As part of an ongoing effort to showcase important sources of data, the Robert Wood Johnson Foundation joined CMS in offering a May 15 webinar to feature recently released data on the prices that more than 3000 hospitals charge for the 100 most common inpatient procedures. The webinar focused on best practices in using analytics to transform data into actionable information and provided an overview of the data source, including what led CMS to produce the data, how the data may be accessed, and high level methodology. A panel of experts offered their reactions and answered questions from webinar participants. The webinar recording can be accessed online.

Informing Policymakers and Other Key Constituents

Small Meetings

On November 1, 2013, HCFO hosted a small meeting, moderated by Ashish Jha, M.D., Harvard School of Public Health, focused on hospital readmissions. The meeting was designed to help inform public and private sector decision makers who are responsible for implementing Medicare’s hospital readmissions reduction program (HRRP) and refining it going forward. Participants included federal policymakers, providers, economists/researchers, and policy analysts. The meeting was structured as a moderated, highly interactive, in-depth discussion framed within the current evidence base and focused on questions for which more and better evidence may be needed to make informed decisions around hospital readmissions. Dr. Jha led the participants through a series of questions, which were framed using both a regulatory and legislative lens and focused on ways to refine the HRRP. The goal of the meeting was to develop actionable recommendations aimed at ensuring appropriate accountability and assisting providers in their efforts to reduce readmissions. The meeting discussion was captured in a report that will be available on the HCFO website at the end of January.

Grantee Briefings

A HCFO activity lauded by both researchers and policymakers is the grantee briefing. The briefings are designed to ensure that policymakers are aware of important research, even before those studies are published. Policymakers are invited to an “early look” at evidence that can help inform their decision-making. The grantees receive feedback from attendees on future analyses and ways to strengthen manuscripts. The briefings also serve as a connection point, identifying the “go-to” experts for policymakers on various topics.

In 2013, two HCFO grantees participated in briefings:

Study Snapshots

In an effort to make findings from HCFO-funded projects more accessible to our policy audience, we launched the “Study Snapshot” publication series. These one-page documents capture the key findings from a study and describe the most important complexities of the research.  We released five Snapshots in 2013:

HCFO Findings Briefs

In addition to the Snapshots, HCFO staff publishes Findings Briefs, which are designed to reach a broad range of audiences. In this publication, staff summarizes the work of a grantee and discusses important policy implications of the study findings. In 2013, we produced the following five briefs:

Grantee Publications

The high quality of HCFO grantees’ work is most clearly demonstrated in their peer-reviewed publications. In 2013, grantees published 16 articles in a variety of journals.

Moving Forward

The year ahead will provide new opportunities to study the impacts of the ACA and address both emerging and long-standing health care policy questions. As we move into 2014, HCFO looks forward to building on its work over the last 12 months as well as its accumulated experience as a neutral broker of the high quality information needed to inform policymakers’ decisions.