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HCFO Year in Review

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Publication Date: 
January 15, 2015

As a wise Greek philosopher once noted, the only thing constant is change. One exciting change for the Robert Wood Johnson Foundation is the movement towards building a Culture of Health in America, with a new emphasis on investments that promote health beyond the medical system to places where people live, learn, work, and play. While this means we will wind down the Changes in Health Care Financing and Organization (HCFO) program, the contributions of HCFO-funded research will certainly endure. During the upcoming year, staff will focus its efforts on dissemination and convening, using findings from ongoing and past studies to help inform the work of policymakers and health care leaders.

HCFO’s activities in 2014 addressed a variety of topics, including innovations in insurance markets and benefit design, pay for performance and other issues in provider payment, Affordable Care Act (ACA) implementation, and virtual physician visits.

Supporting Researchers

Grantmaking

The five grants funded in 2014 address some of the most pressing health policy issues, including the role of private exchanges within the unfolding ACA environment and continuing strategies to engage consumers and control health care costs.

Special Topic Solicitations

Six grants were funded in early December 2013 following a special topic solicitation, Understanding the Impact of Price Data in Health Care. During the past year, HCFO staff have connected the grantees with federal policymakers and other relevant stakeholders interested in advancing the transparency of the health care system. These connections are designed to ensure that the researchers address the most pressing policy questions and that the end-users of the research are aware of the work and upcoming findings.

Working in collaboration with the team at SHADAC, on January 13, 2014, HCFO released a RWJF special topic solicitation, State Health Access Reform Evaluation: Coverage Provisions of the Affordable Care Act. The solicitation was designed to solicit studies examining the implementation of the ACA in states and/or the impact of the ACA on coverage, health care utilization, and affordability. Researchers submitted 113 brief proposals from which 23 full proposals were invited. Ten grants were funded in October 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. Anticipating the changes in insurance coverage measurement, we conducted the following webinar in 2014.

  • “Measuring Health Insurance Coverage: Improvements and New Opportunities in the Current Population Survey”

The Current Population Survey (CPS), a household survey conducted jointly by the U.S. Census Bureau and the U.S. Bureau of Labor Statistics (BLS), is a primary source of economic and labor market data for the U.S. population. Because CPS’s Annual Social and Economic Supplement (ASEC) has collected data about health insurance coverage every year since the 1980s, the CPS has become a rich resource for health services researchers tracking coverage trends. Beginning with the 2014 ASEC (which is administered in February, March and April of 2014 and asks questions about coverage during the calendar year 2013), the Census Bureau implemented a redesign of the health insurance questions to provide more precise measures of coverage. Among other changes, the new method captures current health insurance coverage in addition to coverage on a monthly basis since the beginning of the previous calendar year.This webinar discussed the use of CPS data for applied policy research and explored the survey redesign. Kathleen Adams, Emory University, and Patricia Ketsche, Georgia State University, discussed how they are using CPS data in their current HCFO-funded project and the issues the survey redesign raises for this type of research. Following their presentation, Joanne Pascale from the U.S. Census Bureau provided an overview of the CPS, explained the changes in detail, and discussed both the opportunities and potential challenges the redesign creates for researchers.  The webinar recording can be accessed online.

Informing Policymakers and Other Key Constituents

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, particularly around implications of study findings for policy and practice. The briefings also serve as a connection point, identifying the “go-to” experts for policymakers on various topics.

In 2014, three HCFO grantees participated in briefings:

Policy Briefings   

For research of particular relevance to specific federal agencies, AcademyHealth staff facilitate policy briefings, or meetings for HCFO researchers with policymakers at their offices to present findings from recently completed studies. These face-to-face meetings are an effective means of sharing study findings with policy audiences, as well as helping grantees broaden their connections with research end-users. This year, two grantees met with staff from CMS, GAO, FTC, CBO, CMS, ASPE, CRS and ONC.

Andrew Ryan, Ph.D., Weill Cornell Medical College, presented findings from his study evaluating the effects of the Medicare Hospital Value-Based Purchasing Program on quality of care during the program’s first year of implementation. June 14, 2014.

R. Adams Dudley, Ph.D., UCSF, presented findings from his study examining the processes and quality of care provided by virtual physician websites for minor acute illnesses. December 4, 2014.

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 and implications for policy.  We released seven Snapshots in 2014:

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 2014, we produced the following five briefs:

In an effort to help develop the next generation of health policy analysts and health services researchers, HCFO collaborated with the George Washington University Department of Health Policy to offer an experiential learning opportunity for one of their M.P.H. students. For her project, Julie Saha, M.P.H., drafted a policy brief that highlights findings from HCFO-funded research on physician and hospital responses to changes to Medicare payment.

Grantee Publications

The high quality of HCFO grantees’ work is most clearly demonstrated in their peer-reviewed publications. In 2014, grantees published 16 articles in a variety of journals.

A Successful 25 Years

For the last 25 years, HCFO staff have worked diligently to support the best in health care financing and organization research. HCFO has been recognized as an objective, rigorous investigator-initiated grantmaking program that excels in identifying and supporting research that is useful and used by policymakers. In 2015, HCFO staff look forward to supporting the dissemination and convening activities of our final grantees and documenting the tremendous impact and legacy of the HCFO program on health policy and health services research.