The diverse, innovative faculty and students at HCP engage in research covering a wide variety of subjects in health care. Below is a list of the seven specialty areas that broadly encompass HCP research; it is not all-inclusive but is meant to provide an overview of interests and accomplishments. For more details or for information on a particular subject or faculty member, go to the Publications section of the website and search by faculty member, or type in keywords in the Search field at the top right-hand side of the website.
Aging, Disability, and End of Life
Aging research at HCP builds on over a decade of studies on the quality and costs of care in long-term care and post-acute care settings. This work, which examines the financing, delivery, and organization of services, has fundamentally changed the way policymakers and researchers think about this area. Currently, the work includes several studies of health-related work capacity at older ages, as well as the broad effects of aging on the economy. Disability is now being developed as a new area of research with a focus on appropriate treatment of pain and restoring work capacity, in collaboration with a large team of researchers affiliated with the National Bureau of Economic Research. The study of decision-making in older adults is another emerging area of interest at HCP. End of life care has also been an important area of study for years with both current and former faculty.
Price transparency tools have grown in popularity in the past few years as a response to two factors: marked price variation across providers/physicians for a variety of health care services and the requirement that for many insurance plans patients bear a larger fraction of spending through increased deductibles, copays, and co-insurance. Over half of U.S. states have passed legislation establishing price transparency websites or mandating that health plans, hospitals, or health care providers/physicians make price information available to patients. Websites have emerged to “crowd source” price information, and health plans have introduced price transparency tools for enrollees. Employers have also contracted with private vendors to provide their employees with price transparency tools.
Despite the enthusiasm for price transparency efforts, little is known about their impact or association with health care spending. HCP has been on the forefront of examining the impact of price transparency to answer questions such as who uses such tools, where is there the greatest potential, and whether increasing price transparency decreases spending.
Comparative Effectiveness Research
Comparative effectiveness work has been part of the HCP portfolio since its inception, initially determining how different health care services (e.g., tests or treatments) differ from each other in cost or quality. In more recent years, the definition of this work has extended to site of service, specifically, how the same service delivered at different sites or under different insurance plans contrast in outcomes. Sites can be hospitals or provider groups (e.g., the Veterans Administration) and plans can include various types of insurers. HCP faculty have had extensive and ongoing experience with comparative research involving alternative sites of care.
Health Care Economics and Policy
Health care economics is the foundation of much of health care policy, and HCP has the largest and most productive group of social scientists studying health care economics in the United States. Faculty at HCP lead the field in both academic and policy research, which focuses on the organization and financing of health care in public and private health insurance markets (e.g., Medicare, Medicaid, ACOs, and payment reform). The research on health economics extends to studies of benefit design, productivity in health care, bundled payments, and the role of innovation in costs of care and quality of care. HCP's research has been supported for decades by grants from the National Institute of Aging, the National Institutes of Health, and by private foundations, including a major grant from the Laura and John Arnold Foundation.
New Models of Delivery
New models of health care like retail clinics and telemedicine have emerged over the past decade, and only now is research and evaluation of their effectiveness being done. These models have the potential to drastically change and improve the landscape of medical care; they are also controversial, raising concerns like quality of care, disruption to the doctor-patient relationship, and lost opportunities for preventive care. HCP has been on the forefront of evaluating these innovations and their impact on access, costs, and efficacy.
Physician Behavior and Clinical Practice
Ensuring efficiency in health care delivery means that high value care – care that improves patient outcomes at appropriate cost – must be identified and rewarded, whereas low value care should be discouraged. This work at HCP is supported by multiple grants including mentoring awards to support the development of junior faculty and frequently involves work with collaborators from the Harvard teaching hospitals. Work covers quality of care, appropriateness of care, and the impact of alternative payment approaches on quality. In particular, improving care delivery for patients with cancer is important, particularly given the high prevalence of cancer, substantial burden of disease, and high costs of care. Other disease-specific areas include mental health and cardiology. Because physicians are the major deliverers of care, we also study multiple components of physician behavior including responses to risk and malpractice.
This area is critical to all aspects of health policy and includes statistics as well as particular components like risk adjustment that are essential to many areas of economic analyses. For more than 25 years, HCP faculty have been at the forefront of developing and applying statistical methods necessary for answering critical questions in health care policy. This work spans the entire field of health services research and focuses on population-based investigations in observational and experimental data, including both massive data sets and smaller survey-based instruments. Methodology ranges from parametric Bayesian hierarchical models to nonparametric machine-learning-based approaches.
At HCP, faculty members in statistics and biostatistics are fully integrated team members and team leaders, bringing a crucial perspective to the scientific process. This leads to studies designed and analyzed with additional statistical rigor, as well as the positing of novel research questions that otherwise would not have been examined. A deep understanding of health care systems