Institute on Healthcare Systems

Schneider Institutes for Health Policy

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Welcome to the Institute on Healthcare Systems


The Institute on Healthcare Systems (IHS) is home to many innovations in healthcare research and policy, and is dedicated to providing rigorous technical solutions to policymakers and other stakeholders who are striving to improve quality, efficiency, and value.  We respect the complexity of healthcare, the corresponding need for rigorous and robust approaches to meaningful and stable reform, and the vital strength of empirical illumination and validation.

IHS was built originally on the vast experience in national health policy of our founders, Stuart Altman and Stan Wallack.  Their tradition continues with accomplishments of our director, Christopher Tompkins, including his leadership in developing the shared-savings payment model and related delivery system innovations, hospital value-based purchasing, and  a comprehensive episode-of-care system for Medicare and the public domain.  Similarly, our deputy director, Jennifer Perloff, has led IHS studies in value for capitated delivery systems, and the potential roles of nurse practitioners to implement sustainable delivery system reforms.

Christine Bishop is a national expert on financing of post-acute and long-term care, as well as the economics of healthcare labor markets.  Donald Shepard and colleagues have done pioneering and enduring work in cost-effectiveness analysis, domestically and internationally.  John Chapman, Moaven Razavi and Chris Sistrom are leaders in developing groundbreaking tools and approaches for transforming substantial aspects of healthcare services.

IHS staff also covers a range of delivery systems issues, such as Cindy Thomas' work in prescription drug policy and state health reform. Given the broad range of work done at IHS, our research spans both quantitative and qualitative techniques. Jeff Prottas, for example, is an expert in program implementation and evaluative case studies. Grant Ritter provides expertise in statistics and econometric methods.  Palmira Santos spearheads organizational and delivery system reforms aimed at improving quality for vulnerable populations ranging from neonates to the elderly.  

As health care organizations increasingly enter new reimbursement arrangements like global and episode-based payment, Rob Mechanic has led several new studies evaluating how organizations are adapting to these new payment models.

Policy analysis is an important component of the work at IHS and is led by Rob Mechanic at the Health Industry Forum and Michael Doonan at the Massachusetts Health Policy Forum. 

Chris Tompkins signature


Stuart  H. Altman, Chair of the Massachusetts Health Policy Commission and Sol C Chaikin Professor of National Health Policy, Schneider Institutes for Health Policy,The Heller School for Social Policy and Management was honoree of the Robert M. Ball Award for Outstanding Achievements in Social Insurance from the National Academy of Social Insurance, June 27, 2018 

new Publications

Thomas, C.P. J Addic Med. Published online August 7, 2018. Commentary: Addressing Workforce Needs for Medication Treatment of Opioid Use Disorder

Perloff, J., Clarke, S., DeRoches, C.M., O'Reilly-Jacob, M., and Buerhaus, P. (2017). Medical Care Research and Review. Published online Sept. 14, 2017. Association of State-Level Restrictions in Nurse Practitioner Scope of Practice with the Quality of Primary Care Provided to Medicare Beneficiaries

Landon, B.E., and Mechanic, R.E. (2017) New England Journal of Medicine. 377(13), pp. 1211-1213. The Parodox of Coding -- Policy Concerns Raised by Risk-Based Provider Contracts.

Glied, S.A., and Altman, S.H., (2017) Health Affairs 36(9), pp. 1572-1577. Beyond Antitrust:Health Care and Health Insurance Market Trends and the Future of Competition

 Maynard, A., Altman, S.H., and Stearns, S.C. (2017).Health Economics. 26(6), pp. 687–690.  Redistribution and Redesign in Health Care: An Ebbing Tide in England Versus Growing Concerns in the United States 

Ades, P.A., Keteyian, S.J., Wright, J.S., Hamm, L.F., Lui, K., Newlin, K., Shepard, D.S., and Thomas, R.J. (2017).Mayo Clinic Proceedings. 92(2), pp. 234-242.  Increasing Cardiac Rehabilitation Participation From 20% to 70%: a Road Map From the Million Hearts Cardiac Rehabilitation Collaborative  

Afendulis, C.C., Hatfield, L.A., Landon, B.E., Gruber, J., Landrum, M.B., Mechanic, R.E., Zinner, D.E., and Chernew, M.E. (2017). Health Affairs. 36(3), pp. 468-475. Early Impact of CareFirst’s Patient-Centered Medical Home With Strong Financial Incentives 

 Akobirshoev, I., Bowser, D., Parish, S.L., Thomas, C., and Bachman, S.S. (2017). Health and Social Work. Published online March 2, 2017. Does Parental Health Mediate the Relationship Between Parental Uninsurance and Insured Children’s Health Outcomes? Evidence From a U.S. National Survey  

Mechanic, R. (2016) Clinical Orthopaedics and Related Research. 474, pp. 1920-1921. Medicare Bundled Payment Is Here to Stay  

Kaur, R., Perloff, J.N., Tompkins, C., and Bishop, C.E. Health Services Research, Published online Dec. 15, 2016. Hospital Post-Acute Care Referral Networks: Is Referrral Concentration Associated With Medicare-Style Bundled Payments? 

Doonan, M., (2016). Book Review on "Obamacre Wars Federalism: State Politics and the Affordable Care Act," Series:  Studies in Government and Public Policy, by Daniel Beland, Philip Rocco and Alex Wadan (University Press of Kansas, 2016). Publius: The Journal of Federalism.                                                                                                                                                                                                               


The Council on Health Care Economics and Policy, under the leadership of chairman Stuart Altman and director Michael Doonan, PhD’02, held its 24th Princeton Conference, titled “Implica­tions of the Election for the Health Care System,” at the Robert Wood Johnson Foundation in Princeton, N.J., May 23-25, 2017. The conference assembled over 130 attendees, including health care industry leaders, academic experts and policymak­ers, who discussed pressing issues and challenges facing the U.S. health care system. The aims of the meeting were to incite policy recommendations and some conclusions regarding session topics, and to offer attendees meaningful opportunities to network and connect with professionals from varied sectors and with diverse areas of expertise. The Princeton Conference also aimed to create discussions that could be the fodder for policy creation and industry transformation as attendees return to their respec­tive organizations with new knowledge and insights into health care topics and use that material to inform their future work. 

On March 31, 2017, the Health Industry Forum hosted a forum in Washington, D.C., examining “The Future of Medicare Advantage.” More than 30 percent of Medicare beneficiaries now select private Medicare Advantage (MA) plans for their health coverage. Prior to the Affordable Care Act, payments to MA plans averaged 15 percent more than fee-for-service coverage, and plans could profit simply by targeting counties where premiums exceeded underlying costs. The Affordable Care Act lowered MA premiums close to parity and added a star rating system with additional payments to reward high-quality plans. Republicans generally favor using private plans to provide public health benefits and will likely propose new policies to advance the MA program. This forum examined current key policy issues, including pricing and risk adjustment, reviewed innovative delivery models developed by MA plans, discussed the new administration’s poten­tial approach to MA and examined the implications of possible changes for beneficiaries and taxpayers.

May 16, 2016 The State of Senior Living in Waltham, Waltham News Tribune, Senior citizens are a vital part of any community, but do they have the opportunities and support to lead healthy and fulfilling lives in Waltham?That was the question raised by Walter Leutz, a professor at the Heller School for Policy and Management at Brandeis University. Leutz, who teaches classes in social welfare, long-term care and aging at Brandeis, onducted a study on the state of senior citizen living in Waltham. The State of Senior Living

May 2, 2016, Professor Walter Leutz, PhD’81 spent the 2015 calendar year on sabbatical conducting a community-based participatory action research (CBPAR) project focused on healthy aging in Waltham and Greenfield, Mass. CBPAR is a partnership approach to research between community members and researchers in which both parties contribute to the conceptualization, execution, and dissemination of a research study. Leutz recruited, trained, and led 13 older adult co-researchers who volunteered their time to help conduct a qualitative study of five characteristics related to healthy aging: physical infrastructure, services, social participation/civic engagement, safety and healthy behaviors. The study’s results show that both towns exhibit elements of age-friendliness across all five categories, but that more work can be done to promote healthy aging in these communities. Do Waltham & Greenfield, MA Enable Healthy Aging? 

January 2016   Nurse practitioner patients less costly to Medicare than physician patients. First national study contradicts previous research on health care costs. With Medicare enrollment and cost concerns growing, a new study finds that patients with a nurse practitioner as a primary care provider are less costly to Medicare than patients with a physician primary care provider. The study—the first to examine national data—contradicts previous research suggesting that both types of providers generate equal costs or that nurse practitioners actually cost Medicare more.   Read More


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