Community Tracking Study Series

Investigator(s): Center for Studying Health System Change

The Community Tracking Study (CTS), a project of the Center for Studying Health System Change (HSC), is a large-scale longitudinal investigation of health system change and its effects on people. Designed to track a cohort of American communities at two-year intervals beginning in 1996, this major research effort, sponsored by The Robert Wood Johnson Foundation (RWJF), gathers information to monitor and understand the evolution of health care in the United States. CTS is investigating the ways in which hospitals, health plans, physicians, safety-net providers, and other provider groups are restructuring their systems, and the forces driving the organizational changes. Additionally, the project tracks health insurance coverage, access to care, use of health services, health care costs, and perceived quality of health care. Sixty sites (51 metropolitan areas and 9 nonmetropolitan areas) were randomly selected to form the core of CTS and to be representative of the nation as a whole. Much of the information collected by CTS comes from nationally representative surveys of households, health plans, and physicians conducted by HSC. The Household Survey is administered to households in the 60 CTS sites, plus a supplemental national sample of households, covering some 60,000 individuals. A survey of health plans, the Followback Survey, elicits detailed information on private health insurance coverage reported in the Household Survey from organizations that offer or administer private health insurance policies in the CTS sites. The Physician Survey interviews physicians in the 60 CTS sites and a supplemental national sample of physicians. RWJF has built a network of research organizations that are studying various facets of the changing health care system, some of which are simultaneously examining the CTS communities. Stephen H. Long and M. Susan Marquis at RAND conducted an employer survey (Robert Wood Johnson Foundation Employer Health Insurance Survey [Community Tracking Study and State Initiatives in Health Care Reform Program], 1997) with a special emphasis on the 60 CTS sites. At UCLA and RAND, Kenneth B. Wells, Audrey Burman, and Roland Sturm are examining how public policies and markets are affecting access to substance abuse and mental health services. Their survey, National Survey of Alcohol, Drug, and Mental Health Problems [Healthcare for Communities], 1997-1998, reinterviewed some 9,600 respondents from the CTS Household Survey about their health and daily activities, use of alcohol, illicit drugs, and medications, health insurance coverage and coverage for mental health, plus access to, utilization, and quality of behavioral health care.