Changes in Health Care Financing and Organization (HCFO), in operation since 1989, is a national program of the Robert Wood Johnson Foundation (RWJF). It is one of RWJF's main vehicles for funding health services and policy research and the nation's largest source of private funding for investigator-initiated health policy research on financing and organization.

It represents the most significant resource available to researchers to address financing and organization issues related to public programs such as Medicare and Medicaid and is one of the only resources available to examine issues related to the private health care financing market.

HCFO serves as a bridge between the research and policy communities to provide useable and timely information on health care policy and market developments. Policy relevance is a clear funding criterion for projects.

HCFO solicits policy analysis, research, evaluation, and demonstration proposals examining major changes in health care financing and organization with implications for current policy issues.

Key Results to Date
As of February 2008, HCFO encompasses 261 current and completed projects at universities and institutes across the country funded at $75,452,747. Each is directed by a principal investigator working alone or with a project team, including four projects addressing public health systems research.

Some 38 of these projects are current and ongoing, and 223 have completed their work. Approximately 25 projects receive funding each year. These figures do not include funds supporting projects focused on public health or quality.

The HCFO Web site provides access to:

• Recent grant findings.
• Grant findings by topic area.
• Search of research or grants by topic area.
• Publications.

The many studies already funded under HCFO have informed discussion of a wide variety of public policy issues, providing a better understanding of:

• The individual insurance market.
• Physician payment and behavior.
• Consumer-Directed Health Care.

Projects have been initiated within many disciplines, including health services research, economics, sociology, political science, public policy, public health, public administration, law and business administration. See Funded Projects for descriptions of some projects that the program director believes have had a "significant influence on policy and practice."

Program Management
HCFO operates under the direction of a national program office at AcademyHealth, a nonprofit health policy center located in Washington.

One of the hallmark features of the HCFO program is its ability to provide guidance and technical assistance to both applicants and grantees. The program features a rolling application process that permits an opportunity to provide feedback when needed. Once grants are made, HCFO staff at AcademyHealth continues to provide or arrange technical assistance as necessary to ensure the successful completion of the project. This includes:

• Assisting grantees in overcoming obstacles as they arise.
• Working with grantees to encourage them to disseminate findings through peer-reviewed journals that are accessible to policy-makers.

This Report
The report describes the program and the results and findings of a selection of HCFO projects that have been completed starting in 1996; as of June 2008, 49 project reports are linked to this report via the Project List. New reports on projects completing their work are added on a regular basis. Projects that were completed prior to 1996 are not covered in project reports.

Funding
HCFO is an ongoing program of RWJF, most recently authorized for up to $12 million over three years, bringing the total authorization since 1989 to 89.5 million.