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Introduction to Health Services Research : A Self-Study Course

Module 2: Brief History of Health Services Research (Page 40 of 40)

Key Projects and Milestones in Health Services Research

Overview

Below are listed key projects, issues, and milestones in health services research during this century. This list is augmented with events and milestones that may not be discussed in the history section but which are nevertheless important events. These are included for your interest.

By examining this timeline, you can view the progression of key events in health services research and be able to put them into a time frame. This list accompanies the section on history and is offered in a condensed format.

Additional resources for many of the items listed in this list of key events can be found in the Enrichment section of this module.

Following this module in a separate section are listed some of the key players and resources in health services research. If you want additional information, click on the (What Is?), (History), (Players) or (Search) links after an entry.

Pre 1900s | 1900-1930s | 1940s | 1950s | 1960s |
1970s | 1980s | 1990s | 2000s

Pre 1900sTimeline of Key Projects, Issues and Milestones in Health Services Research
1798

Public Health Service created to provide for the care and relief of sick and injured merchant seamen. (History)

1683

William Petty, 1623-1687, a physician and economist in seventeenth century England, attempted to apply quantitative reasoning to assess the benefits of physician practice and hospital care. (History)

1828

The Boston Medical and Surgical Journal [Journal] is first published by the Massachusetts Medical Society. It eventually becomes the well-known New England Journal of Medicine in 1928. (Search)

1837

William Farr, collected statistical data on mortality, morbidity and disability. (History)

1858

Florence Nightingale began work with Farr on a uniform reporting system for London hospitals and publishes Notes on Matters Affecting the Health of the British Army. (History)

1872

American Public Health Association founded. (History)

1876

American Medical College Association formed. The American Medical College Association (later the Association of American Medical Colleges, AAMC) is organized. (Players)

1883

The first issue of the Journal of the American Medical Association appeared. (Search)

1887

The Laboratory of Hygiene, predecessor to the National Institutes of Health, was established. (Players)

1889

The Marine Hospital Service was given quarantine responsibilities by the U.S. Congress.

1892

American Psychological Association is established.

1898

Medical Library Association founded.

1899

Association of Hospital Superintendents is founded. It is the predecessor organization of the American Hospital Association (AHA).


1900s-1930sTimeline of Key Projects, Issues and Milestones in Health Services Research

1902

Marine Hospital Service Reorganized into the U.S. Public Health and Marine Hospital Service

1905

Milbank Memorial Fund is established.

1908

Hull House Birth Survey conducted to examine the role of midwives in birth outcomes. (History)

1909

First White House Conference on Children held.

Report on National Vitality (History)

1910

Flexner Report published. Its title is: Medical Education in the United States and Canada. (History)

1912

Public Health Service reorganized into the U.S. Public Health Service, with added responsibility for research beyond communicable diseases.

1914

E.A. Codman, M.D. monitored surgical outcomes. (History)

1918

The Commonwealth Fund, a philanthropic foundation established in 1918 by Anna M. Harkness, has the broad charge to enhance the common good. (History) (Players) (Case 1)

1919
AMA's Hospital Survey and State Boards of Health survey conducted. (History)

1921

Sheppard Towner Act passed.

After WWI the Public Health Service transferred the responsibility for the care of all returning veterans to the Veterans Bureau in 1921.

1923

Milbank Quarterly [journal] published its first issue under the title: Milbank Memorial Fund Quarterly Bulletin.

1925

Edgar Sydenstricker studied the incidence of illness in Maryland (History)

Alice Hamilton, documented workplace hazards and published Industrial Poisons in the United States. (History)

1927

Committee on the Costs of Medical Care (CCMC) established in 1927 and published numerous reports on health services costs and distribution. (History)

1928

The Boston Medical and Surgical Journal becomes the well-known New England Journal of Medicine [Journal]. (Search)

1929

The start of the Great Depression. The Depression of 1929 lasted until 1942 and was the spur for social reform in health care. (History)

early 1930s

A time of social unrest and militancy characterized by union and communist organizing drives, strikes, and the Bonus Marches of unemployed WWI veterans. (History)

1930

Duke University established the first program in the U.S. to train hospital administrators.

The Kellogg Foundation begins funding research and books on various aspects of the health care system

Ransdell Act (P.L. 71-251) transforms the Hygienic Laboratory into the first National Institute of Health, later the National Institutes of Health. (Players)

The Veterans Affairs Consolidation Act creates the Veterans Administration.

1932

Committee on the Costs of Medical Care publishes the landmark book titled, Medical Care for the American People. (History)

1933

American College of Hospital Administrators Is founded. It is the precursor to the American College of Healthcare Executives (ACHE).

Blue Cross Plan Organized in Newark, New Jersey. This , the first Blue Cross plan covering hospital services, is organized by the Hospital Association of Newark, New Jersey

1935

Social Security Act passed into law. (History)

First National Health (Interview) Survey. (History)

Department of Labor, Division of Cost of Living surveys (History)

1936

Robert Wood Johnson Foundation created to improve the health and health care of all Americans. (Players)

Walsh-Healy Act (P.L. 74-846) passed. This act authorizes federal regulation of industrial safety in companies doing business with the government

1937

AHA establishes Committee on Hospital Service. It is established to assist community efforts in forming hospital insurance plans. This later becomes the Blue Cross Commission.

1938

J. Allison Glover documented variations in tonsillectomy rates in England (History)


1940sTimeline of Key Projects, Issues and Milestones in Health Services Research

1943

Committee on Medicine and the Changing Order (New York Academy of Medicine) made a intensive study of medical care in the United States. (History)

Alice Hamilton publishes Exploring the Dangerous Trades (History)

mid-1940s

Commonwealth Fund publishes monographs reflecting the evolving concept of health services research. The work was done by the Committee on Medicine and the Changing Order. (History)

1944

Commission on Hospital Care (AHA) created to survey hospital needs. (History)

Hospital Research and Educational Trust (AHA) founded.

Public Health Service Act (P.L. 78-410) passed. This Act codifies all accumulated federal public health laws into a single statute.

Public Health Economics and Medical Care Abstracts was published by the Bureau of Public Health Economics, Univ. of Michigan this year. This journal eventually became Medical Care Review (1967) and later on Medical Care Research and Review (1995). (Search)

1945

Permanente Foundation in California was an early HMO. (History)

1946

Hill-Burton Act for hospital construction passed with big impacts on hospital and bed numbers and availability of care. (History)

National Mental Health Act passed. (History)

National Health Service Act enacted. (History)

1947

Health Insurance Plan of Greater New York (HIP). (History)

1948

World Health Organization (WHO) established. (History)

Pew Charitable Trusts established as the Pew Memorial Foundation. It later changed its name. (Players)

The Karnofsky Performance Status Scale (Karnofsky Scale) introduced to measure cancer patients'outcomes (History)

1949

Harry Truman tried to make enactment of National Health Insurance a major goal of his administration.


1950sTimeline of Key Projects, Issues and Milestones in Health Services Research

1950

A. Donabedian, M.D. conceptualized medical care as structure, process, and outcomes. (History)

National Technical Information Service (NTIS) established. (Search)

1951

The Joint Commission, a private, nonprofit organization dedicated to improving the quality of care in organized healthcare settings, is formed. (Players)

early 1950s

Physician and allied health practitioner supply studied (History)

1953

Department of Health, Education, and Welfare (DHEW) established in 1953 (later to become Department of Health and Human Services) (History)

1954

Presidential Commission on Health Needs report titled, Building America's Health, released. It reports a shortage of physicians and considers training of more physicians necessary.

The Polio vaccine developed by Salk is widely distributed (History)

1954-1955

Commission on Financing Hospital Care created.

1955

Hill-Burton Act expanded to research in hospital operation/administration. (History)

NIH Nursing Research study section established. (History)

The Public Health Service became fully responsible for the health of American Indians in 1955. PHS transferred all Indian health programs of the Bureau of Indian Affairs to the PHS's Indian Health Service. (History)

ECRI, then known as the Graduate Pain Research Foundation began operation. (Players)

1956

Health Insurance Association of America is established.

Health Research Act (History)

National Health Survey Act (P.L. 84-652) Passed. This act provides for data collection, research, and statistical analysis on health needs (including special sickness and disability studies) by the Public Health Service. Created the National Center for Health Statistics. (Players)

1957

Jeremy N. Morris publishes the Uses of Epidemiology, important for future work in chronic disease epidemiology. (History)

late 1950s

Civil rights and anti-poverty movements raised important health issues. (History)

1959

Association of Schools of Public Health formed. It accredits Schools of Public Health.


1960sTimeline of Key Projects, Issues and Milestones in Health Services Research

early 1960s

Civil rights and anti-poverty movements - late 1950s and early 1960s (History)

1960

NIH Health Services Research Study Section established in 1960 (History)

National Center for Health Statistics (NCHS) established through a merger of the National Office of Vital Statistics and the National Health Survey in 1960. (History) (Players)

early 1960s

Issues of the medically underserved, quality of care, medical technology, the role of physician assistants and nurse practitioners studied (History)

Lester Breslow, M.D. developed the “Seven Healthy Habits” as a result of research studies in Alameda County, California. (History)

1961

White House Conference on Aging issues its report, The Nation and Its Older People: Report of the White House Conference on Aging. It is concerned with the provision of medical care to the elderly.

1963

Inquiry [Journal]. The first issue of this key health services journal is published by Blue Cross Association. (Search)

Medical Care [journal]. This key health services research journal appeared this year. (Search)

Anti-measles vaccine was developed this year (History)

1964

Medical Care Research, a symposium organized by Kerr L. White was held this year (History)

Civil Rights Act of 1964 passed.

Economic Opportunity Act. The Act provided funding for three neighborhood health centers in Boston, New York City & Denver; five others funded in 1965; the 1966 amendment provided $50 million to develop Comprehensive Health Service Projects in urban and rural areas of poverty and inadequate health service.

Kaiser Permanente Center for Health Research was established to do health services research at the Kaiser HMO.

1965

Medicare and Medicaid bills passed in 1965 (History)

mid 1960s

American Statistical Association creates a Section on Medical Sociology. (History)

1966

Health Services Research journal started in 1966 (History) (Search)

Comprehensive Health Planning & Services Act passed in 1966 (History)

Neighborhood health centers supported by the Office of Economic Opportunity (OEO) (History)

1967

First human heart transplant.

Medical Care Review [journal] continues Public Health Economics and Medical Care Abstracts. MCR provides the health services research community with seminal articles in the field. (Search)

Social Science and Medicine began publication this year. (Search)

Social Security Act Amendments (P.L. 90-248) passed. This Act mandates studies, experiments, and demonstrations of alternative reimbursement systems to control rising health care expenditures; creates the intermediate care facility and establishes educational requirements for long-term care administrators.

1968

National Center for Health Services Research and Development (NCHSR&D) established by Executive Order in 1968. (History)

Milbank Memorial Fund Quarterly's special issue on health services research published. (History)

Funding for Health Services Research Centers.

Urban Institute created by President Johnson in 1968 to examine American cities and urban populations. (History)

1969

Age Discrimination Act passed. It prevented employers from terminating employees at age 65.

Association of Academic Health Centers established.

The Hastings Center, a center for the study of ethics, is established.

Norman M. Bradburn, Ph.D. produced a measure of psychological well-being that was outlined in a book titled, The Structure of Psychological Well-Being in 1969. (History)


1970sTimeline of Key Projects, Issues and Milestones in Health Services Research

1970

The Institute of Medicine was established in 1970 to examine policy issues that affect the health of the public (History) (Players)

Healthcare Financial Management [Journal] appears.

International Journal of Health Services [Journal] appears. (Search)

Occupational Safety and Health Act of 1970 (P.L. 91-596) passed. This piece of major legislation is intended to implement safety and health in the workplace.

Medical Association. Center for Health Policy Research formed.

National Clearinghouse for Drug Abuse Information. was established to provide information on drug-related subjects. It became the National Clearinghouse for Alcohol and Drug Information in 1987 when it merged with the National Clearinghouse for Alcohol Information.

1971

Rand Health Insurance Experiment begun in 1971 and completed in 1982. (History)

International Journal of Health Services published its first issue. (Search)

Comprehensive Health Manpower Act of 1971 (PL 92-157) passed.

Department of Health and Human Services, Policy Information Center established.

early 1970s

Neighborhood health centers were transferred to the PHS's jurisdiction in the early 1970s and were renamed community health centers. (History)

The influence and impact of the NCHSR&D declined following loses in political favor and budget support in the early 1970s. (History)

The Emergency Care Research Institute dropped its full name and adopted the acronym ECRI. (Players)

1972

Security Amendments (P.L. 92-596) passed. This was the largest set of Social Security amendments in U.S. history. They added 1.7 million disabled to Medicare eligibility and expanded eligibility to include anyone with end-stage renal disease. Professional Standards Review Organizations (PSROs) were created to review medical necessity, quality of care, and cost of Medicare and Medicaid services over the objections of physicians. The amendments relate health financing to health planning.

1973

Veterans Administration established a Health Services Research and Development Field Program office in 1973 began doing research under this name (History) (Players)

Activities of Daily Living (ADL) scale developed by Solomon Katz. (History)

Office of Health Maintenance Organizations created by the Health Maintenance Organization Act (P.L. 92-222). The Office was open until 1982.

Older Americans Act passed. This Act establishes the National Clearinghouse for Information on Aging and creates the Federal Council on Aging; grant money made available for training and research in the field of aging.

Surveillance, Epidemiology, and End Results Program (SEER), National Cancer Institute established. SEER maintains computerized data on cancer incidence, mortality, and survival for about 14 percent of the U.S. population.

1974

National Center for Health Services Research (NCHSR) established by Congress in 1974 (NCHSR&D). (History)

Topics in Health Care Financing [Journal] started publication in 1974. It later changed its name to Journal of Health Care Finance. (Search)

Economic crisis that started this year made health care cost containment a priority. (History)

Employee Retirement Income Security Act (ERISA) passed. This Act authorized extensive federal control over employee benefits, pre-empting state regulatory schemes. Health benefits included within scope of legislation encouraged employers to become self-insured

National Institute on Aging established by PL 93-523, Research in Aging Act. It establishes the National Institute on Aging within the National Institutes of Health, to conduct and support biomedical, social, and behavioral research and training related to aging processes and the diseases of older people.

National Research Act (P.L. 93-348) passed. P.L. 93-348 mandates that institutional review boards be used to protect the human subjects of biomedical and behavioral research.

Office of Technology Assessment (OTA) established.

Privacy Act of 1974 (P.L. 93-579) passed. Federal hospitals and agencies must get written consent from patients before releasing personal information. Patients are also allowed to inspect and correct their medical files.

1975

Cancer Information Clearinghouse established.

1976

Sickness Impact Profile (SIP) by Bergner, et al. (History)

Journal of Health Politics, Policy and Law. This key health services journal published its first issue this year. (Search)

Health Care Management Review [Journal] appeared.

Hospital and Health Services Administration [Journal].

National Consumer Health Information and Health Promotion Act (PL 94-317) set out national goals for health promotion and health education.

1977

Health Care Financing Administration (HCFA) (now CMS) created this year. Medicare and Medicaid are transferred into the Health Care Financing Administration (History)

1978

Journal of Ambulatory Care Management [Journal] first appeared. (Search)

Social Science and Medicine split into several related publications this year. (Search)

National Hospice Organization (NHO) established.

1979

L. Breslow, M.D. provided scales to measure physical, mental, and social well-being to correspond to WHO's definition of health ("a state of complete physical and social well-being...") (History)

National Committee for Quality Assurance (NCQA) established this year to make health plans accountable for the quality of their care and services. (Players)

GMENAC Report issued. This big study looked at the need for more physicians.

Health Care Financing Review. [Journal] This journal began publishing in 1979 and has been consistent in its printing of useful statistical information and articles. (Search)

Joint Commission on Accreditation of Hospitals Develops a New Quality Assurance Standard for Hospitals.

National Health Information Center established to identify health information resources and provide an information and referral system for the public and for health professionals.

The Surgeon General of the United States issues his report titled, "Healthy People".

IOM published, "Health Services Research: Report of a Study" in 1979. (What Is?)


1980sTimeline of Key Projects, Issues and Milestones in Health Services Research

1980

The Department of Health, Education and Welfare became the Department of Health and Human Services on May 4, 1980. The Department of Education is split off from Department of Health Education and Welfare and the remaining agency is renamed the Department of Health and Human Services (DHHS). (History)

Journal of Public Health Policy [Journal] appears this year.

Center for Disease Control is renamed Centers for Disease Control and Prevention and is reorganized.

Department of Health and Human Services issues its report titled, "Promoting Health/Preventing Disease: Objectives for the Nation".

Smallpox eradicated. One of the great infectious diseases is defeated.

Reconciliation Act of 1980 (PL 96-499) passed. The Medicare and Medicaid amendments are significant and include: changes in utilization review requirements, coverage of nurse-midwives services; Medicaid fraud control units funding increased

1981

Association for Health Services Research established. (History) (Players)

Foundation for Health Services Research established. This is the education arm of the Association for Health Services Research.

Health Affairs [Journal] published under the editorship of Arnold Relman, former editor of the New England Journal of Medicine. (Search)

Advances in Health Economics and Health Services Research. [Journal].

Omnibus Budget Reconciliation Act (OBRA). (P.L. 97-35) passed. Omnibus Budget Reconciliation Act (OBRA) mandated significant reductions in funding for virtually all federal health programs; scope of PSRO federal certificate of need program, and all other federal regulatory efforts reduced. It imposed cuts on Medicare and Medicaid and introduces changes in Medicaid to encourage competition and efficiency in health care.

1982

Social Science and Medicine returned to one publication this year from a series of split titles. (Search)

Paul Starr published The Social Transformation of American Medicine. The book offers one of the best descriptions of the American Health Care system.

Tax Equity and Fiscal Responsibility Act (TEFRA) (P.L. 97-248) passed. Tax Equity and Fiscal Responsibility Act (TEFRA) mandated further reductions in many federal health programs; required DHHS to develop plan for prospective reimbursement of hospitals; authorized Medicare reimbursement for hospice services.

Health Resources and Services Administration formed. HRSA is formed as a result of the merger of the Health Resources Administration and the Health Services Administration.

1983

Prospective payment system established for Medicare recipients. (History)

The President's Commission for the Study of Ethical and Legal Problems in Medicine and Biomedical and Behavioral Research report is released.

Prospective Payment Assessment Commission (ProPAC).

Established by Congress under the Social Security Act Amendments of 1983 (PL 98-21) to serve as an advisory body to Congress and to the Secretary of Health and Human Services. Conducts research and develops recommendations

Health Care Strategic Management [Journal].

Utilization review committees established in hospitals

1984

Frontiers of Health Services Management [journal] published its first issue. (Search)

Quality of Well-Being Scale (QWB) developed by Robert M. Katz. (History)

Deficit Reduction Act (DEFRA) passed. This act adds the Child Health Assurance Program to Medicaid.

Frontiers of Health Services Management [Journal] published for the first time.

1985

Avedis Donabedian publishes Explorations in Quality Assessment and Monitoring in 1985 (History)

International Society of Technology Assessment in Health Care (ISTAHC) was organized in 1985 to encourage research, education, cooperation, and the exchange of information. In 2003 it became the Health Technology Assessment International (HTAi). (Players)

International Journal of Technology Assessment in Health Care. [Journal] appeared this year. (Search)

Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985. (P.L. 99-272) enacted. COBRA provides for a number of Medicare and Medicaid reforms and enables discharged workers to purchase individual insurance policies at group insurance rates. This is in response to the increasing cost of health insurance.

International Journal of Health Planning and Management. [Journal] appears.

Mausner and Kramer wrote Epidemiology, an introductory text in 1985 for those entering the field. (History)

1986

National Association of Health Data Organizations (NAHDO) was established to "improve health and health systems through publicly available health information". (Players)

Milbank Memorial Fund Quarterly. Health and Society changed its name to The Milbank Quarterly. (Search)

Health Care Quality Improvement Act (P.L. 99-660) passed. P.L. 99-660 authorizes the creation of a National Practitioner Data Bank, a medical malpractice data bank.

Physician Payment Review Commission (PPRC) created. Congress created the Physician Payment Review Commission to advise it on reforms of the methods used to pay physicians under the Medicare program. PPRC has conducted analyses of physician payment issues, provided a forum for groups representing beneficiaries, physicians and other interests to present their views, and worked closely with the Congress to reshape Medicare policy. They issued their first report to Congress in 1989

Sixth Omnibus Budget Reconciliation Act (SOBRA) enacted. The Sixth Omnibus Budget Reconciliation Act (SOBRA) and the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1986 included a variety of changes in Medicaid and Medicare.

1987

The former Joint Commission on Accreditation of Hospitals (JCAH) changes its name to Joint Commission on Accreditation of Health Care Organizations (JCAHO). (History)

Health Care Financing Review [Journal] appeared. (Search)

Budget Reconciliation Act (OBRA) (P.L. 100-203) passed. The Omnibus Budget Reconciliation Act (OBRA) scheduled major reductions in federal spending including $6 billion (over two years) in Medicare spending reductions and encouraged home and community‑based care provision to elderly.

Medicare and Medicaid Patient and Program Protection Act (P.L. 100-93) passed. This Act authorizes a major expansion of government authority to sanction Medicare and Medicaid providers who are found to have engaged in fraud and abuse activities

Clearinghouse for Alcohol and Drug Information created.

1988

Institute of Medicine issues its report called, The Future of Public Health. This report cites the failures of the public health system in the United States and leads to change in public health.

Medicare Catastophic Coverage Act of 1988 (MCCA) (P.L. 100-360) enacted. It eliminated most cost-sharing requirements for Part A and added coverage for prescription drugs and a few other services. MCCA also required states to buy Part B for eligible Medicaid recipients and to expand coverage for pregnant women.

The 1973 HMO Act is rewritten to allow experience rating by HMOs and to allow employers to contribute less to HMO plans than to indemnity options.

1989

Omnibus Budget Reconciliation Act of 1989 (OBRA 1989) (PL 101-239). The Act included: authorization for resource-based, relative value scale (RBRVS) reimbursement of physicians under Part B of Medicare (to be fully implemented by 1996); limits on charges by all physicians to Medicare patients to more than 115% of Medicare payment and a ban on "balance billing" to all indigent Medicare patients among other provisions.

AHCPR established by Congress in 1989 under The Omnibus Budget Reconciliation Act of 1989 (P.L. 101–239) (formerly, NCHSR). (History)

AHCPR sets up the Web-based National Guideline Clearninghouse during this year (History)

Clinical Practice Guidelines initiative supported by AHCPR. (History)

Quality Assurance in Health Care [Journal], later to become International Journal for Quality in Health Care, published its first issue. (Search)

The 1988 Catastrophic Coverage Act is repealed by Congress. The repeal reinstated Medicare's part A deductible and copayment for elderly patients and eliminated unlimited inpatient hospital coverage.

International Journal for Quality in Health Care. [Journal]

U.S. Bipartisan Commission on Comprehensive Health Care (the Pepper Commission) does its work.


1990sTimeline of Key Projects, Issues and Milestones in Health Services Research

1990

Americans with Disabilities Act of 1990. The ADA is passed by Congress in 1990 to prevent discrimination against people with handicaps.

National Practitioner Data Bank. The first data is entered into the database in September 1990. The aim of the databank is to collect information about malpractice payments, licensure disciplinary actions, clinical privileging restrictions by hospitals and other health care entities, and professional membership restrictions.

Omnibus Budget Reconciliation Act of 1990 (OBRA 1990) passed. It scheduled reductions in Medicare spending.

Patient Self-Determination Act of 1990 passed. Part of the Omnibus Budget Reconciliation Act of 1990, this law required that by December 1, 1991 health care facilities receiving Medicaid or Medicare payments must provide adult patients with written information about their rights under state statutes or common law to make decisions concerning medical care.

1991

Patient Outcomes Research Teams (PORTs) initiative at AHCPR. (History)

NCQA began accrediting managed care organizations (MCOs) in response to mounting criticism of the care provided. (History)

Health Services Research: Key to Health Policy published.

IOM Report issued: Improving information services for health services researchers: a report to the National Library of Medicine, 1991.

Kaiser Commission on the Future of Medicaid created.

1992

John E. Ware developed the SF-36 scale, a health status assessment tool. (History)

SAMHSA was established by Congress on October 1, 1992 to strengthen the nation's health care delivery system for prevention and treatment services for substance abuse and mental illnesses. (Players)

1993

The 1993 NIH Revitalization Act created a National Information Center on Health Services Research and Health Care Technology (NICHSR) at the National Library of Medicine." (History) (Players)

Family Medical and Leave Act passed. Employers of more than five persons are required to allow eligible employees up to twelve weeks of leave during any twelve-month period for personal illness, birth, adoption, or illness of a spouse, child, or parent. Employers are required to continue to provide the same health insurance during this time.

President Clinton promoted access to health for all in the Health Security Plan of 1993. (History)

mid 1990s

Health care reform issues debated in Congress (History)

Managed care arrangements flourished (History)

Congress launched massive cutbacks in federal health programs, threatening AHCPR; Medicaid; Medicare; health, safety, and environmental regulations; and other public health and research agencies

1994

International Journal for Quality in Health Care, renamed from Quality Assurance in Health Care. (Search)

Topics in Health Care Financing [Journal] was renamed Journal of Health Care Finance (Search)

1995

Senators Kennedy and Kassebaum successfully introduced the Health Insurance Reform Act of 1995 to prohibit insurers from canceling people's health insurance when they become sick or excluding people with pre-existing conditions. This Act is called the Health Insurance and Portability Act of 1996. (History)

IOM Report issued: Health services research: work force and educational issues in 1995. (What Is?)

Medical Care Review [Journal] again changes its name to become Medical Care Research and Review. (Search)

Hospital Literature Index changes title to Hospital and Health Administration Index.

1996

L.Shi publishes Health Services Research Methods, one of the first compilations of health services research methods. (History)

J. Wennberg publishes The Dartmouth Atlas of Health Care in the United States. (History)

John E. Wennberg developed the SF-12 scale, a scaled-down version of the SF-36 health status assessment tool. (History)

Journal of Health Services Research and Policy [Journal] was first published this year. (Search)

Health Insurance Portability and Accountability Act of 1996 enacted requiring private insurers to offer group and in some cases individual policies to people who have had prior coverage.

1997

Children's Health Insurance Program (CHIP). (History)

The Medicare Payment Advisory Commission was established in 1997 by the merger of the Physician Payment Review Commission (PPRC) and the Prospective Payment Assessment Commission (ProPAC). (Players)

The Balanced Budget Act of 1997 added new Part C to Medicare and expanded options for enrollment in managed care plans.

1998

Mental Health Parity Act enacted 1996 but came into effect in 1998. (History)

1999

Agency for Healthcare Research and Quality (AHRQ) reauthorized by Congress from AHCPR. (History)

National Guideline Clearinghouse established (History)


2000s (The New Millenium)Timeline of Key Projects, Issues and Milestones in Health Services Research

2000

Academy for Health Services Research and Health Policy (AcademyHealth) created from the merger of Association for Health Services Research (AHSR) and the Alpha Center. (History) (Players)

Health Services and Outcomes Research Methodology [Journal] published its first issue. (Search)

New definition of the term "health services research" developed by Kathleen Lohr and colleagues for the Association for Health Services Research (now AcademyHealth). (What Is?)

The Institute of Medicine published the first of several books on medical errors. The book was titled, To Err Is Human: Building a Safer Health System. (History)

2001

Health Care Financing Administration (HCFA) became the Centers for Medicare & Medicaid Services (CMS). (History) (Players)

The second in the series of books on medical errors from the Institute of Medicine's Committee on Quality of Health Care in America publishes Crossing the Quality Chasm: A New Health System for the 21st Century.

2002

AcademyHealth became the official name of the Academy for Health Services Research and Health Policy. (History)

2003

The Medicare Prescription Drug, Improvement & Modernization Act of 2003 was signed into law by George W. Bush. It provides prescription drug coverage for seniors and individuals with disabilities. (History)

HTAi was officially launched in June 2003. (Players)

2004

Index Medicus ceased as a print publication December 2004

2005

The number of uninsured in the United States reached 46.6 million people according to a Bureau of the Census report titled, Income, Poverty, and Health Insurance Coverage in the United States: 2005.

2006

The number of obese people in the United States continued to rise according to a report from the Trust for America's Health (TFAH) titled, F as in Fat: How Obesity Policies are Failing America, 2006. (History)

In March 2006, JCAHO rebranded itself to become "The Joint Commission." (Players)

2007

Health care again becomes a priority in Congress and among Presidential candidates running for election in November 2008.


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