RAND Health Research Archive

2014

  • Blog

    RAND Health Reform Opinion Study: Few Changes After Open Enrollment

    Apr 16, 2014

    At the close of the ACA's open enrollment period, no significant changes in opinion were observed in the RAND Health Reform Opinion Study. This may be because open enrollment has no bearing on the health insurance of many people.

  • Blog

    Four Ways to Help Military Caregivers

    Apr 15, 2014

    As momentum continues to build, stakeholders across the board should keep in mind four broad recommendations for how to help military caregivers.

  • Blog

    Improving Physical Health Care for Adults with Serious Mental Illness

    Apr 14, 2014

    A promising strategy for helping adults with serious mental illness gain access to appropriate primary and preventive medical services is to integrate those services into a setting in which the population already receives care.

  • Announcement

    Team Wins Prestigious Translational Science Award for Depression Research

    Apr 9, 2014

    A team of community leaders and researchers from UCLA and RAND was recognized for a decade-long effort to improve depression care in low-income areas. “With community leaders and scientists working together,” said RAND's Kenneth Wells, “we can improve mental and physical health and reduce homelessness, as well as provide relief for those suffering from depression.”

  • Report

    ACA Could Change Costs of Auto, Malpractice, and Other Liability Insurance

    Apr 9, 2014

    As more Americans become newly covered under the Affordable Care Act, the cost of providing automobile insurance, workers compensation, and homeowners insurance may decline. Meanwhile, an increase in the number of people using the health care system may trigger a corresponding increase in the number of medical malpractice claims.

  • Blog

    Survey Estimates Net Gain of 9.3 Million American Adults with Health Insurance

    Apr 8, 2014

    Early survey evidence indicates that the Affordable Care Act has already led to a substantial increase in insurance coverage. Consistent with the ACA's design, this gain in insurance has come not only from new enrollment in the marketplaces, but also from new enrollment in employer coverage and Medicaid.

  • Blog

    Is the ACA Keeping a Lid on Growth in Healthcare Spending?

    Apr 3, 2014

    Some point to the healthcare spending slowdown as an early success of the Affordable Care Act. Others warn that it's merely a hangover from the recession, and that the inevitable spending rebound will be exacerbated by the ACA coverage expansions.

  • Blog

    Military Caregivers Are Hidden Heroes

    Apr 2, 2014

    Right now there are 5.5 million wives, husbands, siblings, parents, children and friends devoted to the care of those injured fighting America's wars. Theirs is an all-consuming, emotionally draining task, one that has been driven for too long by loyalty and love, but little support.

  • Blog

    A World Without America's Military Caregivers

    Mar 31, 2014

    A world without military caregivers would be a harsher one for all, particularly for those who have served. Caregivers' sacrifices improve the lives of wounded, ill, and injured service members and veterans, more of whom would suffer without them.

  • Research Brief

    Support Resources for Military Caregivers

    Mar 31, 2014

    Caregiving can take a lot of time and impose a heavy burden on caregiver health and well-being. But finding and utilizing support resources can help. Support services for military caregivers may provide respite care, financial stipends, health care and mental health care services, and more.

  • Report

    Hidden Heroes: America's Military Caregivers (Executive Summary)

    Mar 31, 2014

    This summary distills a longer report, Hidden Heroes: America's Military Caregivers. It describes the magnitude of military caregiving in the United States, identifies gaps in support services, and offers recommendations.

  • Research Brief

    Supporting Military Caregivers: The Role of Health Providers

    Mar 31, 2014

    Health care providers can support military caregivers in many ways: acknowledge them as part of the health care team, routinely assess caregiving needs and the presence of caregiver support, integrate them into health providers' culture, and adopt appropriate caregiver documentation requirements to facilitate their engagement.

  • Research Brief

    Who Are Military Caregivers? And Who Is Supporting Them?

    Mar 31, 2014

    There are 5.5 million Americans caring for wounded, ill, and injured service members and veterans, providing indispensable services and saving the nation millions in health and long-term care costs. Researchers describe who these caregivers are, the burden they bear, available programs and resources, and areas where they need more support.

  • Research Brief

    Military Caregivers in the Workplace

    Mar 31, 2014

    The business community can support military caregivers in many ways: raise awareness by promoting messages that support military caregivers, offer support services, work with employees to accomodate their caregiver duties, and hire caregivers.

  • Research Brief

    Supporting Military Caregivers: Options for Congress

    Mar 31, 2014

    Congress can support military caregivers in many ways: reconsider eligibility requirements for caregiver support programs, ensure health care coverage for military caregivers, promote the integration and coordination of programs and services, and fully fund the Lifespan Respite Care Act.

  • Report

    Hidden Heroes: America's Military Caregivers

    Mar 31, 2014

    There are 5.5 million military caregivers across the United States, with nearly 20 percent caring for someone who served since the terrorist attacks of Sept. 11, 2001. Military caregivers experience more health problems, face greater strains in family relationships, and have more workplace issues than noncaregivers. Changes are needed to both provide assistance to caregivers and to help them make plans for the future.

  • Report

    Redirecting Innovation in U.S. Health Care: Decreasing Spending, Increasing Value

    Mar 31, 2014

    A novel approach to curbing America's growing health care spending is to change the drugs, devices, and health information technology that get invented in the first place. Realigning incentives for inventors, investors, payers, providers, and patients could yield medical products that reduce spending and improve health.

  • Blog

    Assessing and Addressing Women's Health and Health Care

    Mar 28, 2014

    Women make up a majority of the U.S. population. Yet research policies and practices often treat women's health and health care as special topics or minority issues. The resulting knowledge gaps hamstring efforts to improve women's health care and outcomes even for cardiovascular disease, the leading cause of death among women.

  • Blog

    RAND Health Reform Opinion Study: Attitudes Shift as the ACA's Open Enrollment Draws to a Close

    Mar 27, 2014

    A brighter spotlight on the Affordable Care Act due to its impending open enrollment deadline on March 31 may be further polarizing an already divided populace.

  • Blog

    Restaurant Standards Could Curb Fat America

    Mar 26, 2014

    Given the high prevalence of obesity and chronic diseases and their enormous societal burden, every restaurant, including fast food outlets, should offer healthier meal options and discourage over-consumption.

  • Blog

    Many Americans Are Confused About the Affordable Care Act

    Mar 26, 2014

    In a nationally representative sample of more than 6,000 Americans, researchers found an acute lack of understanding among low-income people regarding finances in general, and health reform and health insurance in particular.

  • Blog

    Spotlight on America's Hidden Heroes: Military Caregivers

    Mar 24, 2014

    Despite military caregivers' vital contributions, little is known about their numbers, the burden of caregiving that they shoulder, or the resources that exist to support them. To shed light on these "hidden heroes," a RAND team conducted the largest, most comprehensive study to date of military caregivers.

  • Blog

    Obesity Epidemic: Standardized Portion Sizes in Restaurants Could Help Solve Public Health Crisis

    Mar 22, 2014

    Ideally, restaurant food should be tailored and sold the way clothing is, so people can get the exact amount that is appropriate for their bodies. Such sizing options should be required in all dining establishments to give people the option of consuming meals that fit.

  • Blog

    RAND Health Reform Opinion Study: Steep Decline in Favorable Opinion

    Mar 19, 2014

    With the end of the ACA's open enrollment period looming on March 31, it is perhaps unsurprising that opinions are again changing in a significant way. The final push to encourage or discourage enrollment may be renewing public attention to the ACA.

  • Project

    The RAND Military Caregivers Study

    Mar 18, 2014

    The RAND Military Caregivers Study focuses on caregivers of wounded, ill, and injured U.S. military servicemembers and veterans.

  • Blog

    Checking the ACA's Vital Signs

    Mar 17, 2014

    Despite pervasive challenges associated with the rollout of the Affordable Care Act (ACA), the administration remains optimistic about its fate. Critics, however, have seized upon the recent mishaps as evidence of the ACA's inevitable demise.

  • News Release

    Improving Continuity of Care for Elderly Patients with Chronic Diseases Cuts Costs and Complications

    Mar 17, 2014

    Among a large group of Medicare patients, even modest improvements in the continuity of care for those with diabetes, congestive heart failure, or emphysema were associated with sizable reductions in use of hospital emergency departments and hospitalizations.

  • Blog

    California's Misguided Approach

    Mar 17, 2014

    Despite the frequency with which people are convicted of multiple DUI offenses, California continues to require that all individuals with a DUI attend a 30- or 60-hour education program. However, these programs aren't that effective.

  • Blog

    RAND Health Reform Opinion Study: Are ACA Opinions Unstable?

    Mar 11, 2014

    For many individuals, opinion is not stable. New information—whether gleaned from the media; interactions with health care providers, insurers, or peers; or some other channel—could lead to further changes in opinion.

  • Blog

    Physicians' Concerns About Electronic Health Records: Implications and Steps Towards Solutions

    Mar 11, 2014

    If practicing physicians are correct, the current state of EHR technology has introduced several impediments to providing patient care, undermining physician professional satisfaction. Many of these problems also should be of great concern to patients.

  • Blog

    Hard Drugs Demand Solid Understanding

    Mar 8, 2014

    Due to budget concerns the federal government just shut down a critical data source that provides insights into abuse, dependence on, and spending on heroin and other hard drugs like crack and methamphetamine.

  • Blog

    Who Does the Affordable Care Act Leave Behind?

    Mar 7, 2014

    Although one of the primary objectives of the ACA is to achieve near-universal health insurance coverage, the Congressional Budget Office projects that 30 million residents, more than 10 percent of the nonelderly population, will remain uninsured after the major provisions of the ACA take full effect.

  • Report

    What America's Users Spend on Illegal Drugs, 2000-2010

    Mar 7, 2014

    Each year, drug users in the United States spend on the order of $100 billion on cocaine, heroin, marijuana, and methamphetamine. This has been stable over the decade, but there have been important shifts. In 2000, users spent much more on cocaine than marijuana; in 2010, the opposite was true.

  • Blog

    RAND Health Reform Opinion Study: Positive Opinion on the ACA Rises

    Mar 5, 2014

    This week, more than 38 percent of respondents reported a favorable opinion of the ACA. This is the highest level of favorable opinion we've seen since we began the RHROS in September.

  • Blog

    Where There's Vapor, Is There Fire? We Need Evidence on E-Cigarettes

    Mar 4, 2014

    Currently, evidence for the safety, harmfulness, utility, and addictiveness of e-cigarettes is lacking. The questions that research needs to answer, however, are clear as day—particularly since business is booming.

  • Report

    Promise of Value-Based Purchasing in Health Care Remains to Be Demonstrated

    Mar 4, 2014

    After a decade of experimentation with reforms that give health providers financial incentives to improve performance, relatively little is known about how to best execute such strategies or judge their success.

  • Blog

    Employer Mandate Delay II: Nothing to See Here

    Mar 3, 2014

    Amid mounting political pressure and angst in the business community, the Obama administration announced an additional delay in enforcing the employer mandate component of the Affordable Care Act for some firms until 2016. The additional delay will have little impact.

  • Blog

    Caring for Cardiovascular Disease and Diabetes, Why Gender Matters

    Feb 27, 2014

    High-quality routine care for both cardiovascular disease and diabetes is at least as relevant to women's health and survival as it is to men's. Yet evidence suggests that women continue to face gaps in even low-cost, routine aspects of care.

  • Blog

    No Insurance Last Year? Then You Might Be Undecided About the ACA

    Feb 27, 2014

    As open enrollment in insurance continues, many of those who were uninsured in 2013 remain uninsured. They may be still learning about how the ACA will affect them.

  • Blog

    Medical Homes Show Limited Quality Improvements, No Cost Reductions

    Feb 27, 2014

    A study suggests that medical home interventions may require further refinements before their full potential can be realized. Evaluations like this can help guide the improvement of the medical home model.

  • Journal Article

    Limited Quality Improvement and No Cost Containment Found in a Medical Home Demonstration

    Feb 25, 2014

    A three-year pilot of a “medical home” model of primary care yielded few improvements in the quality of care and no reductions in hospitalizations, emergency department visits, or total costs of care.

  • Blog

    Quick Takes: Do Workplace Wellness Programs Make Business Sense?

    Feb 20, 2014

    The press and trade publications strongly endorse workplace wellness programs as a good investment for employers. Soeren Mattke, a physician and RAND senior scientist, explains why his work tells a different story.

  • Blog

    Maintaining Health and Well-Being: A Shared Responsibility

    Feb 20, 2014

    Everyone should take the time to ask themselves what they can do to improve their health, and to support the health of friends, families, and communities. When it comes to good health, it takes a community.

  • Blog

    RAND Health Reform Opinion Study: Stability Masks Churn in ACA Opinion

    Feb 18, 2014

    While we see remarkable overall stability in opinion of the Affordable Care Act over time, 10 to 15 percent of respondents continue to change their responses each month.

  • Blog

    Some Tired Myths About Sleeping with Your Valentine, or Not

    Feb 14, 2014

    Two-thirds of U.S. adults report that they regularly sleep with a partner. Yet, through 60 years or so of sleep research, scientists have tended to view sleep as an individual behavior, largely ignoring the potential impact of bedmates.

  • Journal Article

    Economic Burden of Childhood Autism Spectrum Disorders

    Feb 10, 2014

    Compared to their peers, children with autism spectrum disorders have higher annual costs for health care appointments and prescriptions ($3,000 on average) and non-health care costs ($17,000 on average), such as special education at school. Previous analyses underestimated this economic burden, particularly for school systems.

  • Blog

    First Steps on a Long Road: Three Key Findings from ACA's Early Enrollment Numbers

    Feb 7, 2014

    The vision of the ACA was “no wrong door” and an affordable option for everyone, but it appears based on the data available so far that, in the non-Medicaid expansion states, there is a closed door.

  • Blog

    CVS and the Effect of In-Store Tobacco Displays on Smokers

    Feb 6, 2014

    CVS Caremark will stop selling cigarettes and other tobacco products at its CVS/pharmacy stores beginning Oct. 1. Though it stands to lose $2 billion dollars in annual revenue, CVS CEO Larry J. Merlo said that selling tobacco products is at odds with the company's mission of improving health outcomes.

  • Journal Article

    National Efforts to Lower Health Care-Associated Infections Are Having Success

    Feb 6, 2014

    Infections that strike patients are one of the most preventable leading causes of death in the United States. A federally sponsored plan to lower health care-acquired infections was successful in addressing the challenges of prioritizing and coordinating strategies.

  • Blog

    Women's Heart Disease Awareness

    Feb 5, 2014

    Friday is National Wear Red Day, when people are asked to wear red to raise awareness about the health risks women face from heart disease. Too little attention is devoted to preventing heart disease in women and improving the quality and outcomes of their care.

  • Journal Article

    First Assessment of National Telemedicine Service Finds Efforts Appear to Expand Access to Acute Medical Care

    Feb 3, 2014

    People who are younger, more affluent and do not have established health care relationships are more likely to use a telemedicine program that allows patients to get medical help — including prescriptions — by talking to a doctor over the telephone.

  • Report

    Women's Heart Health: Research That Matters

    Jan 31, 2014

    The care that women receive for cardiovascular disease (CVD) lag behind those of men, despite the fact that more women have died from CVD each year for decades. Experts explain CVD within the context of women's health, outlining possible solutions for improving quality of care.

  • Blog

    New Numbers May Suggest a Trend Toward Declining Disapproval of the ACA

    Jan 31, 2014

    For the past four weeks, the percentage of individuals with a favorable opinion of the Affordable Care Act (ACA) has remained stable. However, we are seeing in this week's numbers a decline in unfavorable opinion.

  • Report

    Small Ideas for Saving Big Health Care Dollars

    Jan 30, 2014

    A focused review of recent RAND research identified small ideas that could save the U.S. health care system a total of up to $22 billion per year. These small ideas do not require systemic change, which may make them more feasible to implement and less likely to encounter stiff political and organizational resistance.

  • Blog

    Small Ideas for Saving Big Health Care Dollars (No. 11-14)

    Jan 29, 2014

    Focusing on smaller, more focused approaches can identify less controversial opportunities for modest health care savings.

  • Blog

    State of the Union 2014: President Obama Calls for a Year of Action

    Jan 29, 2014

    Obama called for “a year of action” to achieve his 2014 agenda — from helping people sign up for health insurance, to immigration reform, to completing the mission in Afghanistan. RAND is committed to raising the level of public policy debates and offering evidence-based, actionable solutions.

  • Blog

    U.S. Needs to Improve Community-Based Drug, Alcohol Prevention

    Jan 28, 2014

    As familiar as Americans are with the problems of youth drug and alcohol abuse, we are not identifying all the potential solutions. While observers criticize overemphasis in U.S. policy on enforcement and scant resources devoted to treatment, the focus on these approaches often ignores a key piece of the puzzle: prevention.

  • Blog

    Public Opinion of the Affordable Care Act Appears to Remain Stable

    Jan 23, 2014

    Overall opinion of the ACA continues to be stable with no discernible changes in the rate of favorable opinion since last week. Unfavorable opinion was in line with findings from the last few weeks of December and the first week of January.

  • Blog

    Small Ideas for Saving Big Health Care Dollars (No. 8-10)

    Jan 22, 2014

    Focusing on smaller, more focused approaches can identify less controversial opportunities for modest health care savings.

  • Report

    Plans Allowing People to Keep Health Insurance Will Not Threaten New Insurance Marketplaces

    Jan 21, 2014

    Although three options put forward to help people keep their old health insurance plans all would cause some disruption of the risk pools that are important to the insurance exchanges, none of the changes would be severe enough to threaten their viability.

  • Report

    Mapping Gender Differences in Cardiovascular Disease and Diabetes Care

    Jan 16, 2014

    The cardiovascular and diabetes-related care that women receive—and their relevant health outcomes—both lag behind those of men. This is true even for routine care, such as cholesterol monitoring and control. Awareness of this disparity is limited, in part, because quality of care is not routinely measured and reported by gender.

  • Blog

    Michelle Obama Shouldn't Be the Only One Fighting Obesity

    Jan 16, 2014

    To identify the policies that will make a big fat dent in obesity rates, we first need an accurate diagnosis: Americans are overweight and obese because they are inundated with too much food. The use of impulse marketing strategies has skyrocketed, with invitations to indulge at every turn.

  • Blog

    Digging Deeper Into Public Opinion of the Affordable Care Act

    Jan 15, 2014

    Unfavorable opinion of the ACA has dropped to the lowest point since the opening of the exchanges. Positive opinion has remained stable for the last three weeks.

  • Blog

    A Warm Bed on a Cold Morning: When Waking Up Is Hard to Do

    Jan 15, 2014

    As seductive as a warm bed may be on a cold morning, staying in bed too long can lead to disrupted sleep and a sleep-sapping case of the winter blues. These are the times when we need to resist the urge to hibernate and force ourselves to get going.

  • Blog

    Small Ideas for Saving Big Health Care Dollars (No. 4-7)

    Jan 15, 2014

    Focusing on smaller, more focused approaches can identify less controversial opportunities for modest health care savings.

  • Blog

    The Feds' Role After Legalization

    Jan 14, 2014

    Since Colorado and Washington allow profit-maximizing firms to grow and sell marijuana, there is concern they will use advertising to promote consumption by heavy users. With help from the federal government, the states will be better positioned to head off the negative consequences associated with commercialization.

  • Blog

    RAND Health Reform Opinion Study Update: Opinion 'Churn' Continues to Decline

    Jan 10, 2014

    The significant decline in public opinion 'churn' regarding the Affordable Care Act continues. Those reporting a change in their opinion dropped from 25 percent from September to November, to 15 percent from November to December, and to less than 10 percent from the first week of December to the first week of January.

  • Research Brief

    Do Workplace Wellness Programs Save Employers Money?

    Jan 9, 2014

    Employers and policymakers should not assume that workplace wellness programs will reduce health care costs. Researchers found that while the disease management component of a large program was associated with lower costs, its lifestyle management component was not.

  • Blog

    Ask Me Anything: Deborah Cohen on How to End the Obesity Epidemic

    Jan 8, 2014

    Perhaps the most common New Year's resolution is improving our eating habits. According to Dr. Deborah Cohen, who hosted an “Ask Me Anything” session on Reddit yesterday, that's much easier said than done.

  • Blog

    Support for Implementing Home Visiting Under the Affordable Care Act

    Jan 8, 2014

    One groundbreaking provision of the Affordable Care Act is its funding for home visiting programs that match the parents of young children with trained specialists who provide information, social support, parental skill instruction, and more.

  • Blog

    Small Ideas for Saving Big Health Care Dollars (No. 1-3)

    Jan 8, 2014

    Focusing on smaller, more focused approaches can identify less controversial opportunities for modest health care savings.

  • Blog

    The Conspiracy to Keep You Fat

    Jan 6, 2014

    Just as we needed policies to protect people from having alcohol thrust in their faces everywhere they went, we need to develop and implement policies that protect people from food cues and triggers designed to make them eat when they're not hungry and over-consume.

  • Journal Article

    Workplace Wellness Programs Can Cut Chronic Illness Costs; Savings for Lifestyle Improvements Are Smaller

    Jan 6, 2014

    In a large employee wellness program offered by PepsiCo, efforts to help employees manage chronic illnesses saved $3.78 in health care costs for every $1 invested in the effort. However, the program's lifestyle management components that encourage healthy living did not deliver returns that were higher than the costs.

  • Report

    Developing Effective Prevention Programs and Initiatives for Young People

    Jan 2, 2014

    These e-learning modules show how to strengthen planning, implementation, and evaluation efforts for youth-serving programs and community-based coalitions or initiatives.

2013

  • Blog

    RAND Health Reform Opinion Study Update: Positive Opinion on the ACA Continues to Rise

    Dec 30, 2013

    The latest data from the RAND Health Reform Opinion Study indicates that positive opinion of the ACA continues to increase. The overall favorable rating is now as high as it was in late September, prior to the opening of the health insurance exchanges.

  • Blog

    Five Myths About Obesity

    Dec 27, 2013

    The obesity epidemic is among the most critical health issues facing the United States. Although it has generated a lot of attention and calls for solutions, it also has served up a super-sized portion of myths and misunderstandings.

  • Blog

    RAND Health Reform Opinion Study Update: Positive Opinion on ACA Grows, Negative Opinion Stabilizes

    Dec 23, 2013

    Last week we introduced the RAND Health Reform Opinion Study, a new way to measure public opinion of the Affordable Care Act. Negative opinion about the ACA seems to be stabilizing, while positive opinion is increasing. Those undecided about the ACA are decreasing.

  • Blog

    'Tis the Season to Be Wary

    Dec 23, 2013

    During the holiday season, a time when overindulgence is a tradition for many, food marketing creates especially serious challenges for people trying to limit their intake and make careful decisions about healthier eating.

  • Periodical

    The State of Workplace Wellness Programs in the United States

    Dec 23, 2013

    U.S. workplace wellness programs are prevalent, and most observers expect uptake to grow, especially as the Affordable Care Act will increase employment-based coverage and promotes workplace wellness programs through numerous provisions. But there is currently insufficient evidence to definitively assess their impact on health outcomes and cost.

  • Blog

    A New Way to Measure Public Opinion of Health Reform

    Dec 18, 2013

    Whether the public will begin to settle on an overall positive or negative perception of the Affordable Care Act (ACA) is very much an open question. But understanding how opinion of the law evolves over time could offer valuable insight into Americans' appetite both for the ACA and for health reform more broadly.

  • Report

    Marijuana Consumption in Washington State Twice as Large as Previously Estimated

    Dec 18, 2013

    In Washington state, marijuana consumption likely will range from 135 to 225 metric tons during 2013. Understanding the current market should help state policymakers with decisions about the number of marijuana sales licenses to issue, to project tax revenues, and provide a foundation for assessments of legalization.

  • Project

    The RAND Health Reform Opinion Study

    Dec 16, 2013

    The RAND Health Reform Opinion Study tracks public opinion of the Affordable Care Act by surveying the same people over time. This allows us to observe true changes in public opinion, rather than changes based on who was surveyed randomly.

  • Research Brief

    Will the Affordable Care Act Make Health Care More Affordable?

    Dec 11, 2013

    For most lower-income people who obtain coverage as a result of the Affordable Care Act, health care spending will fall. But spending by some newly insured higher-income people will increase because they will be now paying insurance premiums.

  • Blog

    Deadly Aftermath of 'Microsleep'

    Dec 11, 2013

    Though “microsleep,” commonly referred to as “highway hypnosis,” may enter the public discourse most often when it's cited as the possible cause of a disaster like the Metro-North train wreck, it is responsible for fatal accidents on American highways every day.

  • Report

    Central Nervous System Diseases Are Becoming “Neglected” Diseases

    Dec 11, 2013

    Market forces are stacking the deck against development of drugs for common central nervous system disorders, such as Alzheimer's, schizophrenia, and depression. But policy changes could steer investment into drugs for these neglected diseases by reducing development cost and uncertainty and increasing expected revenue.

  • Blog

    Is There Really a Physician Shortage?

    Dec 5, 2013

    Large coverage expansions under the ACA have reignited concerns about physician shortages. These estimates result from models that forecast future supply and demand for physicians based on past trends and current practice. While useful exercises, they do not necessarily imply that intervening to boost physician supply would be worth the investment.

  • Research Brief

    How to Develop Home Visiting Programs

    Dec 4, 2013

    Home visiting has achieved prominence on the national policy agenda because of the long-lasting positive outcomes. But how can stakeholders best plan, implement, and evaluate home visiting programs?

  • Blog

    How to Sleep in Heavenly Peace This Holiday Season

    Nov 29, 2013

    The holiday season is a time when people try to do too much. And that often leads to stress and worry, which can be the enemies of a good night's sleep. Here are a few tricks to help manage the episodic bouts of insomnia that are common during the holidays.

  • Research Brief

    New Approaches for Delivering Primary Care Could Reduce Predicted Physician Shortage

    Nov 27, 2013

    Growth of patient-centered medical homes and nurse-managed health centers could halve projected U.S. physician shortages by 2025—without training a single additional physician.

  • Periodical

    Ramifications of Health Reform

    Nov 26, 2013

    2014 will be an important year for the Patient Protection and Affordable Care Act. Health insurance exchanges will offer people new ways to buy insurance. Medicaid will expand in many states. And people without “minimum essential coverage” may have to pay a fee.

  • Blog

    The FDA Ban on Trans Fat Should Be Just the Beginning

    Nov 26, 2013

    Most people lack the information they need to judge or track the quantity and quality of the nutrients they consume. The FDA should take a disease prevention approach — as it is currently doing with trans fat — in promoting standards that address how all foods are prepared and served away from home.

  • Blog

    Quick Takes: The Convenience Revolution in the Treatment of Minor Health Problems

    Nov 26, 2013

    Convenient options for treating minor health problems are an important new feature of the health care landscape. Ateev Mehrotra discusses these options and their implications for the medical marketplace.

  • Blog

    Employer-Provided Health Insurance: Why Does It Persist, and Will It Continue after 2014?

    Nov 25, 2013

    As the ACA is implemented, policy makers should be attuned to potential inefficiencies and inequities created by a system with different regulatory and tax rules for small employers, large employers, and individual health plans. Attempts to equalize the playing field may be difficult.

  • Blog

    Here's to Our Health

    Nov 24, 2013

    Atop the new mayor's agenda should be improving the health and well-being of Pittsburgh residents. With an unassailable electoral mandate in hand, Mr. Peduto is positioned to take bold steps. And the best way to do that is by applying scientific and medical evidence to shape an integrated, citywide, health-policy framework.

  • Blog

    Can the Affordable Care Act Help Asthma Sufferers Breathe Easier?

    Nov 20, 2013

    ACA reforms can potentially address barriers that get in the way of individuals with asthma getting the care they need. At the population level, the law has the potential to improve outcomes and efficiency and equity of services for chronic conditions such as asthma for which cost-effective preventive treatments exist.

  • Blog

    Are County Masking Requirements the Future of Influenza Prevention?

    Nov 20, 2013

    If it doesn't seem that state laws as currently written can help increase the number of health care workers vaccinated against influenza, then what can? There is evidence that imposing consequences for vaccination refusal, including the requirement to wear a surgical mask, can help.

  • Blog

    An Inexpensive Prescription for Medicare

    Nov 18, 2013

    If Congress wants to save Medicare, it can start by driving waste and excess out of the system. This can be done without impoverishing patients or driving doctors out of business, if physicians are willing to practice smarter, more efficient medicine. Spending on prescription drugs is a case in point. 

  • Blog

    They Also Serve: Understanding the Needs of Military Caregivers

    Nov 18, 2013

    Military families play a critical role in supporting U.S. servicemembers during deployment and afterwards. Equally vital but often less visible is the role played by those who care for the servicemembers who return with disabling injuries or illnesses and require long-term support beyond what the formal health care system provides.

  • Journal Article

    Influence of Pro-Smoking Media Messages Can Last for Seven Days

    Nov 18, 2013

    College students documented their exposure to pro-smoking media messages during their normal routine over a three-week period. After exposure to just one, their smoking intentions immediately increased by an average of 22 percent. Smoking intentions decreased with each passing day but remained elevated for seven days.

  • Report

    The Hidden Forces Behind the Obesity Epidemic—And How We Can End It

    Nov 18, 2013

    With more than 150 million Americans overweight or obese and an estimated 1.5 billion affected globally, obesity is the world's most pressing public health crisis. In A Big Fat Crisis, RAND's Deborah Cohen unpacks the hidden causes of the obesity epidemic and outlines concrete strategies for defeating it once and for all.

  • Blog

    One Year Later: Hurricane Sandy's Lessons in Resilience and Recovery

    Nov 15, 2013

    The recovery from Sandy shows once again that how well communities bounce back from disasters depends not just on how they react after a crisis, but on how resilient they have made themselves beforehand. Building community resilience should be part and parcel of disaster preparedness.

  • Blog

    Four Questions on Canceled Insurance Policy Fix

    Nov 14, 2013

    David Mastio, Forum editor at USA TODAY, asked RAND's Christine Eibner four questions about President Obama's plan to fix the problem with people getting their insurance canceled.

  • Blog

    The Future of the Health Care Workforce: RAND Researchers Well Represented in Health Affairs Special Issue

    Nov 7, 2013

    In “Redesigning the Health Care Workforce,” a new special issue of the journal Health Affairs, RAND researchers contribute to several timely examinations of challenges, opportunities, and potential solutions relating to the future of health care staffing in the U.S. and abroad.

  • Blog

    Quick Takes: Health Literacy and ACA Enrollment

    Nov 7, 2013

    The Affordable Care Act (ACA) expands coverage to millions of Americans. But the newly eligible may face challenges enrolling if they lack understanding of how the health care system itself works. Laurie Martin explains the role of health literacy in determining how successful the ACA will be in providing coverage for America's uninsured.

  • Tool

    Health Surveys and Tools

    Nov 6, 2013

    Instruments and scoring instructions for many major health services surveys are available from the RAND Health website, as well as practical tools for improving quality of care.

  • Tool

    Interactive Community Health Needs Assessment

    Nov 6, 2013

    This interactive web tool draws attention to specific findings in the community health needs assessment in a format that is user friendly and can help to inform the public.

  • Research Brief

    Road to Resilience: Building Stronger, More Sustainable Communities

    Nov 5, 2013

    This infographic illustrates how communities can become more resilient as they plan ahead for potential disasters.

  • Journal Article

    Foreign-Educated Health Workers Play Vital Role, but Changes May Be Needed to Stabilize U.S. Health Workforce

    Nov 4, 2013

    Foreign-educated and foreign-born health professionals fill important gaps in the U.S. health care workforce, but strategic shifts such as changes in immigration laws may be needed to stabilize the nation's health workforce.

  • Journal Article

    New Models of Primary Care Could Ease U.S. Physician Shortage

    Nov 4, 2013

    Much of the shortage of primary care physicians expected over the next decade could be eliminated if the nation increases use of new models of medical care that expand the role of nurse practitioners and physician assistants.

  • Journal Article

    Junk Food Intake in Friendship Networks

    Nov 1, 2013

    Half of adolescents' junk food consumption happens outside the home—and often among peers. Social network analysis shows that when it comes to eating junk food, adolescents follow their friends' lead.

  • Testimony

    Suicide Prevention in California: Strategies from Science

    Oct 30, 2013

    In this testimony before the California State Senate, Rajeev Ramchand discusses effective strategies for preventing suicide, the tenth leading cause of death in the state.

  • Blog

    Group Motivational Interviewing Can Help Teens Make Healthy Choices

    Oct 29, 2013

    Group motivational interviewing is a guided therapeutic approach that helps people think about their motivations for behavior and their commitment to change. It is an excellent fit for adolescents, because it engages them about their personal experiences while eliciting ideas about how they can change and make healthy choices.

  • Project

    Group Motivational Interviewing for Teens

    Oct 28, 2013

    Group MI for Teens provides guidance on facilitating motivational interviewing (MI) interventions to groups of adolescents, helping them make healthy choices regarding alcohol and drug use.

  • Blog

    Mark Schuster Elected to the Institute of Medicine

    Oct 25, 2013

    Dr. Mark Schuster has been elected to the Institute of Medicine. He is an adjunct researcher at RAND and the William Berenberg Professor of Pediatrics at Harvard Medical School and Chief of General Pediatrics and Vice Chair for Health Policy in the Department of Medicine at Boston Children's Hospital.

  • Journal Article

    Treating Co-Occurring Depression and Substance Use Disorder

    Oct 24, 2013

    Providing on-site group cognitive behavior therapy to those receiving residential substance abuse treatment is a cost-effective way to treat depression.

  • Journal Article

    Benefits of Slowing the Aging Process

    Oct 23, 2013

    Most medical research focuses on fighting individual disease. But delayed aging could boost life expectancy by more than two years and yield more than $7 trillion over 50 years. Greater investment in research to delay aging could be a very efficient way to prevent disease, improve public health, and extend healthy life.

  • Journal Article

    U.S. Chain Restaurants and Nutrition: One Step Forward, Two Steps Back

    Oct 22, 2013

    Restaurants make changes to their menus regularly, but they may make both healthy and unhealthy changes simultaneously. Overall, there were no meaningful changes in average energy or sodium content in main entrées from top U.S. restaurant chains between 2010 and 2011.

  • Announcement

    RAND Launches Initiative to Study Drug Discount Program

    Oct 21, 2013

    The RAND Corporation is launching a new research initiative to provide objective and nonpartisan analysis about the impact and future of the 340B program, a major federal program that gives safety net hospitals and other health care providers access to discounted outpatient medications.

  • Blog

    Quick Takes: The Math of Medicaid Expansion

    Oct 21, 2013

    Expanding Medicaid under the Affordable Care Act (ACA) is both contentious and complicated. RAND mathematician Carter Price has been using the COMPARE model to help those making decisions understand what their choices mean for their budgets and population health.

  • Blog

    Has U.S. Gone Further Than Netherlands Over Marijuana?

    Oct 18, 2013

    Colorado and Washington will remove the prohibition on commercial marijuana production and distribution for nonmedical purposes and start regulating and taxing it. Not even the Netherlands goes that far, writes Beau Kilmer.

  • Blog

    What's in a Name? Calling Obesity a Disease Could Help Improve Chronic Disease Outcomes

    Oct 16, 2013

    The American Medical Association officially designated obesity as a disease, hoping to help change the way doctors approach the issue with their patients, increase funding for research on effective treatments, spur insurers to cover prescription weight loss medications, and maybe even help de-stigmatize the condition.

  • Research Brief

    Factors Affecting Physician Professional Satisfaction

    Oct 11, 2013

    While numerous factors contribute to physician professional satisfaction, their perceptions about quality of care and the state of electronic health record technology are the most important.

  • Journal Article

    Middle Schoolers Overestimate How Many of Their Peers Drink, Smoke, and Use

    Oct 10, 2013

    Adolescents' perceptions of peer substance use grow significantly during their middle school years. These can affect current and future use. Early interventions that limit this influential factor may be appropriate during this developmental period.

  • Report

    Quality of Patient Care Drives Physician Satisfaction; Doctors Have Concerns About Electronic Health Records

    Oct 9, 2013

    Being able to provide high-quality health care is a primary driver of job satisfaction among physicians, and obstacles to quality patient care are a source of stress for them. For example, the systems for electronic health records in use today are cumbersome to operate and contribute to their dissatisfaction.

  • Journal Article

    Factors Linked to Creation of Accountable Care Organizations Identified

    Oct 7, 2013

    Regions of the United States where doctors and hospitals are consolidated into large networks are more likely to have accountable care organizations, medical practice structures intended to improve medical care and cut costs.

  • Blog

    Medicaid Access for the Formerly Incarcerated Under the ACA: Helping the Oft-Forgotten

    Oct 3, 2013

    America's prison population tends to be sicker than the general population. While Medicaid eligibility under the ACA offers an historic opportunity, enrolling the formerly incarcerated into the health exchanges or Medicaid will be neither simple nor straightforward.

  • Blog

    Removing Road Blocks to Climate Change Adaptation Planning

    Oct 3, 2013

    Despite increasing interest and investments in climate adaptation science, the implementation of adaptation plans through institutional policies or other actions designed to reduce health vulnerabilities has been slow. Institutionalized assumptions are an important roadblock.

  • Blog

    Understanding the Affordable Care Act

    Oct 2, 2013

    One of the chief aims of the Affordable Care Act (ACA) is the expansion of insurance coverage to individuals who at present either cannot afford it or choose not to purchase it. Unfortunately, many Americans lack the financial literacy needed to navigate the numerous and complex options thrust upon them by the ACA.

  • Blog

    Will the Affordable Care Act Make Health Care More Affordable?

    Oct 1, 2013

    Out-of-pocket spending on health care will decrease for both the newly insured as well as for those changing their source of insurance. These decreases will be largest for those who would otherwise be uninsured.

  • Blog

    Ask Me Anything: Carter Price on the Affordable Care Act

    Oct 1, 2013

    As of October 1, many Americans can now shop for health insurance through state exchanges created as part of the Affordable Care Act (ACA)—the sweeping health care reform often referred to as “Obamacare.” To provide some insight into the ACA, RAND's Carter Price hosted an “Ask Me Anything” session on Reddit today.

  • Report

    Affordable Care Act Will Reduce Out-of-Pocket Medical Spending for Many Americans

    Oct 1, 2013

    The Affordable Care Act will have a varied impact on health spending by individuals and families, depending primarily on their income and whether they would have been uninsured in 2016 without the program.

  • Blog

    Will ACA Implementation Lead to a Spike in Demand for Care?

    Sep 26, 2013

    The growing number of Americans newly-insured under the ACA will undoubtedly lead to a surge in demand for care, whether through Medicaid or insurance exchanges. But, if predictions hold, the increase won't be as dramatic as some may fear, writes David I. Auerbach.

  • Report

    Does It Cost More to Train Medical Residents or to Replace Them?

    Sep 26, 2013

    If a hospital has service needs, adding a resident presents a marginal benefit. This is especially true for more-lucrative specialty and subspecialty programs, before considering the additional benefits of any Medicare revenues related to graduate medical education.

  • Tool

    Planning, Implementing, and Evaluating a Home Visiting Program

    Sep 24, 2013

    Home visiting programs can help parents address the struggles of caring for young children by matching them with trained professionals who can support the development of quality parenting skills.

  • Blog

    What to Do About 'Futile' Critical Care

    Sep 13, 2013

    There are times when no amount of care, however cutting-edge it is, will save a patient. In these instances, further critical care is said to be “futile.” This type of treatment is not uncommon in intensive care units, and that raises some uncomfortable questions.

  • Journal Article

    Requiring Vaccinations Among Health Care Personnel

    Sep 11, 2013

    California's influenza immunization requirement for health care personnel was too weak to encourage hospitals with low vaccination rates to improve. Hospitals with high vaccination rates were able to comply by simply maintaining current practices.

  • Report

    Addressing the Obesity Epidemic Through Restaurant Standards

    Sep 5, 2013

    A set of common-sense guidelines discouraging restaurant serving practices that increase caloric consumption or undermine a nutritious diet could help combat America's obesity epidemic.

  • Blog

    Translating Policy Into Action to Build Community Resilience

    Sep 4, 2013

    The philosophy and motivation surrounding community resilience has strongly resonated with community leaders but there remains a divide between how experts articulate resilience policy and how that policy translates to on-the-ground implementation. Building Community Resilience: An Online Training addresses that tension.

  • Blog

    What Effect Does Media Have on Youth?

    Sep 3, 2013

    American youth enjoy increasing access to television, movies, music, games, websites, and advertising—often on pocket-size devices. Given the prominent and growing role that media plays in the lives of U.S. children and adolescents, what effects do these conditions have on their health and well-being?

  • Journal Article

    The Effect of Prospective Payment on Admission and Treatment Policy

    Sep 1, 2013

    Provider responses to the Medicare inpatient rehabilitation facility prospective payment system were found to simultaneously reduce marginal reimbursement and increase average reimbursement.

  • Journal Article

    Household Preparedness Is Not Enough: Assessing Community Readiness for Disasters

    Sep 1, 2013

    Measuring community preparedness and resilience is a challenge. A study of measures of partnership, self-sufficiency, and social connectedness, as well as gaps and opportunities in the measurement of community preparedness and resilience, found major limitations in existing data.

  • Blog

    Data Points: Why Delay of the Employer Mandate May Not Actually Mean That Much

    Aug 29, 2013

    The bottom line is that the employer mandate does not provide a large inducement for firms to change their health insurance offerings, but it does raise a substantial amount of money to pay for the ACA's coverage provisions over time.

  • Report

    Simulating the Effects of ACA Regulation on Health Insurance Markets

    Aug 29, 2013

    The Affordable Care Act requires insurers in the nongroup and small group markets to issue and renew policies to everyone seeking coverage, regardless of health status. Researchers examine the likely effects this will have on insurance enrollment and premiums.

  • Journal Article

    Lessons from the Public Health Response to the 2009 H1N1 Pandemic

    Aug 28, 2013

    The response to the 2009 H1N1 influenza pandemic provides an opportunity to learn about the public health system's emergency response capabilities and to identify ways to improve preparedness for future events.

  • Blog

    Using the Power of Communities to Beat Depression

    Aug 27, 2013

    Under-resourced communities of color have limited access to programs that could improve recognition and treatment of depression. RAND and UCLA investigators applied an engagement model to determine how to better serve these communities.

  • Research Brief

    Major Changes to Medicare Would Cut Costs, Squeeze Enrollment, Raise Spending for Seniors

    Aug 26, 2013

    Potential policy changes, such as raising the eligibility age of Medicare from 65 to 67, would save Medicare from $400 billion to $4 trillion between 2012 and 2036 but would also reduce the number of seniors enrolled.

  • Blog

    Big Tobacco vs. Tobacco Regulation and Control: An Even Match?

    Aug 26, 2013

    Anti-tobacco policies that have clear scientific support will strengthen the FDA's regulatory position. While the evidence base is solid in this area, it needs to be much stronger and broader if the TCA is going to have any lasting success against the industry.

  • Journal Article

    Going Online for Health Care: Which Patients Use eVisits?

    Aug 23, 2013

    Many physician-patient encounters do not require face-to-face contact, and “eVisits” have gained acceptance among many health systems and health plans. But what do we know about the types of patients who opt for online visits over conventional office appointments?

  • Blog

    The Skinny on the Freshman 15

    Aug 20, 2013

    Colleges should acknowledge their responsibility not to put their students at risk for weight gain, obesity and the host of chronic diseases related to poor diets, writes Deborah Cohen. Students have to make their own food choices, but it's colleges who're setting the table.

  • Report

    CMS Innovation Center Health Care Innovation Awards

    Aug 15, 2013

    The Centers for Medicare & Medicaid Services (CMS) has funded 108 Health Care Innovation Awards through the Affordable Care Act. Award recipients are those who propose compelling new models of service delivery or payment improvements that promise to deliver better health, better health care, and lower costs through improved quality of care for Medicare, Medicaid, and Children's Health Insurance Program enrollees.

  • Blog

    How Electronic Health Records Can Lead to Care Coordination

    Aug 13, 2013

    Inadequate care coordination is a major problem in health care delivery, but information technology is emerging as an important tool for enhancing coordination and, ultimately, improving the delivery of care, writes Robert Rudin.

  • Multimedia

    Building Resilient Communities: An Online Training

    Aug 13, 2013

    This easy-to-use, self-guided online training shows organizations and communities how to strengthen their resilience, helping them recover and learn from disaster—both natural and man-made.

  • Report

    Maternal Depression: Implications for Systems Serving Mothers and Children

    Aug 12, 2013

    Since women are almost twice as likely as men to experience depression and most women age 15 to 50 have children, maternal depression is an important issue. This report informs policymakers and practitioners of evidence connecting maternal depression and negative outcomes for both mother and child.

  • Report

    Delaying the Employer Mandate Could Have a Big Cost in the Long Run

    Aug 8, 2013

    The one-year delay in enforcing the Affordable Care Act's employer mandate will not have a substantial effect on insurance coverage—but it will lead to less revenue to offset the ACA's costs.

  • Journal Article

    Efforts by Religious Congregations to Address Community Health Needs May Play a Unique Role

    Aug 8, 2013

    Health programs run by religious congregations may be small-scale, but congregations are skilled at identifying local needs that are going unmet.

  • Journal Article

    How Do Neighborhood Parks Contribute to Physical Activity?

    Aug 2, 2013

    Neighborhood parks can support vigorous physical activity, but they are underutilized. Efforts to promote vigorous activity in local parks could help both child development and adult physical fitness.


  • Research Brief

    Infographic: What We Know About Workplace Wellness Programs

    Aug 1, 2013

    This infographic presents findings from a national survey on workplace wellness programs, including typical components, incentives for participation, and levels of employee engagement.

  • Journal Article

    Racial/Ethnic Differences in Medicare Experiences and Immunization

    Jul 30, 2013

    Compared to other Medicare beneficiaries, whites have better access to care, assuming no major health conditions. Disparities in receiving timely care and immunizations are smaller among those with greater disease burden. Outreach to minorities with low utilization and few or no major health conditions could help.

  • Journal Article

    Getting the Most Out of Anxiety Treatment

    Jul 29, 2013

    Research confirms that showing up for therapy sessions substantially improves treatment outcomes for patients suffering from anxiety disorder.

  • Journal Article

    Are Websites on Medical Provider Performance Transparent About Their Methods?

    Jul 26, 2013

    Transparency varies across websites that provide information on the performance of medical providers. This is especially true of how providers can review or correct results, how case mix adjustments are made, and how the reliability of measures is assessed.

  • Journal Article

    Media Influence on Adolescent Alcohol Use

    Jul 25, 2013

    Media exposure related to alcohol or other drugs may affect adolescents' alcohol use. However, media literacy education may help.

  • Project

    Resilience in Action

    Jul 25, 2013

    Resilient communities withstand and recover from disasters. They also learn from past disasters to strengthen future recovery efforts. The Resilience in Action website offers toolkits, training, multimedia, newsletters, and other resources to help communities build and strengthen their resilience.

  • Journal Article

    A Vision for Care Coordination and Electronic Health Records

    Jul 22, 2013

    Health information technology could improve care coordination, but providers don't yet have the tools that they need.

  • Multimedia

    The Math of State Medicaid Expansion

    Jul 17, 2013

    Mathematician Carter Price discusses the potential impacts to low-income populations and local economies in states that choose not to expand Medicaid under the Affordable Care Act.

  • Blog

    Health Care Spending: What's in Store?

    Jul 16, 2013

    Resolving the question of whether or not the U.S. has finally gotten a handle on health care spending is vitally important, because the choices we make going forward will have profound implications for our economy, the financial wellbeing of millions of American families, and ultimately America's standing in the world.

  • Testimony

    Designing a Performance-Based Incentive Program for Physicians

    Jul 12, 2013

    Value-based payment programs may encourage providers to innovate and redesign care delivery, potentially driving improvements in quality and efficiency.

  • Periodical

    Enemy Within: Military Sexual Assault Inflicts Physical, Psychological, Financial Pain

    Jul 11, 2013

    Awareness of sexual violence within the U.S. military has grown over the past decade, but barriers still exist for servicemembers who report the crimes and seek psychological health care. A research agenda needs to take full account of the types of damage being done.

  • Testimony

    What Should We Learn from Boston?

    Jul 10, 2013

    We cannot assume, based on Boston's response to the marathon bombings, that other U.S. cities are as prepared. Emergency managers and public safety agencies remain focused on disaster preparedness, but some hospitals have lapsed into thinking that it is a costly distraction from daily business.

  • Journal Article

    Growth of Cardiac Services Tied to Competition, Not Improving Patient Care

    Jul 9, 2013

    New interventional cardiac catheterization services offered by U.S. hospitals generally duplicate existing programs and do not help patients gain access to timely emergency cardiac care. Instead, the focus has been on competing with other hospitals.

  • Report

    Coordination May Improve VA Efficiency, Reduce Health Care Spending

    Jul 2, 2013

    To improve health care spending and efficiency, the Department of Veterans Affairs should reduce dual use of both Veterans Health Administration (VHA) and non-VHA care, coordinate care between both systems, integrate electronic information, and consider a pilot program through which to test these recommendations.

  • Research Brief

    Improving Coordination and Efficiency of Care for Veterans

    Jul 2, 2013

    The Veterans Health Administration (VHA) can better use its scarce resources through improved coordination with the private sector to reduce potential redundancies. The VHA can also provide access to high-quality care and meet rapidly changing needs.

  • Journal Article

    Building Community Disaster Resilience

    Jul 1, 2013

    Using the example of the Los Angeles County Community Disaster Resilience Project, this paper discusses the experience and perspective of a large urban county to better understand how to implement a community resilience framework in public health practice.

  • Blog

    Wellness Now, Value Later

    Jun 29, 2013

    Wellness programs do in fact reduce health risks, like smoking and obesity, write Soeren Mattke and Kristin Van Busum. But resulting cost savings could not be detected, especially when compared to the costs of the programs.

  • Multimedia

    Events @ RAND Podcast: Women's Health Panel Discussion, Featuring Chloe E. Bird

    Jun 27, 2013

    Listen in on this panel discussion featuring sociologist Chloe E. Bird on women's health, heart health, gender-based disparities in health care, and the need for gender-specific approaches to diagnosis and treatment.

  • Report

    Helping Decisionmakers Implement the ACA's Medicaid Provisions

    Jun 26, 2013

    The Affordable Care Act (ACA) contains many Medicaid-related provisions. RAND is working closely with decisionmakers at the federal and state levels to help resolve challenges associated with implementing the ACA's sweeping reforms.

  • Blog

    AcademyHealth Presents Ateev Mehrotra with Alice S. Hersh New Investigator Award

    Jun 26, 2013

    RAND congratulates physician researcher Ateev Mehrotra on receiving AcademyHealth's 2013 Alice S. Hersh New Investigator Award. The award recognizes early-career health services researchers who “show exceptional promise for future contributions.”

  • Report

    Community Health Needs Assessment Recommends Improvements in D.C.

    Jun 26, 2013

    Better integration of health and social services in Washington, D.C., may help facilitate the use of preventive health services such as for asthma, obesity, and sexual and mental health, according to a community health needs assessment.

  • Report

    Measuring the Quality of Health Care

    Jun 26, 2013

    RAND is engaged in developing and supporting the use of quality measures by the Centers for Medicare & Medicaid Services (CMS)

  • Report

    Assessing Patients' Experiences with Care

    Jun 26, 2013

    Understanding how patients experience care can encourage delivery of high-quality services. It also helps payers, including the Centers for Medicare & Medicaid Services, ensure that they pay for effective and efficient care.

  • Report

    Evaluating Medicare Demonstration Projects

    Jun 26, 2013

    RAND works closely with the Centers for Medicare & Medicaid Services to design, test, implement, and evaluate demonstration projects that span a wide range of care settings and issues.

  • Report

    Improving Medicare Payment Policies

    Jun 26, 2013

    RAND's work on Medicare payment policies has played a major role in improving payment systems, helping to better align incentives for providers and promote delivery of high-value care for patients.

  • News Release

    Incorporating Community Groups Into Depression Care Can Improve Coping Among Low-Income Patients

    Jun 25, 2013

    Improving care for depression in low-income communities — places where such help is frequently unavailable or hard to find — provides greater benefits to those in need when community groups such as churches and even barber shops help lead the planning process.

  • Journal Article

    How Well Do Medicare's Pay-for-Performance (P4P) Programs Match Desirable P4P Design Criteria?

    Jun 25, 2013

    Alignment with best P4P practices varies across Medicare programs; the program for Medicare Advantage aligns most strongly. It is unclear which P4P design elements are critical for quality improvement. Unintended consequences of design features are poorly understood.

  • Report

    Revenue, Spending Reductions Will Offset Costs of Expanding Medicaid in PA

    Jun 24, 2013

    While the expansion of Medicaid under the Affordable Care Act will require additional spending by the Commonwealth of Pennsylvania, these costs will be more than offset by additional revenue or reductions in other spending in the 2014-2020 timeframe.

  • Blog

    Will Small Firms Self-Insure After Jan. 1, 2014?

    Jun 17, 2013

    Because of the ACA's regulations, some smaller employers with young and healthy workers are considering avoiding the purchase of health care coverage in the regulated market, opting instead to self-insure their employees.

  • Journal Article

    Engagement Is Key to Improving Depression Care in Underserved Communities

    Jun 14, 2013

    Incorporating community programs such as churches, social service providers, and beauty salons into efforts to improve depression care in low-income neighborhoods can help improve quality of life and lower the risk of a life crisis.

  • Project

    Improving Infant and Maternal Health in Rural Nigeria

    Jun 13, 2013

    The BORN Study examines efforts to improve maternal and infant health in Nigeria, where more than 250,000 infants die each year. BORN findings could have wide-ranging impact on health in the region.

  • Blog

    Saving Grady: Reflections on Kate Neuhausen's Narrative Matters Essay

    Jun 10, 2013

    It was widely assumed that Atlanta's Grady Memorial Hospital would be the next storied public hospital close its doors, but at its darkest hour, it received help from an unexpected quarter, says Art Kellermann.

  • Journal Article

    Getting Actionable About Community Resilience

    Jun 7, 2013

    The findings of a baseline survey on community resilience in Los Angeles highlighted opportunities for engaging communities in disaster preparedness and informed the development of a community action plan and toolkit.

  • Research Brief

    The Math of State Medicaid Expansion

    Jun 7, 2013

    RAND researchers have analyzed how opting out of Medicaid expansion would affect insurance coverage and spending and whether alternative policy options—such as partial Medicaid expansion—could cover as many people at lower costs to states.

  • Blog

    Covering Emergency Care for Young Adults: Is the ACA Doing Its Job?

    Jun 5, 2013

    The dependent coverage provision of the Affordable Care Act is working as intended, say Andrew Mulcahy and Katherine Harris. In 2011, it spared individuals and hospitals from $147 million in emergency room costs.

  • Testimony

    Improving Care for Medicare Beneficiaries with Physician Payment Reform

    Jun 5, 2013

    Physician payment policy is shifting from one that incentivizes the delivery of more services without regard to quality or outcomes to one that incentivizes the delivery of high quality, resource conscious health care. Thoughtful incentive design can ease the transition process for both physicians and the Medicare program.

  • Journal Article

    Jury Is Still Out on Bariatric Surgery for Patients with Moderate Obesity and Diabetes

    Jun 4, 2013

    Bariatric surgery for diabetic people who are not severely obese has shown promising results in controlling glucose, but more information is needed about the long-term benefits and risks before recommending bariatric surgery over non-surgical weight-loss treatment for these individuals.

  • Journal Article

    Expanding Medicaid Is Best Financial Option for States

    Jun 3, 2013

    States that choose not to expand Medicaid under federal health care reform will leave millions of their residents without health insurance and increase spending on the cost of treating uninsured residents, at least in the short term.

  • Journal Article

    Reliability of Utilization Measures for Primary Care Physician Profiling

    Jun 1, 2013

    While there has been interest in using utilization measures to profile physicians, examinations of these measures are rare. This study found only a small number of commonly used utilization measures reliably capture real differences in utilization among physicians.

  • Journal Article

    The Value of Diagnostic Testing in Personalized Medicine

    Jun 1, 2013

    A framework derived from information economics for assessing the value of diagnostics demonstrates that the social value of such diagnostics can be very large, both by avoiding unnecessary treatment and by identifying patients who otherwise would not get treated.

  • Journal Article

    Association Between Perceived Discrimination and Racial/Ethnic Disparities in Problem Behaviors Among Preadolescent Youths

    Jun 1, 2013

    An examination of the contribution of perceived racial/ethnic discrimination to disparities in problem behaviors found that eliminating discrimination could considerably reduce mental health issues, including problem behaviors, among Black and Latino youths.

  • Blog

    Moore Must Be Ready for Psychological Aftermath

    May 31, 2013

    Ensuring the availability of needed mental health resources was critical in the immediate aftermath and recovery phase of the 2011 Joplin, Missouri tornado. Authorities in Oklahoma must ensure that such services are in place early so that Moore's residents can begin the long journey to recovery.

  • Report

    Reviewing Workplace Wellness Programs

    May 30, 2013

    Workplace wellness programs are becoming quite common, and employers are optimistic about their benefits. However, such programs must be well-executed to have a meaningful effect on employee health, and significant reductions in health care cost may take time to materialize.

  • Journal Article

    Health Reform Shields Young Adults from Emergency Medical Costs

    May 29, 2013

    A new federal law allowing young adults to remain on their parents' medical insurance through age 25 has shielded them, their families, and hospitals from the full financial consequences of serious medical emergencies.

  • Blog

    Resources for Schools and Parents Following the Deadly Oklahoma Tornado

    May 29, 2013

    The toll of the tornado on school students in Moore, Oklahoma, cannot be overstated. To assist with recovery, RAND's CBITS program offers resources on psychological first aid for schools, as well as additional materials for educators and parents.

  • Blog

    Eating Better for Less

    May 25, 2013

    A combination of factors could slow the U.S. obesity epidemic while also improving overall nutritional well-being: lowering prices on healthier food, initiatives to control portion sizes, and a long-term campaign to support better food quality.

  • Blog

    Research Is a Fundamental Component of Suicide Prevention

    May 24, 2013

    While our research has taught us many things about suicide prevention, we think additional research is critically needed in two areas, writes Rajeev Ramchand. The first is gun control. The second area is the quality of behavioral health care available to those who need it.

  • Journal Article

    Three Large-Scale Changes to Medicare Could Curb Costs but Reduce Enrollment

    May 24, 2013

    The rising cost of Medicare can be slowed by increasing premiums, switching to a premium support program, and raising the eligibility age, but those moves might drive many elderly Americans from the program.

  • Blog

    Applying What Works to Reduce Non-Urgent Emergency Department Use

    May 22, 2013

    It is likely that communities with low rates of non-urgent ED use not only have better access to primary care, but patients who are educated about appropriate care seeking and convenient alternatives for acute care, writes Lori Uscher-Pines.

  • Blog

    Legalization in the U.S. and Crime in Mexico

    May 22, 2013

    Driving Mexican marijuana out of the U.S. would probably reduce the traffickers' export revenue by a few billion dollars a year, writes Beau Kilmer. But would reducing that revenue lead to a corresponding decrease in trafficker violence?

  • Blog

    From Boston to Oklahoma—Lessons for the Regional Trauma Response System

    May 21, 2013

    Three mass-casualty events occurring in three very different settings show that disaster preparedness should not be limited to large cities or “target” areas in the United States. One trait that is common to all such events is the need for coordinated, responsive trauma care for victims.

  • Report

    Hospital Emergency Departments Play a Growing Role in the U.S. Health Care System

    May 20, 2013

    Emergency departments account for a rising proportion of hospital admissions and serve increasingly as an advanced diagnostic center for primary care physicians. While often targeted as the most expensive place to get medical care, emergency rooms remain an important safety net for Americans who cannot get care elsewhere.

  • Journal Article

    The Nursing Workforce in an Era of Health Care Reform

    May 19, 2013

    As health care reforms emphasize prevention and introduce new models of care delivery, registered nurses will become even more important to addressing Americans' health care needs.

  • Journal Article

    Adequate Depression Treatment for Youth Enrolled in Medicaid

    May 17, 2013

    A large number of youth enrolled in Medicaid with depressive symptoms do not receive adequate acute treatment. Due to workforce constraints in the child mental health sector, quality improvement and system redesign efforts are likely required to address this issue.

  • Research Brief

    Infographic: How Pennsylvania May Fare Under the ACA

    May 15, 2013

    This infographic presents findings from a RAND analysis of the economic and other effects of Medicaid expansion on the commonwealth of Pennsylvania.

  • Announcement

    At 65, RAND Continues to Make a Difference

    May 14, 2013

    To celebrate our first 60 years, we created 60 Ways RAND Has Made a Difference, an online book. On our 65th birthday, we share five more recent ways that RAND has made a difference. This includes our efforts to develop, implement, and evaluate a school-based program to help children traumatized by violence.

  • Journal Article

    Racial Disparities in Criminal Court Referrals to Drug Treatment

    May 13, 2013

    The U.S. prison population grew nearly fivefold between 1980 and 2009, at least partially due to the “War on Drugs.” Racial disparities in criminal justice referrals to drug treatment potentially affect access to treatment for hundreds of thousands of individuals arrested for drug offenses each year.

  • Blog

    H7N9 Bird Flu — Health Authorities Are Prepared, but Must Stay on High Alert

    May 10, 2013

    Having dealt with outbreaks of H5N1 bird flu and other communicable diseases like Severe Acute Respiratory Syndrome (SARS) in 2003 and H1N1 swine flu in 2009, health officials are now far better prepared to detect new diseases early and react quickly to monitor and contain their spread.

  • Journal Article

    Medicare Payment Reform and Provider Entry and Exit

    May 7, 2013

    An investigation of the impacts of Medicare payment reform on post-acute providers found that payment reforms reducing average and marginal payments reduced entries and increased exits from the market, which may affect market structure, access to care, quality and cost of care, and patient outcomes.

  • Report

    Responding to Foodborne Disease Outbreak

    May 7, 2013

    The Guidelines for Foodborne Outbreak Response and the companion Toolkit developed by the Council to Improve Foodborne Outbreak Response (CIFOR) are valuable resources, according to their target audience. However, lack of resources may be a challenge when it comes to implementing the CIFOR's recommendations.

  • Report

    Oral Health: Parental and Provider Perspectives

    May 3, 2013

    Oral health is important to children’s overall health and well-being. However, access to care can be a challenge for parents seeking oral health services for children who are Medicaid beneficiaries. Also, providers have noted a general unawareness among parents about the importance of preventive oral health care.

  • Journal Article

    Options for Collecting Revenue from Legal Marijuana

    May 2, 2013

    Potential tax rates and revenues have been a common theme in discussions about legalizing marijuana. However, policy goals, types of taxes, and components of revenue are also important to consider.

  • Journal Article

    Reducing the Stigma of Mental Illness

    Apr 30, 2013

    California's Mental Health Services Act emphasizes stigma and discrimination reduction. Researchers examined whether this effort changed the public perception of mental illness and the individual experience of stigma.

  • Blog

    Improvement of Prevention Capacity Unveiled at a Summit of Maine Officials and Stakeholders

    Apr 29, 2013

    Community-based practitioners can improve their programs using Getting To Outcomes®, a toolkit, training, and onsite-support package which enhances their ability to prevent drug and alcohol use among youth.

  • Blog

    Dementia's Growing Cost to Caregivers

    Apr 29, 2013

    At the rate that the U.S. population is aging, the total cost of dementia could reach half a trillion dollars a year by 2040. Those who care for impaired relatives and friends are acutely aware of the effects of dementia, and unfortunately they are all too familiar with its costs, writes Kathleen J. Mullen.

  • Blog

    Governors Missing the Point on Medicaid

    Apr 29, 2013

    While a governor or legislator may disagree with Medicaid expansion for philosophical reasons, the claims that the expansion will be a burden on states' economies seem misguided given the full range of projected economic impacts on the states, writes Carter C. Price.

  • Project

    Health Services and the Head Start Program

    Apr 29, 2013

    A RAND project surveys Head Start health managers to determine how services are prioritized, sustained, and implemented. Researchers will also identify program features and policy levers that support Head Start health services.

  • Journal Article

    Impact of Socioeconomic Adjustment on Physicians' Relative Cost of Care

    Apr 26, 2013

    Ongoing efforts to profile physicians on their relative cost of care have been criticized because they do not account for differences in patients' socioeconomic status (SES).

  • Blog

    Ask Me Anything: Beau Kilmer Answers Drug Policy Questions on Reddit

    Apr 26, 2013

    Beau Kilmer, co-director of the RAND Drug Policy Research Center and coauthor of Marijuana Legalization: What Everyone Needs to Know, hosted an “Ask Me Anything” (AMA) session on Reddit this week. He fielded questions from participants on a variety of drug policy issues.

  • Blog

    7 Key Questions on Marijuana Legalization

    Apr 25, 2013

    Policymakers in Washington and Colorado are confronting some new and tricky issues that have never been addressed. For them, and for anyone else thinking about changing their pot laws, there are seven key decision areas that will shape the costs and benefits of marijuana legalization.

  • Blog

    Lessons from Boston

    Apr 24, 2013

    Boston's health care providers reacted the way they did because they knew what they were supposed to do. Those who did not were smart enough to follow the lead of those who did. That's how a “ritualized” disaster plan works.

  • Journal Article

    The Effects of Tobacco Marketing

    Apr 23, 2013

    Viewing tobacco ads in retail locations may be associated with higher smoking risk. The tobacco industry has begun using these promotions more than traditional channels, such as billboards and magazines.

  • Blog

    Can Catholic Colleges Block Free Condom Distribution?

    Apr 22, 2013

    If this issue were to be decided on the basis of public health benefits, the outcome would be clear: Condoms indisputably prevent both unintended pregnancies and the spread of sexually transmitted infections, writes Chloe Bird.

  • Journal Article

    Aggression Among Children and Adolescents

    Apr 19, 2013

    Data confirm that boys engage in more direct aggression than girls. Direct aggression is also related to externalizing problems, poor peer relations, and low prosocial behavior.

  • Blog

    Why U.S. Was Surprised, but Prepared for Boston Attack

    Apr 18, 2013

    Although official after-action reports are still being compiled, it looks like Boston's first responders and hospitals delivered under difficult circumstances, writes Arthur Kellermann.

  • Blog

    Can “Fixing” Food Deserts Curb Obesity? The Jury Is Still Out

    Apr 18, 2013

    We know that the obesity epidemic is a serious public health concern. What's less clear, however, is how our surroundings fit into the equation.

  • Journal Article

    Price Shopping in Consumer-Directed Health Plans

    Apr 17, 2013

    Based on insurance claims for nine common outpatient services in consumer-directed health plans (CDHPs), researchers found no evidence that those with lower expected medical expenses engaged in more price shopping. Consumers did not engage in more price shopping before reaching the CDHP deductible, either.

  • Journal Article

    Physician-Patient Communication About Dietary Supplements

    Apr 16, 2013

    More physician-patient discussions about dietary supplements could help inform patient decisions. Physicians should address the risks, effectiveness, and costs of supplements.

  • Journal Article

    Insomnia: Can't Sleep, Can't Get Diagnosed

    Apr 15, 2013

    Insomnia is very common, but most of its sufferers don't receive a diagnosis or treatment. However, educating primary care providers and other professionals about insomnia can help.

  • Journal Article

    Medication in the Mailbox

    Apr 11, 2013

    Questionnaires suggest similar levels of satisfaction between patrons of mail-pharmacy services and those using traditional pharmacy services.

  • Research Brief

    Infographic: How Arkansas May Fare Under the Affordable Care Act

    Apr 8, 2013

    This infographic presents findings from a RAND analysis of the economic and other effects of the Affordable Care Act on the state of Arkansas.

  • Journal Article

    Preventing Falls in Hospitals

    Apr 8, 2013

    To prevent and respond to falls, many hospitals employ numerous techniques, including patient education, bed-exit alarms, post-fall evaluations, and more. However, better reporting of outcomes, implementation, adherence, and interventions is necessary to establish evidence on how hospitals can best prevent falls.

  • Journal Article

    What Influences Whether Alcohol Merchants Enforce Practices for Reducing Underage Drinking?

    Apr 3, 2013

    Merchants who engage in state-approved “responsible beverage service” training are more likely to believe they'll be cited for selling alcohol to minors. Therefore, targeting merchant attitudes could be a successful way to encourage them to check IDs.

  • Journal Article

    Providers' Motivations for Improving Communication Matter

    Apr 2, 2013

    Improvements in provider-patient communication can enhance efficiency and lead to higher-quality care. However, the success of communication interventions depends largely on the motivation and skill of the participating providers.

  • Blog

    Helping Obama—and Other Americans—Weigh Which Health Insurance Exchange to Pick

    Apr 1, 2013

    Multistate plans are most likely to appeal to out-of-state students, interstate migrants, out-of-state workers, seasonal movers (e.g., “snowbirds”), and similar groups that require improved access to health care across state lines.

  • Blog

    Remove Medicare's Straitjacket

    Mar 29, 2013

    Removing the constraints on Medicare would not only lead to lower prices at the drugstore, hospital and doctor's office, it could spark a new era of healthcare innovation, writes Arthur Kellermann.

  • Report

    The Economic Impact of Medicaid Expansion on Pennsylvania

    Mar 28, 2013

    If Pennsylvania opts into Medicaid expansion under the Affordable Care Act, more residents would have health coverage and the state would enjoy a positive economic effect. However, benefits would have a long-term cost, with uneven regional results.

  • Journal Article

    Monogamy on the Street: A Study of Homeless Men

    Mar 27, 2013

    Men experiencing homelessness valued committed relationships but were frustrated by their lack of access to female partners—accentuated by the stigma attached to homelessness—and also by logistical barriers to relationships.

  • Journal Article

    Understanding Adolescent Sexual Decisionmaking

    Mar 26, 2013

    Sexual health problems affect adolescents disproportionately more than adults, and efforts to improve their sexual health and decision making have not been fully successful. However, research integrating insights from neuroscience and other areas could increase our understanding of sexual risk behaviors among youth.

  • Blog

    Guns in Homes: A Health Hazard

    Mar 25, 2013

    An ample body of evidence indicates that the benefits of keeping a gun for protection are substantially outweighed by the associated risks, writes Art Kellermann.

  • Blog

    Making Heart Disease a Women's Issue

    Mar 22, 2013

    When it comes to women's health, cancer gets a good deal of the attention; somehow, it hasn't fully registered that so many of our mothers, sisters, friends and daughters are being affected by another, often silent killer, writes Chloe E. Bird.

  • Journal Article

    Toddlers' Sleep and Future Emotional and Behavioral Problems

    Mar 21, 2013

    Secure parent-child relationships can affect children's self-regulation, including the ability to “self-soothe” at bedtime. Sleep, in turn, may serve as a pathway linking attachment security with future emotional and behavioral problems in children.

  • Report

    Multistate Health Plans in the ACA's State Insurance Exchanges

    Mar 20, 2013

    The ACA requires the government to work with insurance issuers to establish at least two multistate plans (MSPs) in each state's health insurance exchange. MSPs may be especially attractive to those interested in issuers that operate in multiple states, such as out-of-state students or temporary workers.

  • Report

    Helping Families Raise Healthy Children

    Mar 19, 2013

    Simultaneous developmental delays among young children and depression among parents can create serious challenges for many families. However, results from the Helping Families Raise Healthy Children initiative suggest that aligning early intervention and behavioral health systems can help.

  • Journal Article

    Discounts on Healthy Foods Can Improve Diet Quality; First Result from a National Program

    Mar 19, 2013

    Lowering the costs of healthy foods in supermarkets increases the amount of fruits, vegetables, and whole grain foods that people eat, while also appearing to reduce consumption of nutritionally less-desirable foods.

  • Journal Article

    Depression During Childbearing: A Major Public Health Concern

    Mar 18, 2013

    Nearly 15 percent of women develop depressive episodes during pregnancy. A similar percentage develop depression in the first three months following birth. Physiologic and psychological challenges unique to pregnancy can complicate the identification and management of perinatal depression.

  • Journal Article

    Greater Interpersonal Stress Among Adolescent Girls May Lead to Greater Risk of Depression

    Mar 15, 2013

    The way adolescents react to stress has been shown to be a significant factor in our understanding of sex differences in depression. Adolescent girls experienced greater total stress than boys, particularly interpersonal stress, which may explain their higher rates of depression.

  • Blog

    When CPR Is the Wrong Call: Mistaking Medical Treatment for Care

    Mar 14, 2013

    If a medical treatment worked only a fraction of the time and resulted in bad outcomes more often than not, practitioners would not make this treatment the default approach. Yet that is exactly what has happened when it comes to CPR for individuals 85 years and older who suffer cardiac arrest in a community setting.

  • Journal Article

    The Relationship Between Urban Sprawl and Coronary Heart Disease in Women

    Mar 13, 2013

    Women living in more compact communities had a lower probability of experiencing a coronary heart disease (CHD) event or dying as a result of CHD.

  • Blog

    Ruling Can Lead to Tougher New York Soda Ban

    Mar 12, 2013

    New York should see the judge's ruling as an opportunity to revise the law to close the loopholes, including the Big Gulp exemption, and develop regulations in line with the scientific consensus that even 16 ounces is way too much, writes Deborah Cohen.

  • Blog

    Tuberculosis Outbreak Reminds Shows Importance of 'Bread and Butter' Public Health Capabilities

    Mar 12, 2013

    The TB outbreak in Los Angeles shows that bioterrorism isn't the only threat our country faces in the health security realm. Routine public health practices such as outbreak detection, laboratory diagnosis, epidemiological investigation, and disease control must continue to be a priority.

  • Journal Article

    Patients Can Complete Routine Data Collection Themselves

    Mar 11, 2013

    Patient-facing kiosks are feasible in routine care and can provide data that can be used to substantially improve the quality of care.

  • Journal Article

    Follow-Up Treatment for Substance Use Disorders May Play a Significant Role

    Mar 8, 2013

    Substance use disorders are a serious issue, but treatment is often sporadic, despite ongoing need. Low rates of follow-up care among adults who received detoxification without subsequent residential treatment and among those with serious mental illness suggest that targeting these individuals could help.

  • Journal Article

    Could Increasing Nurse-Patient Ratios Improve Patient Safety?

    Mar 7, 2013

    A small percentage of patients die during hospitalization or shortly thereafter. More or better nursing care may be able to prevent some of these deaths. However, stronger conclusions are impossible until research evaluates an intentional change in nurse staffing to improve patient outcomes.

  • Journal Article

    Future Supply of Registered Nurses Could Vary Significantly by Region

    Mar 6, 2013

    Considerable differences across U.S. regions in workforce age structure could result in gaps in the supply of registered nurses (RN) over the next fifteen years. Projections indicate substantial growth in RN supply in the Midwest and South and declines in the Northeast and West.

  • Journal Article

    Children of Substance Abusing Parents May Have Unmet Mental Health Needs

    Mar 5, 2013

    Several barriers may prevent children of parents with substance use disorders from obtaining mental health services, including children's ambivalence about treatment and parental disagreement and lack of involvement. However, peer support, afterschool activities, and family counseling may help.

  • Multimedia

    Palliative Care: Improving Quality of Life for the Seriously Ill

    Mar 1, 2013

    Karl Lorenz discusses the delivery of palliative care services, training in palliative care, and how research can improve—and philanthropy can support—this vital aspect of health care.

  • Journal Article

    Thirty-Seven Percent of U.S. Emergency Department Visits Are for Nonurgent Conditions

    Feb 28, 2013

    Patients' use of emergency departments (ED) for nonurgent conditions may lead to excessive health care spending, unnecessary testing and treatment, and weaker primary care relationships. These patients tend to be younger and may visit the ED due to a physician referral or for convenience.

  • Blog

    A Health Care Entitlement Worth Ending

    Feb 27, 2013

    The health care “entitlement” we need to reform is the notion that America's health care system is entitled to an ever-growing share of America's wealth, writes Arthur Kellermann.

  • Project

    How Do Military Teens' Environments Affect Their Exercise and Nutrition?

    Feb 27, 2013

    M-TEENS, the Military Teenagers' Environments, Exercise, and Nutrition Study, will examine how military adolescents' schools and neighborhoods influence their physical activity, eating behaviors, and more.

  • Blog

    The Delayed Promise of Health-Care IT

    Feb 26, 2013

    Globally, the health IT industry should not wait to be forced by government regulators into doing a better job. Developers can boost the pace of adoption by creating more standardized systems that are easier to use, truly interoperable, and afford patients greater access to and control over their personal health data.

  • Journal Article

    Refining Assessments of Elderly Patients

    Feb 25, 2013

    Significant changes to the Minimum Data Set (MDS), a standardized assessment of nursing home residents, aim to improve the tool's clinical utility.

  • Report

    Addressing the Global Cataract Problem

    Feb 21, 2013

    Most of the millions of cataract cases worldwide can be cured by quick, inexpensive procedures. But a shortage of trained surgeons remains a challenge. The HelpMeSee approach, a high-volume training and development system, could help close this gap.

  • Journal Article

    Both Peers and Parents May Influence Body Image Among Young Adolescents

    Feb 21, 2013

    Getting along with peers and fear of being viewed negatively by them may influence the difference between how adolescents view their body size and what they think the ideal size should be. Those with warm, nurturing parents are more likely to have positive views about their body size.

  • Blog

    “Implementation Science” May Help Providers Adopt New Treatments Despite Real-World Constraints

    Feb 18, 2013

    A new field called implementation science examines how to best support providers in taking up new, research-proven treatments and implementing them well. A RAND study will test how Boys & Girls Clubs carry out a program proven to prevent teen pregnancy and sexually transmitted infections, with and without an intervention called Getting To Outcomes®.

  • Testimony

    Efforts to Reform Physician Payment by Tying Payment to Performance

    Feb 14, 2013

    Public and private sector purchasers are actively working to design value-based payment programs to achieve the goals of improved quality and more efficient use of health care resources. How these programs are designed is a complex undertaking and one that will determine the likelihood of their success.

  • Research Brief

    Are Performance-Based Accountability Systems Effective? Evidence from Five Sectors

    Feb 12, 2013

    Creating an effective Performance-Based Accountability System (PBAS) requires careful attention to selecting an appropriate design for the PBAS, given the context in which it is to operate, and to monitor, evaluate, and adjust the system, as appropriate.

  • Blog

    Do You Get What You Pay For? Maybe Not in Health Care

    Feb 12, 2013

    While the current state of the evidence does not provide clear guidance to policymakers seeking to address the twin pillars of health care quality and cost, it is apparent that researchers must produce more detailed data on how to reduce health care spending while improving quality, writes Peter Hussey.

  • Announcement

    Jeffrey Wasserman Named New Vice President and Director of RAND Health

    Feb 11, 2013

    Jeffrey Wasserman, a health policy expert who has led efforts to strengthen the United States' preparedness for a major health event, has been named vice president and director of RAND Health.

  • Journal Article

    Who Becomes Addicted and Why?

    Feb 8, 2013

    Relationships between specific features of individuals and particular features of specific objects over time in specific contexts could be what creates the conditions necessary for stopping problematic substance use.

  • Report

    Optimal Health Insurance and the Distortionary Effects of the Tax Subsidy

    Feb 7, 2013

    The health insurance subsidy in the U.S. tax code enables individuals to pay premiums in pre-tax dollars and encourages the purchase of more generous health insurance plans. This paper explores how the income tax subsidy distorts optimal cost-sharing in health insurance and influences cost-sharing in private plans.

  • Report

    California Should Collect Physician Identifiers from Hospitals

    Feb 7, 2013

    California health regulators should begin collecting physician identifiers as part of their routine data collection efforts about the services provided at the state's hospitals. Such a move would help providers improve quality by aiding efforts to benchmark performance and reduce variations in the delivery of care.

  • Blog

    Are You a 'Wise' Health Care Consumer?

    Feb 5, 2013

    To be wise purchasers of health care services, consumers need access to accurate and understandable information about health plans and providers. They wrongly assume that more expensive providers are better than less expensive ones, despite inconsistent evidence that there is any link between health care cost and quality.

  • Periodical

    Danger in the Aisles?

    Feb 5, 2013

    Have you ever come home with a grocery bag full of food that you didn't mean to buy? That's because you might have less control over your food choices than you think.

  • Periodical

    Smoke Alarm: Clocking in Could Prove Hazardous to a Teen's Health

    Feb 5, 2013

    A teen who starts working for pay while still in school may be more than eight times as likely to report tobacco use than peers who don't start working while in school.

  • Journal Article

    Shared Decision Making Between Patients and Doctors Will Require Investment by Health Systems

    Feb 4, 2013

    Health care providers are encouraged to implement “shared decision making” in which patients and doctors together choose the treatment that is best for each patient. However, doctors need more instruction on how to engage patients and better information systems to make sure patients know their options and receive individualized care.

  • Journal Article

    Care Experiences of Managed Care Medicare Enrollees Near the End of Life

    Feb 4, 2013

    Research based primarily on reports from an individual's surviving relatives often suggests that end-of-life care experiences are particularly poor. However, this examination of reports from patients found that those who died within a year of being surveyed reported slightly better experiences than other enrollees.

  • Journal Article

    Understanding Sleep Disturbances Among Veterans with PTSD

    Feb 2, 2013

    Sleep disturbances and interpersonal problems are common in military veterans with PTSD and are associated with increased health care costs. Findings suggest that attachment anxiety and avoidance are linked with specific disruptions in sleep among these veterans.

  • Blog

    The Super Bowl Halftime Show Should Not Be Promoting a Public Health Threat

    Feb 1, 2013

    People who consume just one or two sugar-sweetened drinks a day have a 26 percent greater risk of developing type 2 diabetes than people who rarely drink these beverages, write Kristin Van Busum and Lauren Hunter.

  • Journal Article

    Bullying: Adults Can Be Part of the Problem

    Feb 1, 2013

    Bullying is a serious medical and public health issue. While adults can help in a number of ways, they may also make things worse by serving as negative role models, ignoring bullying, or even bullying children themselves. Clinicians can help, but they must first be able to recognize the signs of bullying.

  • Journal Article

    What Is the Price of Prevention?

    Jan 31, 2013

    The potential for treatment costs can discourage screening in developing countries. A field experiment in Nigeria offered cervical cancer screening to women at randomly chosen prices, as well as a chance for treatment subsidies. Findings indicate that preventive efforts in developing countries should subsidize both testing and treatment costs.

  • Blog

    25 Small Ideas for Saving Big Health Care Dollars

    Jan 30, 2013

    Given the size of the annual “health care spend”—$2.7 trillion—summing up the savings associated with very minor cost-saving policy changes is likely to achieve significant aggregate savings, writes Jeffrey Wasserman.

  • Blog

    Health Care Spending Growth Tamed? Hardly

    Jan 25, 2013

    The growth of health care costs has slowed dramatically for the third consecutive year, but as the economy rebounds, spending growth could skyrocket, says Arthur Kellermann.

  • Journal Article

    Nearly 11 Percent of Physicians' 40-Year Careers Spent with an Open, Unresolved Malpractice Claim, on Average

    Jan 24, 2013

    The U.S. malpractice system is widely regarded as inefficient, in part because of how long cases take to resolve. Malpractice reforms should be assessed by how well they reduce litigation time without undermining patients' needs.

  • Report

    Medicare Facts and Figures Chartbook

    Jan 23, 2013

    By 2030, California's entire elderly population is projected to double what it was in 2000. This profile provides a factual framework to help consumer advocates, health care providers, and policymakers better understand California's Medicare population and inform their efforts to design programs and policies.

  • Multimedia

    In Brief: Amelia M. Haviland on Consumer-Directed Health Plans

    Jan 23, 2013

    Amelia Haviland presents the results of several new RAND studies on cost and quality in consumer-directed health plans, and explores how switching plans affects the quality of care.

  • Blog

    Lois Davis's Prisoner Re-Entry Work Earns Recognition from California Assembly

    Jan 23, 2013

    RAND congratulates senior policy researcher Lois Davis, whose work on the public health consequences of prisoner re-entry in California earned RAND the 64th Assembly District's AB 109 Re-Entry Award.

  • Journal Article

    Mental Health Treatment Experiences of Active-Duty U.S. Service Members

    Jan 23, 2013

    When addressing the unmet mental health need of service members, we should consider their perceptions of treatment and patterns of utilization.

  • Journal Article

    Organizing HIV Prevention Activities in Urban Religious Congregations

    Jan 22, 2013

    Religious organizations in the U.S. may have a unique opportunity to address HIV due to their wide social reach and access to institutional and community resources. However, relatively few formally engage with people with HIV, and many have reported barriers to introducing HIV prevention activities.

  • Journal Article

    Relationship Between Health Care Quality and Cost Remains Poorly Understood

    Jan 21, 2013

    A review of more than 60 studies reveals extremely mixed findings on the association between health care quality and cost. Future work should determine what types of spending effectively improve quality and what types are wasteful.

  • Journal Article

    Plateau in Complementary and Alternative Medicine Spending Points to Role in Reform

    Jan 18, 2013

    Use of and spending on complementary and alternative medicine have flattened out. Including providers of these services in new delivery systems such as accountable care organizations could help slow growth in national health care spending.

  • Journal Article

    Are Sexual Assault and Disease Prevention Programs Considering the Full Range of Young Women's Sexual Goals?

    Jan 18, 2013

    Programming is often based on the assumption that young women only care about risk reduction when making decisions about sexual encounters. However, their most important goals are communicating clearly and avoiding unwanted sex.

  • Blog

    Firearms and Gun Control: Many Questions, Some Answers

    Jan 17, 2013

    President Obama's task force on gun violence has raised the stakes in the policy debate on gun control and policy in the wake of the recent shootings in Colorado and Connecticut. Some of RAND's top researchers share what is, and what isn't, known about firearms and gun control.

  • Blog

    Can Improved Mental Health Care Prevent Gun Crimes? The Truth Is, We Don't Know

    Jan 17, 2013

    If policymakers and the public expect the mental health community to play a significant role in preventing future incidents like Newtown, the mental health research agenda must become a higher national priority in future federal funding decisions, writes Terry Schell.

  • Blog

    Health Care Personnel Could Be Key in Flu Prevention, Not Just Treatment

    Jan 17, 2013

    More than a dozen hospital staffers in four states have been terminated for refusing flu shots in the midst of a fierce flu season. Yet only one-tenth of health care employers require their staff to be vaccinated.

  • Journal Article

    Centers of Excellence: No Difference in Costs But Better Hip Replacement

    Jan 15, 2013

    Medicare and private plans encourage individuals to use hospitals that are designated as centers of excellence. Evidence shows that the costs of knee and hip replacements in centers of excellence do not differ from other hospitals, but patients who had hip replacements in such centers had lower complication rates.

  • Journal Article

    Comparative Effectiveness of Clozapine Among Medicaid Beneficiaries

    Jan 14, 2013

    Clozapine is more effective than other antipsychotics for treating schizophrenia across racial and ethnic groups.

  • Journal Article

    Antiretroviral Therapy and Food Security Support Each Other

    Jan 11, 2013

    In examining the socioeconomic benefits of HIV antiretroviral therapy (ART) in Uganda, researchers find that ART helps alleviate the food insecurity of adults with HIV, which in turn may improve ART outcomes.

  • Journal Article

    Silencing the Science on Gun Research

    Jan 8, 2013

    Injury prevention research has dramatically reduced deaths in the U.S. from motor vehicle crashes, drowning and fire. But since 1996, funds for similar public health science on firearms violence has effectively been muffled.

  • Blog

    Modeling the Effects of the Affordable Care Act in Arkansas

    Jan 7, 2013

    The Medicaid expansion under the ACA will result in about 400,000 people newly insured in Arkansas by 2016. The state is likely to save about $67 million for reduced uncompensated care costs for the uninsured, and receive $430 million in federal funds. Wealthier states, however, will have a different experience.

  • Journal Article

    More Changes in Health Care Needed to Fulfill Promise of Health Information Technology

    Jan 7, 2013

    Despite wide investments nationally in electronic medical records and related tools, the cost-saving promise of health information technology has not been reached because the systems deployed are neither interconnected nor easy to use.

  • Blog

    Health Care Costs Are Killing Us

    Jan 4, 2013

    At a time when our country is teetering on the edge of a “fiscal cliff,” no challenge in health care is more important than reducing health care spending, writes Arthur L. Kellermann.

  • Blog

    Accounting for Risk of Violent Death

    Jan 4, 2013

    As a Southerner who learned to shoot at an early age, I've never had a problem with guns. But emergency-room doctors like me also know how much damage they can cause if misused or allowed to fall into the wrong hands, writes Arthur Kellermann.

  • Report

    How Well Do Americans Anticipate their Health Care Expenses in Retirement?

    Jan 4, 2013

    An examination of whether retirees and near-retirees understand what their likely out-of-pocket health care expenditures might be in retirement found many do not understand the magnitude and variability of their future out-of-pocket health care costs, and may be unprepared to finance higher-than-typical expenditures.

  • Report

    The Economic Impact of the ACA on Arkansas

    Jan 3, 2013

    For Arkansas, the Affordable Care Act will result in an increase in GDP of around $550 million and the creation of about 6,200 jobs. The new law will also increase health insurance coverage by 400,000 newly insured individuals.

  • Blog

    Health Care Cost Growth Is Hurting Middle-Class Families

    Jan 3, 2013

    Unfortunately, nearly every actor in our health care delivery system—hospitals, physicians, other health care providers, insurance companies, and the manufacturers of drugs and devices—is currently focused on maximizing revenue growth, write Arthur Kellermann and David Auerbach.

  • Journal Article

    Predictors of Parent-Child Relationships That Support Physical Activity

    Jan 3, 2013

    Family environments present opportunities for interventions that promote physical activity. Family members share genetic risk factors associated with chronic health conditions, and physical inactivity tends to cluster within families and households.

  • Journal Article

    Access to and Use of $4 Generic Drug Programs

    Jan 2, 2013

    Programs that offer 30 days' worth of selected generic drugs for $4 have become important options for seniors to obtain affordable medications, but little is known about access to these programs and the characteristics of those who use them.

  • Journal Article

    Enhancing Quality Interventions Promoting Healthy Sexuality (EQUIPS)

    Jan 1, 2013

    A look at the Enhancing Quality Interventions Promoting Healthy Sexuality (EQUIPS) study, which tests how well a community-based setting (Boys & Girls Clubs) conducts a program to prevent teen pregnancy and sexually transmitted infections.

  • Journal Article

    Nongovernmental Resources to Support Disaster Preparedness, Response, and Recovery

    Jan 1, 2013

    The development of an assets framework which identifies relevant nongovernmental resources for disaster preparedness and response and assesses their availability at state and local levels found that the capacity of each sector to capture data needs strengthening.

  • Journal Article

    Harnessing a Community for Sustainable Disaster Response and Recovery

    Jan 1, 2013

    This analysis used peer-reviewed literature, relevant policy, and federal guidance to characterize the capabilities of nongovernmental organizations, factors that determine their involvement, and key services they provide during disaster response and recovery.

2012

  • Report

    Are Suicide Prevention Interventions Effective?

    Dec 31, 2012

    Experts find that identifying whether a suicide prevention program is effective is challenging, because suicide is such a rare event. While these programs may show immediate reductions in suicide attempts, long-term effects are uncertain.

  • Report

    What Role Can Schools Play in Addressing Student Mental Health?

    Dec 28, 2012

    Student mental health programs can improve staff, faculty, and student knowledge of mental health problems, provide skills for identifying and referring students in need, and change attitudes toward mental health problems.

  • Report

    Reducing Mental Health Stigma and Discrimination

    Dec 28, 2012

    Experts review what is and is not known about the effectiveness of various approaches to reducing the stigma of mental illness, methodologies that should be employed in the future, and more.

  • Blog

    Creating More Savvy Consumers Through Public Reporting

    Dec 27, 2012

    Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys are designed to capture patients' experiences in a systematic way that facilitates reporting the results publicly to help other consumers make more savvy care decisions. Consumer choices may influence providers to improve the care they offer so that they can effectively compete in the market.

  • Blog

    Shifting the Burden of Mental Health Care: Helping Families

    Dec 21, 2012

    In our national conversation on mental health, we should remember the role of families when thinking about treatment and ensure that our policies open up opportunities to support parents, siblings and relatives, and enhance their capacity for care, writes Ramya Chari.

  • Blog

    Responding to Newtown

    Dec 21, 2012

    Art Kellermann reviews what is known from broad outlines of the Newtown attack and past research on gun violence to offer some preliminary thoughts to the Obama Administration's task force and the public.

  • Blog

    Silencing the Science on Gun Research

    Dec 21, 2012

    The United States has long relied on public health science to improve the safety, health, and lives of its citizens. Perhaps the same straightforward, problem-solving approach that worked well in other circumstances can help the nation meet the challenge of firearm violence, writes Arthur Kellermann.

  • Blog

    In Connecticut, Recovery and Healing Will Take Time

    Dec 20, 2012

    With an event like this, “recovery” doesn't mean a return to normal, because lives have been permanently altered. Recovery can only mean finding a new normal, a new path forward. And schools, those places of safety and healthy development, can help with that process, by providing a structure and community to support healing, writes Lisa Jaycox.

  • Tool

    A Toolkit for Implementing Parental Depression Screening, Referral, and Treatment

    Dec 20, 2012

    Many families experience the challenges of caregiver depression and early childhood developmental delays. Although services and supports across systems could help caregivers to deal with such issues at the family level, numerous obstacles prevent adequate screening and identification, referral, and service delivery.

  • Blog

    Art Kellermann Elected to Institute of Medicine's Council of Governors

    Dec 20, 2012

    RAND congratulates Art Kellermann, M.D., Paul O'Neill–Alcoa Chair in Policy Analysis, on being named by his peers to serve on the Institute of Medicine's (IOM) Council of Governors. The Council is responsible for approving IOM studies, overseeing budget and investments, and guiding policy.

  • Project

    In the Wake of Sandy Hook Tragedy, Resources for Schools and Parents

    Dec 19, 2012

    As Newtown, Connecticut and the rest of the nation tries to recover from the tragic shooting that took the lives of 28 people, the CBITS program offers helpful materials including “psychological first aid” for schools and tips for talking to children about the shooting.

  • Blog

    ACOs: Making Organizations 'Accountable' for Care

    Dec 19, 2012

    The Affordable Care Act focuses primarily on extending coverage to uninsured Americans, but it is also intended to help curb cost growth. M. Susan Ridgely explains one of the key tools for doing that—the “accountable care organization,” an alternative delivery model intended to lower costs while also improving quality of care.

  • Blog

    Teen Employment May Not Always Be a Boon for At-Risk Youth

    Dec 18, 2012

    For all teens, and especially those who have already experienced problems related to alcohol and drug use, it is essential to monitor the quality of work experiences and keep in mind that some work environments might increase risk for substance use.

  • Multimedia

    Skin in the Game: How Consumer-Directed Health Plans Can Affect the Cost and Use of Health Care

    Dec 14, 2012

    In this December 2012 Congressional Briefing, Amelia Haviland presents the results of several RAND studies on cost and quality in consumer-directed health plans, and explores how switching plans affects the quality of care.

  • Blog

    What Happens When a 'Food Desert' Gets an Oasis?

    Dec 13, 2012

    In an era of budget constraints, policymakers confronting the U.S. obesity crisis need strong evidence to inform decisions about where and how to invest, writes Tamara Dubowitz.

  • Journal Article

    Wellness Program Incentives: Can We Legally Pay People for Being Good?

    Dec 11, 2012

    Incentives to participate in wellness programs or reach health-related targets are popular, but could expose employers and insurers to litigation risk because incentives might violate state and federal insurance, anti-discrimination, or privacy laws.

  • Journal Article

    More Frequent Natural Disasters Could Damage Health Outcomes in Developing Countries

    Dec 10, 2012

    Researchers present one of the first investigations into the impact of small and moderate disasters on morbidity, physical growth, and immunizations by combining household data on over 80,000 children from rural India.

  • Journal Article

    You Can't Improve What You Don't Measure

    Dec 7, 2012

    Translating empirical studies, systematic reviews, and clinical guidelines into measurable performance indicators is a key first step in improving the quality of care.

  • Blog

    Frist Calls Healthcare System 'Messy' but He's Optimistic

    Dec 6, 2012

    During a panel discussion at RAND's Politics Aside event, Bill Frist, a medical doctor and former Senate majority leader, says the healthcare industry faces serious obstacles but he believes it ultimately will find its way. Meanwhile, RAND's Arthur Kellermann notes that the recent decade of health care cost growth has wiped out real income gains for average U.S. families.

  • Journal Article

    Effective Communication of Molecular Genetic Test Results

    Dec 6, 2012

    Using a template for molecular genetic test reports, developed to reduce communication errors between the laboratory and ordering clinician, was found to improve physician ratings compared to standard laboratory templates—especially with doctors who were least familiar with the reports.

  • Journal Article

    Schools Can Be a Powerful Setting for PTSD Interventions

    Dec 6, 2012

    The Cognitive-Behavioral Intervention for Trauma in Schools Program (CBITS) is a targeted intervention for school children who have experienced a traumatic or violent event and have symptoms of posttraumatic stress disorder.

  • Journal Article

    Life in the U.S. Linked with Obesity in Mexican Immigrants

    Dec 5, 2012

    The longer that Mexican immigrants stay in the U.S., the greater their odds of becoming obese, according to a new study examining three generations of immigrants. First-generation immigrants are more likely to be obese than their peers still in Mexico. Succeeding generations are even more likely to carry extra weight.

  • Blog

    Health Care Providers May Be the Key to Improving Flu Vaccination Rates

    Dec 4, 2012

    For vaccination to become a public health priority in the U.S., stakeholders must strengthen guidance for providers, which would make it easier for physicians to both assess vaccination needs and aid communication with patients about the efficacy and safety of vaccines.

  • News Release

    Mexican Immigrants to the U.S. Are Not as Healthy as Previously Believed

    Dec 3, 2012

    Immigrants who come to the U.S. from Mexico arrive with a significant amount of undiagnosed disease. About half who have diabetes are unaware they have it, and about one-third of those with high blood pressure are unaware of the illness.

  • Blog

    Far More U.S. Health Security Research Effort Aimed at Bioterrorism than Natural Disasters

    Dec 3, 2012

    Given the broad range of threats facing the United States, including those related to extreme weather, it is imperative that monies invested in enhancing health security be well spent, writes Shoshana Shelton.

  • Journal Article

    Price Elasticity of Expenditure Across Health Care Services

    Dec 1, 2012

    As policymakers worldwide debate ways to reform health care to reduce expenditures, estimates of price elasticity of expenditure are a key component for predicting expenditures under alternative policies. Here, data from Chile was used to estimate elasticity of expenditures across a variety of health care services.

  • Research Brief

    Engage and Empower Consumers to Contain Health Care Spending

    Nov 30, 2012

    Cost-sharing leads consumers to reduce both highly beneficial and less beneficial care, so they must be empowered with useful information to make informed decisions. Public cost and quality reports must be accurate, accessible, and understandable.

  • Journal Article

    Coronary Heart Disease Risk Factors: What Impact Do Neighborhoods Have?

    Nov 30, 2012

    Neighborhood socioeconomic status is significantly associated with coronary heart disease risk, according to a nationally-representative sample. The association is larger in men than women and in whites than minorities.

  • Journal Article

    Do Retail Clinic Visits Interfere With Primary Care?

    Nov 29, 2012

    Researchers determine that retail clinics may disrupt whether patients see a primary care physician first for new conditions, as well as continuity of care. However, retail clinics do not negatively impact preventive care or diabetes management.

  • Journal Article

    What Evidence Says About How Best to Treat Children With Autism

    Nov 28, 2012

    Research evidence has many gaps, but treatment guidelines for children with autism spectrum disorders represent a significant step forward. Future research should focus on assessment and monitoring of outcomes, the needs of pre- or non-verbal children, and the most effective treatment strategies and duration.

  • Report

    A Review of Workplace Wellness Programs

    Nov 27, 2012

    Ninety-two percent of U.S. employers with 200 or more employees reported offering workplace wellness programs in 2009. However, participation remains limited; a 2010 survey suggests that typically less than 20 percent of eligible employees participate in wellness interventions.

  • Journal Article

    The Large Social Value Resulting From Use of Statins

    Nov 16, 2012

    Calculating statins' social value reveals that consumers captured 76 percent of the total social value of the survival gains, with even greater consumer benefits expected in the future as prescribing rates rise and statin costs decrease.

  • Blog

    The 24/7 Sobriety Project: A New Approach to Reducing Drunk Driving and Domestic Violence

    Nov 15, 2012

    Excessive alcohol consumption costs society nearly a quarter of a trillion dollars each year. An innovative program that combines frequent alcohol testing for offenders with swift and certain sanctions for failed tests can help reduce problem drinking and improve public health.

  • Blog

    Hurricane Sandy Highlights Importance of Hospital Preparedness

    Nov 15, 2012

    The problem is that on any given day, disaster preparedness takes a back seat to ongoing operations. The tyranny of the urgent prevents hospital administrators from making investments in preparedness, writes Art Kellermann.

  • Research Brief

    Providers Influence the Bulk of Health Care Spending in the U.S.

    Nov 15, 2012

    Providers can dramatically improve American health care by focusing on “value” instead of “volume,” eliminating wasteful and inappropriate care, applying the best available evidence to their practices, and enhancing patient safety.

  • Research Brief

    To Flatten Health Care Spending, Facilitate High-Value Innovation

    Nov 15, 2012

    Health information technology has not achieved its full potential, but its benefits should grow over time. Because health care is largely regulated at the state level, the states can play a valuable role as “laboratories” for innovative policies.

  • Journal Article

    Five Reasons That Many Comparative Effectiveness Studies Fail to Change Patient Care and Clinical Practice

    Nov 13, 2012

    Despite widespread enthusiasm about the potential impact of new investments in comparative effectiveness research, recent history suggests that scientific evidence may be slow to change clinical practice.

  • Journal Article

    Is There a Robust Relationship Between Neighborhood Food Environment and Childhood Obesity?

    Nov 12, 2012

    Evidence suggests that the existence of more types of food outlets in an area, including supermarkets, is associated with a higher body mass index among youth.

  • Journal Article

    Does Subsidizing Healthy Food Purchases Work?

    Nov 9, 2012

    Evidence suggests that subsidizing healthier foods tends to be effective in modifying dietary behavior. However, future studies should examine its long-term effectiveness and cost-effectiveness at the population level and its impact on overall diet intake.

  • Journal Article

    Clinical Practice Guidelines: A Foundation of Efforts to Improve Health Care

    Nov 7, 2012

    Researchers discuss deciding what type of evidence and outcomes to include in guidelines; integrating values into a guideline; incorporating economic considerations; synthesis, grading, and presentation of evidence; and moving from evidence to recommendations.

  • Journal Article

    Assessing Quality of Mental Health Care for Afghanistan and Iraq Veterans

    Nov 6, 2012

    Efforts to maintain and increase veteran participation in the mental health and substance-use services offered by Veterans Affairs should be informed by individuals' characteristics, such as younger age and better physical health relative to other veterans.

  • Journal Article

    Less-Experienced Physicians Spend More Money Caring for Patients Than More-Experienced Physicians

    Nov 5, 2012

    Commercial health plans and Medicare are using cost profiles to identify which physicians account for more health care spending than others, while devising strategies to reward those who provide quality care at a lower cost. Doctors with less than 10 years of experience had 13.2 percent higher overall costs than those with 40 or more years of experience.

  • Journal Article

    Greater Cultural Competency Could Produce Better Patient Experiences

    Nov 2, 2012

    Hospitals with higher cultural competency ratings have better scores on multiple dimensions of care. Findings also indicate that greater cultural competency may particularly benefit minorities in interactions with hospital staff, while also contributing to general quality improvement.

  • Journal Article

    The Impact of Medical Insurance for the Poor in Georgia

    Nov 1, 2012

    The Medical Insurance Program for the Poor in the republic of Georgia provides a free and extensive benefit package and operates through a publicly funded voucher program, enabling beneficiaries to choose their own private insurance company. This research looks at costs, usage and health behaviors under this system.

  • Journal Article

    Racial/Ethnic Disparities in Medicare Part D Experiences

    Oct 31, 2012

    Racial/ethnic minorities report more difficulties in getting drugs and needed information through Medicare's Part D program. However, quality improvement efforts may reduce these disparities in beneficiary experience with prescription drug coverage.

  • Blog

    Should We Ration End-of-Life Care?

    Oct 30, 2012

    Do patients in the last stages of a terminal illness have an unqualified right to costly treatments of marginal or uncertain value for as long as they want? Because if the answer is “yes,” the rest of us must be prepared to pay the price, writes Art Kellermann.

  • Journal Article

    Comparing Similar Therapies May Yield More Questions Than Answers

    Oct 26, 2012

    About $500 million a year is being spent in the United States. on comparative effectiveness studies that will conclude that therapy A can, or cannot, be distinguished from therapy B. But will physicians be able to use such information to arrive at better decisions for their patients?

  • Journal Article

    Quality Indicators for the Care of Heart Failure in Vulnerable Elders

    Oct 26, 2012

    Fourteen quality indicators for the management of heart failure were selected in 1999 as part of the Assessing the Care of Vulnerable Elders (ACOVE) project. Since that publication, several new therapies have been shown to prolong life for patients with heart failure.

  • Journal Article

    Determining the Relationship of Depression to Work Status and Income Among HIV Clients in Sub-Saharan Africa

    Oct 23, 2012

    Findings suggest that while depression is related to work and income, its influence may only be indirect through its relationship to other factors such as work self-efficacy and physical health functioning.

  • Blog

    Understanding the Roots of Dramatic Black-White Cancer Disparities in the Nation'™s Capital

    Oct 22, 2012

    The burden of cancer is not experienced equally across the population: Nationwide, black Americans have higher rates of death from cancer than white Americans, and nowhere has this disparity been more apparent than in the nation's capital, writes Rebecca Anhang Price.

  • Journal Article

    Can Equal Access to Parks Reduce Socioeconomic Differences in Leisure Time Physical Activity?

    Oct 18, 2012

    Research indicates that individuals of lower socioeconomic status engage in less leisure time physical activity than their higher socioeconomic counterparts. This difference is believed to be due in part to varying access to parks and other resources that support physical activity.

  • Blog

    Health Care Costs Must Be Curbed, No Matter Who Wins

    Oct 17, 2012

    Regardless of which candidate wins in November, and regardless of whether “Obamacare” is repealed, amended, or defended by the next Congress, the next president will have to contend with the spiraling cost of health care in the United States—a problem that is growing more acute with each passing year, writes Arthur Kellermann.

  • Blog

    Kellermann Debates Rationing of End of Life Care

    Oct 17, 2012

    Despite remarkable progress in medical science, the global death rate is still 100 percent. So the question is not whether we will live, or die. The question is where and how we'll die, and who will be with us when we do.

  • Journal Article

    Examining Dental Usage Under Changing Economic Conditions

    Oct 15, 2012

    Only when wealth fell by 50 percent or more did older Americans decrease dental use. This finding might extend to other health care services that are preventive, routine, and relatively inexpensive.

  • Blog

    Is Candy at the Cash Register a Risk Factor for Obesity and Chronic Disease?

    Oct 11, 2012

    Although placement is a factor that is right in front of our noses, we should consider treating it as a hidden risk factor, like carcinogens in water, because placement influences our food choices in a way that is largely automatic and out of our conscious control, write Deborah A. Cohen and Susan H. Babey.

  • Journal Article

    Measuring Community Participation in Research

    Oct 11, 2012

    The value of community engagement in research cannot be empirically determined without good measures of the level of community participation in research activities.

  • Journal Article

    A Framework for Government in Payment and Delivery System Reform

    Oct 10, 2012

    Innovative payment reform initiatives occur in both the public and private sector, but the optimal role of the public sector in such reforms is up for debate.

  • Blog

    California Improves on Affordable Care Act by Letting RNs Dispense Birth Control

    Oct 9, 2012

    As we look for ways to provide efficient, high-quality and cost-effective healthcare to more Americans, states may study California as a potential model for how to do more to deliver on what the Affordable Care Act has to offer women, while saving money at the same time, writes Chloe Bird.

  • Blog

    Caring for the Uninsured: What Role Do Emergency Rooms Play?

    Oct 9, 2012

    Absent from the discussion about health care during the first debate between President Barack Obama and Governor Mitt Romney was any mention of one of the main providers of care for America's uninsured: emergency rooms. What does research tell us about the use of ERs and the relevant implications on health care access and cost?

  • Blog

    Giving "Voice" to Nursing Home Residents: A Revolution in Quality Assessment

    Oct 9, 2012

    It seems obvious to ask nursing home residents about their own health. But until a quiet revolution that took place in 2010, it didn't work that way.

  • Report

    Evaluating California's New Mental Health Emphasis on Prevention

    Oct 8, 2012

    In 2004, California voters passed a proposition intended to transform their community mental health system from a crisis-driven system to one including a focus on prevention and wellness. RAND researchers have developed a framework for evaluating the impact of California's prevention and early intervention services.

  • Journal Article

    Making Children's Health and Well-Being a Priority for the 2012 Presidential Candidates

    Oct 5, 2012

    For the past four decades, children have been the most vulnerable group in America. With this in mind, this commentary poses a series of policy questions for the 2012 presidential candidates to spur a dialogue about the vital issues of child poverty, health, development, and education.

  • Journal Article

    Do Physician Organizations Located in Lower Socioeconomic Status Areas Score Lower on Pay-for-Performance Measures?

    Oct 4, 2012

    Physician organizations (POs) in lower socioeconomic status areas may score poorly in pay-for-performance programs. Programs that do not account for this are likely to pay higher bonuses to POs in areas of higher socioeconomic status, thus increasing the resource gap, which may also increase disparities in care.

  • Periodical

    Check, Please

    Oct 2, 2012

    Many single entrées at U.S. chain restaurants serve up masses of calories, fat, and sodium. This infographic breaks down just how bad a full meal can be.

  • Journal Article

    Examining Morbid Obesity Trends in the U.S.

    Oct 1, 2012

    Morbid obesity entails far more serious health consequences for patients than moderate obesity and creates additional challenges for providers. The prevalence of morbid obesity continues to be increasing, although less rapidly in more recent years than prior to 2005.

  • Journal Article

    Will “Out of Sight, Out of Mind” Work for Candy Bars?

    Oct 1, 2012

    This commentary argues that we should consider treating prominent store placement of unhealthy items as a hidden risk factor for diet-related chronic diseases.

  • Journal Article

    Enhancing Cross-System Collaboration for Parents at Risk for Depression

    Sep 28, 2012

    Cross-coordination of health systems could help fight depression among parents. A new cross-system quality improvement initiative is focused on improving identification and treatment of families faced with the dual challenge of caregiver depression and early childhood developmental delays.

  • Journal Article

    The Effect of Legal and Hospital Policies on Physician Response to Prenatal Substance Exposure

    Sep 27, 2012

    Both a hospital's protocol and a state's legal environment are significantly correlated with physicians' propensity to take action when they suspect Prenatal Substance Exposure. However, physicians prefer a patient-centered approach in these situations over more punitive measures.

  • Journal Article

    Neighborhood Characteristics and the Initiation of Marijuana Use and Binge Drinking

    Sep 24, 2012

    Researchers examine whether residential neighborhood characteristics influence the initiation of marijuana use and binge drinking, and if these factors—including the proportion of households below the poverty line and female-headed, unemployment rate, residential stability, and perceived cohesion and safety—heighten or dampen peer influences on substance use.

  • Periodical

    The Fate of ACA Is a Major Issue in Upcoming Congressional and Presidential Elections

    Sep 21, 2012

    Whether the Affordable Care Act is repealed, defended, or weakened will hinge on who holds the balance of power next January. Regardless of what happens with the ACA, the spiraling cost of health care in the United States will remain a huge challenge.

  • Journal Article

    Medicare Postacute Care Payment Reforms Could Improve Efficiency, But May Need Changes To Cut Costs

    Sep 21, 2012

    The Affordable Care Act requires changes in payment policies for Medicare postacute care services intended to contain spending and help ensure the program's financial sustainability. Policymakers will need to monitor the reforms' impact and amend policies as necessary to ensure that spending is controlled without compromising the service delivery.

  • Blog

    Can New York City's Soda Ban Improve Our Choices and Outcomes?

    Sep 18, 2012

    Much of the talk has focused on how New York City's ban on sugary drinks, intended to curb obesity by improving dietary choices for consumers, will restrict individuals’ options. Of course, even after the ban, consumers can still buy a second soda. But they might want to take a moment to think about the consequences before doing so, writes Chloe Bird.

  • Journal Article

    Disparities in Life Expectancy Are Widening, and Many May Not Catch Up

    Sep 17, 2012

    Alarming disparities in life expectancy persist in the U.S. among racial groups and between the well-educated and those with less education. To reduce this gap in health and longevity, policymakers should improve education at young, middle, and older ages for people of all races.

  • Blog

    New York City Is Right to Treat Soda Like 'Demon Rum'

    Sep 14, 2012

    It is time we treated food with the same respect we hold for the power of alcohol. It's time to develop and implement regulations that will help us moderate our diets and stem the obesity epidemic, write Deborah Cohen and Lila Rabinovich.

  • Blog

    How Might the Federal Government React if States Legalize Marijuana?

    Sep 13, 2012

    This November, Washington state, Oregon, and Colorado voters will consider ballot measures to legalize the production, distribution, and possession of marijuana for nonmedical purposes. Even if voters pass these measures at the state level, marijuana will still be prohibited by the federal government, writes Beau Kilmer.

  • Journal Article

    Perceived Discrimination Among Patients Is Prevalent

    Sep 12, 2012

    Researchers find that patient perceptions of discrimination based on race/ethnicity and Medicaid insurance are widespread and are associated with lower patient assessments of care. Practices must develop and implement strategies to reduce perceived discrimination among their patients.

  • Journal Article

    Workplace Strategies Are Needed to Protect Youth from Starting to Smoke

    Sep 11, 2012

    Because there is a strong association between adolescents' beginning to work and their beginning to smoke, the workplace may be an appropriate venue for antismoking interventions targeting youth.

  • Journal Article

    Hispanic and Black U.S. Children's Paths to Obesity

    Sep 10, 2012

    By 8th grade, Hispanic and black children are 50 percent more likely to be obese than non-Hispanic white children. Obesity is equally prevalent among Hispanic and black children, but it emerges and is sustained earlier in Hispanics. This should have implications for diagnosis and prevention strategies going forward.

  • Project

    RAND Gulf States Policy Institute Supports Long-Term Strategic Planning in the Region

    Sep 6, 2012

    Established in December 2005 to support hurricane recovery and long-term economic development, the RAND Gulf States Policy Institute is dedicated to developing informed public policy in Louisiana, Mississippi, and Alabama and a better future for the people who live there.

  • Journal Article

    Adolescents Girls' Most Common Source of Junk Food Away from Home

    Sep 6, 2012

    High school girls reported consuming an average of 3.5 servings per week of snacks high in solid oils, fats, and added sugars at someone else's house and 3.0 weekly servings at retail food outlets. These findings demonstrate the widespread availability of low-nutrient foods across multiple settings.

  • Report

    Insights and Opportunities for Improving U.S. Drug Policy

    Sep 5, 2012

    Discussions about reducing harms associated with drug use and antidrug policies are often politicized, infused with questionable data, and unproductive. This nonpartisan primer should be of interest to those who are new to the field of drug policy, as well as those working in the trenches.

  • Blog

    Supporting Comprehensive Healthcare for Women Makes Dollars, and Sense

    Sep 5, 2012

    As we look for ways to provide efficient, high-quality, and cost-effective health care to more Americans, we can't afford to ignore women's health issues, including reproductive health care and the cost savings that contraceptive access provides, writes Chloe Bird.

  • Journal Article

    An Innovative—But Risky—Treatment for Late-Arriving Stroke Patients

    Sep 4, 2012

    Treating stroke patients is time-sensitive; risk of death or disability by hemorrhage may increase with stroke size and time. An innovative but risky stroke therapy, recombinant tissue plasminogen activator, may decrease time between symptom onset and drug administration. But is it suitable for late-arriving patients?

  • Journal Article

    A Conceptual Framework and Protocol for Defining Clinical Decision Support Objectives Applicable to Medical Specialties

    Sep 1, 2012

    This article describes a conceptual framework and protocol that combines evidence review with expert opinion, using a modified Delphi expert panel process, to elicit clinically meaningful objectives for clinical decision support directly from specialists.

  • Blog

    What Will Change Most About Our Routine Physicals Over the Next Decade?

    Aug 31, 2012

    Don't forget—an American's odds of living a long and healthy life still depend more on his zip code than his genetic code. That won't change until we make healthcare more affordable, writes Dr. Arthur Kellermann.

  • Blog

    Parents: That Summer Job Could Be Teaching Your Youngster to Smoke

    Aug 30, 2012

    Workplaces across the world that rely on a teenage workforce, like supermarkets and fast food restaurants, need to do a better job protecting young people from starting to smoke, writes Rajeev Ramchand.

  • Blog

    Addressing the Geriatrician Shortage May Help Reduce Costs Without Compromising Quality

    Aug 30, 2012

    Greater use of geriatricians in hospital settings could reduce health care costs while maintaining quality of care, but there are fewer than four certified geriatricians in the U.S. per 10,000 individuals 75 years of age or older.

  • Research Brief

    When Patients Don't Take Their Medicine

    Aug 28, 2012

    Patient nonadherence to prescriptions affects up to 40 percent of older adults in the U.S. and is associated with poor health outcomes, more hospitalizations, and higher mortality. While physicians uniformly feel responsible for promoting adherence, only a minority ask their patients detailed questions on the topic.

  • Journal Article

    Does Emergency Department Crowding Aggravate Health Care Disparities?

    Aug 24, 2012

    Researchers find that hospitals serving large minority populations are more likely to divert ambulances. This suggests that establishing more uniform policies to regulate diversion may help reduce disparities in access to emergency care.

  • Blog

    Strategies Used to Control Alcohol Abuse May Be Useful in Curbing Obesity

    Aug 23, 2012

    Policies that regulate how alcohol is displayed, packaged, and sold long have been used to help curb alcohol abuse and its associated health risks. Could some of those same policies help control obesity if applied to food?

  • Journal Article

    Pushing for Evidence-Based Practices in Homeless Veteran Services

    Aug 22, 2012

    This study engaged staff members from VA homeless programs using Getting-To-Outcomes (GTO), which builds practitioner capacity to plan, implement, and self-evaluate evidence-based practices. Staff found GTO to be helpful and felt that communication, staff commitment to the program, and technical assistance were crucial.

  • Journal Article

    Do Cultural Values Affect Adolescent Alcohol Use?

    Aug 21, 2012

    Higher parental respect was protective against adolescent alcohol use for Whites and Asians, but not for Blacks or Hispanics. Interventions focused on maintaining strong cultural values and building strong bonds between adolescents and their families may help reduce the risk of alcohol initiation.

  • Report

    Health and Economic Outcomes of Wounded Warrior Project Alumni

    Aug 17, 2012

    The not-for-profit Wounded Warrior Project gives injured veterans access to programs to improve their health and economic outcomes. Participants are achieving the goal of not missing work due to physical health problems and have obesity rates proportionate to that of the U.S. population.

  • Report

    Initiatives to Curb Tobacco Use in Arkansas Have Paid Dividends, but More Effort Is Needed

    Aug 16, 2012

    A decade of unprecedented efforts in Arkansas has cut cigarette use by nearly one-third and reduced incidence of tobacco-related illnesses such as heart attacks and stroke. To maintain these gains, Arkansas should continue its financial commitment of devoting tobacco settlement funds to public health programs.

  • Report

    Group Cognitive Behavioral Therapy for Depression in Clients with Alcohol and Substance Use Problems

    Aug 15, 2012

    This DVD set contains demonstrations of techniques, strategies, and exercises used in the BRIGHT group therapy for depression in individuals with alcohol and drug use problems. BRIGHT counselors address common concerns about using a treatment manual, and guide viewers through steps in preparing to lead a BRIGHT group.

  • Journal Article

    Use of Acupuncture by American Physicians

    Aug 14, 2012

    Physicians who incorporate acupuncture into their practice do so mainly to treat pain. These physicians are more likely to work in private practices, to be nonspecialists, and to use or endorse other complementary and alternative practices.

  • Journal Article

    Factors Associated With HIV/STI Testing Among Homeless Youth

    Aug 13, 2012

    Homeless youth are at high risk for HIV and other sexually transmitted infections (STI), yet those at greatest risk may never have been tested. Drop-in centers can play an important role in facilitating testing, including among injection drug users, but more outreach is needed to encourage testing in other at-risk subgroups.

  • Blog

    A Cure for Overtreatment: RAND Guidelines for Appropriate Care

    Aug 9, 2012

    Reducing inappropriate and wasteful tests, treatments, and procedures has the potential to save billions annually and simultaneously improve the quality and safety of American medicine, writes Art Kellermann.

  • Blog

    "Socialized" or Not, We Can Learn from the VA

    Aug 8, 2012

    As the nation struggles to confront the twin challenges of rising health care costs and uncertain quality, we should embrace innovative practices wherever they exist—whether they are developed in private, for-profit health care systems or so-called "socialized" ones, like Britain's NHS or America's VA, writes Art Kellermann.

  • Journal Article

    Perceptions of HIV/AIDS in One's Community Predict HIV Testing

    Aug 8, 2012

    According to new evidence, perceptions of the seriousness of HIV/AIDS in one's community may predict HIV testing behavior. Those with high perceived seriousness had significantly greater rates of testing than those who perceived HIV as less serious.

  • Journal Article

    Medical Relief After Earthquakes: Time for a New Paradigm

    Aug 7, 2012

    National organizations and major nongovernmental organizations that regularly participate in global disaster relief should regularly meet to share experiences, offer insights, and critique response in a nonjudgmental way. This should inform policy decisions around personnel, supplies, transportation, and communication.

  • Journal Article

    Examining Marijuana Use Over the Life Course

    Aug 6, 2012

    Drug use studies typically focus on young people or problematic users (arrestees or those in treatment), however, neither approach captures the full scope of the issue over time. However, a new model can synthesize both sorts of data and may help evaluate policies aimed at reducing marijuana use over the life course.

  • Journal Article

    Relationships Between Mood and Employment Among Depressed Veterans

    Aug 3, 2012

    Researchers examine the relationship between depression, productivity, and work loss among working-age U.S. veterans, finding that improved depression status is associated with a greater chance of gaining employment.

  • Journal Article

    Impact of a Private Health Insurance Mandate on Public Sector Autism Service Use in Pennsylvania

    Aug 1, 2012

    Legislation requiring improved coverage for Autism Spectrum Disorder services by private insurers may decrease the number of families seeking eligibility to obtain Medicaid-funded services, with an associated substantial decrease in Medicaid expenditures.

  • Report

    Quality Measurements of Inpatient Rehab Facilities Must Account for Risk

    Jul 31, 2012

    Inpatient rehabilitation facilities (IRFs) decreased in quality from 2004 to 2009. However, this was a result of increasing severity in case mix. After adjusting for this, IRFs actually improved on every quality metric. Risk-adjustment methods should be used as the basis for revealing overall quality trends.

  • Blog

    Will More Employers Drop Coverage Under the ACA? Don't Bet on It

    Jul 27, 2012

    A problem with using surveys to predict behavior is that they measure employer sentiment toward the ACA today, rather than the economic decisions employers typically make when the time comes, writes Art Kellermann.

  • Blog

    Bedside Manners: Obesity Is Not All Your Fault

    Jul 26, 2012

    We will be more successful at stemming the growing tide of obesity and improving our own health if everyone accepts their share of responsibility for the obesity epidemic, write Chloe E. Bird and RAND Health's Tamara Dubowitz.

  • Blog

    In Brief: Beau Kilmer on Marijuana Legalization

    Jul 25, 2012

    When people talk about legalization they're talking about removing the prohibitions on production, distribution, and possession, and sometimes they also talk about having regulations and taxation. This is very different from decriminalization, which generally focuses on reducing the penalties associated just with possession.

  • Journal Article

    How Do Young Adolescents Choose Between Health and Unhealthy Snacks?

    Jul 25, 2012

    Simulating a convenience store environment, researchers find that young adolescents' snack purchasing choices are affected by taxes on unhealthy snacks, subsidies for healthy options, and the presence of peers.

  • Multimedia

    Marijuana Legalization: What We Know and What We Don't

    Jul 24, 2012

    Researchers from the RAND Drug Policy Research Center (DPRC) discuss marijuana legalization, how it differs from decriminalization, its possible consequences, and federal response to state initiatives.

  • Journal Article

    Pro-Smoking Media Could Be Effective On College Students

    Jul 23, 2012

    College students encounter some form of pro-smoking media—movies, paid advertising, point-of-sale displays—nearly three times per week. Results of this study indicate that exposure to such media increases smoking risk among college students.

  • Research Brief

    Does Watching Sex on Television Influence Teens’ Sexual Activity?

    Jul 22, 2012

    Researchers examine the impact of TV sex on teenagers’ sexual beliefs and activities, finding that teens who watch a lot of TV with sexual content are more likely to initiate intercourse. Moreover, shows in which characters talk about sex affect teens just as much as those that actually depict sexual activity.

  • Multimedia

    Integrative Health Care and Medicine

    Jul 19, 2012

    Ian Coulter, who holds the Samueli Institute Chair in Policy for Integrative Medicine at RAND, joins fellow experts in complementary and alternative medicine (CAM) to discuss patient use of CAM and how hospitals, universities, and the military are integrating CAM into traditional medical practices throughout the U.S.

  • Journal Article

    Retail Clinics Now Providing Millions of Vaccinations Annually

    Jul 17, 2012

    Retail clinics—which provide health care within supermarkets, pharmacies, and stores—are a promising and popular venue for the promotion and administration of vaccinations. However, they could become more viable by reviewing patient histories and providing counsel about vaccination benefits.

  • Journal Article

    Patient Surveys May Not Be Cross-Culturally Compatible

    Jul 16, 2012

    Efforts to measure patients' health care experiences must expand to include non-English speakers. However, drastic differences in “subjective” ratings on medical surveys provided in multiple languages suggest that some questions may not be compatible across cultures.

  • Journal Article

    A Molecular Genetic Tests Report Template for Improved Clinician / Lab Communication

    Jul 16, 2012

    Errors are most likely to occur during the pre- and postanalytic phases of the genetic testing process, which can contribute to underuse, overuse, and misuse of genetic tests. A template that utilizes the combined features of synoptic reporting and narrative interpretation was created to mitigate such errors.

  • Journal Article

    Building Capacity for Evidence-Based Interventions in Communities Affected by Disaster

    Jul 16, 2012

    Lessons learned from implementing evidence-based practices, such as cognitive-behavior therapy, in the wake of Hurricane Katrina could help identify barriers to disseminating evidence-based interventions in other low-resource communities affected by disaster.

  • Blog

    Can Marijuana Use Lead to Dependence or Addiction?

    Jul 12, 2012

    Someone who uses cocaine every other day or more often is probably cocaine dependent; someone who uses marijuana every other day or more often is probably not cannabis dependent. In this regard, marijuana resembles alcohol more than it does the “hard” drugs.

  • Journal Article

    Popularity Could Be a Risk Factor for Underage Drinking Among Middle School Students

    Jul 11, 2012

    A study of middle school students' alcohol consumption habits finds that adolescents with a larger number of school-based friendship ties are more inclined to drink. Popular students may have more direct exposure to drinking role models, access to alcohol, opportunities to use, or social stress.

  • Blog

    Stigma Reduction Programs Could Help Those with PTSD, but the Evidence Is Weak

    Jul 10, 2012

    Determining the effectiveness of programs designed to reduce the stigma of post-traumatic stress disorder is essential to helping servicemembers seek and receive the care they need.

  • Blog

    Could Liability Concerns Derail Clinical Decision Support?

    Jul 9, 2012

    Computerized clinical decision support (CDS) systems have been developed to enhance physician decisionmaking and reduce the incidence of avoidable medical errors. Drug-drug interaction warnings are a mainstay of CDS systems, but they give rise to a fundamental problem that limits the utility of the systems to date.

  • Journal Article

    Cultural Competency in Health Care More Important Than Ever

    Jul 6, 2012

    The importance of cultural competency in health care is growing with the increasing diversity of the U.S. This study examines the relationship between organizational and market factors and cultural competency, finding that linking the latter to performance may be essential to attract more profit-driven hospitals.

  • Journal Article

    The Untested Assumptions of U.S. Disaster Preparedness

    Jul 5, 2012

    U.S. government programs regarding the importance of citizen preparedness are based on several untested assumptions. Despite extensive communications efforts and surveys related to preparedness activities, the role individual Americans are being asked to play is largely based on conventional wisdom.

  • Research Brief

    How Will the ACA Affect Employee Health Coverage at Small Businesses?

    Jul 3, 2012

    The Affordable Care Act will likely increase the probability that small businesses will offer health coverage to their employees, especially for firms with 50 or fewer workers. This will be a result of increased individual demand for insurance, since there is a penalty associated with being uninsured under the new law.

  • Report

    Examining Options for Lowering Procurement Costs for Antiretroviral HIV Medications

    Jul 3, 2012

    Antiretroviral (ARV) treatment allows patients with HIV to live longer, healthier lives, but significant access and affordability barriers persist. High prices pressure government insurers to contain costs by rationing care or restricting eligibility. This study examines options for negotiating lower ARV costs.

  • Report

    Closing the Gap Between Supply, Demand for Nurse Practitioners Providing Sexual and Reproductive Health Services

    Jul 2, 2012

    A shortage of nurse practitioners (NPs), combined with increased demand for sexual and reproductive health (SRH) services under new health care laws that increase coverage, could undermine SRH care delivery in the U.S. This study examines policy options that may help close this future gap between supply and demand.

  • Multimedia

    Prisoner Reentry and Public Health: Is Your State Ready?

    Jun 29, 2012

    In this June 2012 Congressional Briefing, Lois Davis discusses the health care needs of prisoners who reenter the general population; the roles that health care providers, other social services, and family members play in successful reentry; and recommendations for improving access to care for this population in the current fiscal environment.

  • Blog

    Time to Shift Talk to Health Care Costs

    Jun 28, 2012

    The U.S. Supreme Court's ruling on the Affordable Care Act is unquestionably historic, but there is a critical aspect of health care reform that still needs to be fixed. The nation needs to take decisive action to address the rising costs of health care, writes Arthur Kellermann.

  • Research Brief

    Consumer-Directed Plans Could Cut Health Costs Sharply, but Also Discourage Preventive Care

    Jun 28, 2012

    Switching to a consumer-directed health plan (CDHP) could save families 20 percent or more on their health care costs. Families with CDHPs initiate less episodes of care and spend less per episode, however, they also tend to scale back on high-value preventive care, such as child vaccinations.

  • Journal Article

    Adjuvant Chemotherapy May Help Elderly Patients With Colon Cancer

    Jun 27, 2012

    This study examined more than 5,000 elderly patients diagnosed with stage III colon cancer. Use of adjuvant chemotherapy decreased with age and comorbidity among these patients, however, findings suggest that older patients may receive a survival benefit from this form of treatment.

  • Journal Article

    Prolonged Exposure Therapy Could Reduce PTSD Symptoms Among People Living With HIV

    Jun 27, 2012

    People living with HIV report increased levels of post-traumatic stress disorder symptoms (PTSS). This six-month study finds that prolonged exposure therapy could be effective in reducing PTSS—namely, negative cognitions—among people living with HIV.

  • Blog

    Be Hungry or Be Sick? Proposed Medi-Cal Co-Pay Could Force the Choice for Many

    Jun 26, 2012

    The $15 co-pay a mother is expected to cover represents half of a full week's food costs under the U.S. Department of Agriculture's “thrifty” food plan for her six-year-old, write Art Kellermann and Robin Weinick.

  • Blog

    Former RAND Researcher Elizabeth McGlynn Receives AcademyHealth's Distinguished Investigator Award

    Jun 25, 2012

    Former RAND researcher Elizabeth McGlynn has been honored with AcademyHealth's 2012 Distinguished Investigator Award. Her extensive research on health care quality has had an enormous impact on how experts evaluate health care reform.

  • Journal Article

    Group Cognitive-Behavioral Therapy: A Viable Option For Patients Battling Addiction, Depression

    Jun 21, 2012

    This study of nearly 300 residential addiction treatment clients with depressive symptoms suggests that group cognitive-behavioral therapy for depression (GCBT-D) could promote recovery efforts and reduce depressive symptoms.

  • Report

    How Appropriate Are Hysterectomy Recommendations?

    Jun 20, 2012

    Hysterectomies recommended for nonemergency and nononcologic reasons are often unnecessary. Seventy percent of cases examined did not meet the recommended level of care and were deemed inappropriate. Physicians must complete proper diagnostic evaluation and consider appropriate treatments before recommending hysterectomy.

  • Report

    A New Commercial Model for Big Pharma in the Postblockbuster World

    Jun 19, 2012

    The pharmaceutical industry can and should reconfigure its considerable resources to develop innovative and meaningful business models that are based on services that improve access and adherence to prescription drugs for common chronic conditions.

  • Journal Article

    Relationship-Level Interventions Could Reduce HIV Among Homeless Youth

    Jun 18, 2012

    Homeless youth are particularly vulnerable to HIV and other STIs; they are more likely to engage in multiple partnerships, unprotected sex, and sex trading. This study examines levels of social influence and concludes that interventions aimed at the partner/relationship level could be effective in reducing risk behavior.

  • Journal Article

    Placing a Value on Hope for Terminal Cancer Patients

    Jun 15, 2012

    More than three out of four cancer patients surveyed preferred “hopeful gambles” (treatments that potentially offer longer periods of survival) to “safe bets”. Either hope should be incorporated into the value of therapies, or a higher threshold should be set for cost-effectiveness ratios during end-of-life scenarios.

  • Journal Article

    Waste Represents At Least 20% of US Health Care Spending

    Jun 14, 2012

    Cuts and restrictions in care are the common health care cost reduction methods, but cutting waste (including overtreatment, poor clinical and administrative coordination, and fraud) would save at least 20% of health care expenditures. Doing so will require significant cooperation across the health care professions.

  • Journal Article

    Movie Characters' Motives for Smoking Affect Adolescents' Future Risk

    Jun 12, 2012

    This study examines how movie characters' motives for smoking affect self-reported risk for future smoking among early adolescents, finding that those who viewed characters smoking to relax or for social reasons were at greater risk for future smoking.

  • Research Brief

    Cost Reports Do Not Encourage Consumers to Choose Lower-Cost Providers

    Jun 8, 2012

    Reports on the costs of individual providers designed to steer consumers toward lower-cost options may actually accomplish the opposite. Consumers have fixed co-payments and caps on their out-of-pocket spending that make most cost information impractical. Many also equate higher costs with higher quality of care.

  • Project

    Medicines as Service May Offer New Commercial Model for Big Pharma

    Jun 7, 2012

    If the pharmaceutical industry develops innovative and meaningful business models to offer services that improve access and adherence to prescription drugs for common chronic conditions, it can profit far more than by developing more "blockbuster" drugs.

  • Multimedia

    Attempts by States to Save Money by Locking Medicaid Enrollees out of the ED Are Likely to Backfire

    Jun 6, 2012

    A better solution than restricting emergency department use by Medicaid enrollees is to reverse what for many years has been a trend of shrinking access to primary care for Medicaid beneficiaries.

  • Journal Article

    Physician Practice Style Can Predict Breast Cancer Outcomes

    May 30, 2012

    The results of physicians' management style in planning, making treatment decisions and delivering care on patient outcomes is unstudied. Using results from a survey about a hypothetical patient and real patient outcomes, research showed that physicians who co-managed tasks had better patient ratings of care.

  • Journal Article

    A Remedy for Africa's Private Health Care Sector

    May 29, 2012

    Private health facilities provide much of the care in developing countries, but are often poorly integrated into the health system. Barriers, especially financial ones, increase costs and impact patient care. Research indicates that improving facilities' business needs would improve growth and overall success.

  • Research Brief

    A Toolkit to Help Hospitals Improve Quality of Care

    May 25, 2012

    Quality of care in hospitals is a significant problem. However, researchers have developed a toolkit that outlines steps designed to help hospitals calculate desired rates for quality indicators, set priorities for improvement, develop specific strategies and goals, implement these strategies, and sustain improvements.

  • Journal Article

    Building a Better Drug Interaction Warning System

    May 24, 2012

    Most electronic health records (EHRs) automatically alert users to drug-drug interactions (DDIs), but this can result in providers being overloaded by minor alerts and missing severe ones. This project identified a set of critical DDIs for use in EHRs, and built a process to better communicate the alerts to users.

  • Multimedia

    The State of Nutrition in Chain Restaurants

    May 23, 2012

    Helen Wu discusses a RAND study that looked at over 300,000 menu items in 245 restaurants. The largest survey of chain restaurant nutrition, the study found that 96 percent of restaurant items exceeded USDA recommendations.

  • Research Brief

    Why Don't Americans Get Vaccinated?

    May 22, 2012

    Every year, vaccine-preventable diseases cost the economy billions, sicken millions and kill thousands, yet adult vaccination rates are consistently low. An analysis shows that providers are under-promoting vaccinations to adults, possibly due to cost barriers which discourage office-based vaccinations.

  • Journal Article

    How Healthy Are Menus at America’s Top Restaurants?

    May 21, 2012

    This study of menu content at the 400 top restaurant chains in the United States found that 96 percent of entrées exceed a measure based on USDA recommendations for sodium, fat, saturated fat, and calories combined.

  • Journal Article

    How Do Peers and Friends Influence Childhood Obesity?

    May 18, 2012

    Childhood obesity holds wide physical, psychological and social consequences. Unhealthy eating and physical inactivity have been shown to be influenced by peers. A literature study indicates that peer networks may be crucial to prevention and intervention efforts, but the exact mechanisms are as of yet unclear.

  • Journal Article

    U.S. Public Health in the Globalized, Austere Present

    May 17, 2012

    As commerce and travel continues to expose the U.S. to international health risks, the lines between 'local' and 'global' public health increasingly blur. U.S. agencies can aid preparedness by promoting awareness to clinicians, learning from other countries, measuring effectiveness, and keeping a global perspective.

  • Report

    A Prototype Knowledge-Sharing Service for Clinical Decision Support Artifacts

    May 17, 2012

    A description of the development of 22 clinical decision support (CDS) artifacts as part of the Advancing Clinical Decision Support effort to accelerate the effective use of CDS interventions and facilitate evidence-based clinical practice.

  • Journal Article

    Is the Nursing Boom Actually a Recession-Born Bubble?

    May 16, 2012

    Projections of a nursing shortage led to a substantial expansion in the RN workforce between 2005 and 2010. Rather than indicating that the crisis has passed, analysis indicates the growth to be largely a temporary bubble that is likely to burst between 2010 and 2015 as the unemployment rate falls.

  • Journal Article

    Barriers to Family Leave for Parents of Seriously Ill Children

    May 15, 2012

    Parents of newborns and seriously ill children often know about family leave options, but are sometimes too overwhelmed to apply for them or experience difficulties in accessing and using benefits. New parents reported wanting expert guidance, and saw hospitals and clinics as promising information sources.

  • Journal Article

    A Multicultural Web-based Intervention for DUI Risk Reduction

    May 13, 2012

    A culturally relevant web-based Motivational Interviewing in English and Spanish was developed for use in DUI educational settings. The web format was widely accepted by both staff and clients, indicating this tool is feasible and may help help deter recidivism among first time DUI offenders.

  • Journal Article

    Assessing Colonoscopy Quality With Natural Language Processing

    May 12, 2012

    Quality evaluations of medical procedures generating written reports historically required expensive coding and analysis, but new natural language processing programs effectively “read” dictated reports and measure colonoscopy quality. This analysis highlights the need for more routine measurement.

  • Periodical

    Eliminating Individual Mandate Would Decrease Coverage, Increase Spending

    May 11, 2012

    If the individual mandate requiring all Americans to have health insurance were eliminated, it would sharply reduce the number of people gaining coverage and slightly increase the cost for those who do buy policies through the new insurance exchanges.

  • Journal Article

    The Rates and Demographics of Multiple Patient Safety Events

    May 10, 2012

    Multiple patient safety events (MPSEs), in which multiple health problems occur during a single hospitalization, affect thousands of US patients yearly. This first-time national estimate suggests that MPSEs cluster in disadvantaged populations, are resource intensive, and may often be avoidable.

  • Journal Article

    Probiotics Can Reduce Risk of Diarrhea Caused by Antibiotics

    May 8, 2012

    Probiotics are believed to improve health by maintaining a normal balance of microorganisms in the human intestines. Evidence shows that they can reduce the risk of developing diarrhea, which is a common side effect of taking antibiotics.

  • Journal Article

    Expanding Consumer-Directed Health Plans Could Help Cut Overall Health Care Spending

    May 7, 2012

    If consumer-directed health plans grow to account for half of all employer-sponsored insurance in the United States, health costs could drop by $57 billion annually—about 4 percent of all health care spending among the nonelderly.

  • Journal Article

    Is U.S. Spending on Cancer Care Worth the Price?

    May 6, 2012

    The United States spends much more on health care per capita than any European country, but critics argue that US patients gain little from this extra spending. However, comparing cancer survival times in US to the EU show important gains, suggesting costs are justified by the results.

  • Journal Article

    Adults Willing to Pay Higher Premiums for Generous Specialty Drug Coverage

    May 1, 2012

    Coverage of specialty drugs for cancer and other diseases may be valued by healthy people thinking of future need as well as the sick. Surveyed US adults were willing to pay more for premiums than they would pay out of pocket with a less generous insurance plan, implying resistance to cost sharing on expensive drugs.

  • Project

    Could Access to “Green Space” Affect Neighborhood Health?

    May 1, 2012

    PHRESH Plus explores whether making parks, playgrounds, and trails—“green space”—safer and more accessible could impact the health neighborhood residents.

  • Journal Article

    Barriers and Opportunities for Religious HIV/AIDS Outreach

    Apr 30, 2012

    HIV-related stigmas have been seen as a barrier to greater faith-based involvement in HIV prevention and care. A study of diverse religious congregations suggested that stigma doesn’t prevent HIV outreach activities, and may in fact contribute to the further reduction of stigma over time.

  • Journal Article

    Parental Values Relating to Childhood Combination Vaccines

    Apr 26, 2012

    New combination vaccines reduce the number of injections needed for immunization, but with higher prices and increased minor adverse events. Surveys revealed people are willing to pay to avoid increased risk of minor adverse events as well as to increase community-level immunization coverage.

  • Journal Article

    How Will New Resident Duty Hours Rules Impact Teaching Hospital Costs?

    Apr 24, 2012

    2011 rules limiting work hours for medical interns will increase costs for hospitals, but may also lower the amount of preventable adverse events. Costs will be be greatly affected by the specifics of the work transfer, and also the amount of change to adverse events rates.

  • Report

    What is the Impact of Health Care Reform on Workers' Compensation Medical Care?

    Apr 23, 2012

    When enacting, implementing, and evaluating health care reform, policymakers should consider potential spillover effects on workers' compensation insurance. The experience of Massachusetts's heath care reform suggests that reform may reduce medical costs.

  • Announcement

    Marc Elliott Selected as a Fellow of the American Statistics Association

    Apr 18, 2012

    Elliott, a senior statistician with RAND Health, was recognized for outstanding contributions to statistical methods and practice in measuring patient experience with health services, health disparities and survey methods research, and promoting high caliber statistical practice in research.

  • Journal Article

    How Do Consumers and Providers Respond To Public Cost Reports?

    Apr 18, 2012

    Public reporting of health care costs is intended to motivate consumers to choose lower cost providers, and motivate providers to lower costs to retain market share. However, research suggests that consumer beliefs may end up working against the intended outcomes.

  • Journal Article

    The Role of Law in Public Health Preparedness

    Apr 11, 2012

    Most local public health officials rely on their perceptions of the legal environment in which they operate, but those perceptions often do not match the actual laws enacted. While the scope and provisions of laws can be confusing, much more could be done to help practitioners navigate the system.

  • Journal Article

    Does Using EMRs Increase Documentation Time for Nurses?

    Apr 9, 2012

    Electronic Medical Record (EMR) systems are perceived as reducing efficiency for office staff. However, research revealed very little difference in the percentage of time spent completing documentation with or without electronic charting options, compared with all other categories of care.

  • Research Brief

    More Efficient Use of Sedation in GI Procedures Could Save $1.1B Annually

    Apr 4, 2012

    The use of dedicated anesthesia providers for routine gastroenterology (GI) procedures is seen as medically justifiable only for high-risk patients, who account for a small number of cases. Eliminating these services for low-risk patients could generate $1.1 billion in savings per year.

  • Journal Article

    The Effects of Medical Group Mergers on Health Information Exchanges

    Apr 2, 2012

    Under pressure to form accountable care organizations, medical groups may merge and support private health information exchanges, but the private exchanges won't affect the usefulness of community health information exchanges.

  • Journal Article

    Patients Value Metastatic Cancer Therapy More Highly Than Is Typically Shown Through Traditional Estimates

    Apr 1, 2012

    Data on the treatment choices of terminally ill patients used to estimate the value they associate with care revealed that patients place high valuations on metastatic cancer therapy – on average, twenty-three times higher than its cost.

  • Journal Article

    The Impact of Health Care Costs on Employment-Based Insurance

    Mar 30, 2012

    The rapid growth of health care costs has had far-reaching economic effects, including those with work-based insurance. Rising health costs reduce employment-based private insurance availability and enrollment, and the financial protection provided by it, especially for middle-class families.

  • Report

    Focus on Health Information Technology

    Mar 30, 2012

    For nearly a decade, RAND researchers have studied how health information technology (HIT) stands to change health care.

  • Journal Article

    How Well Do PCPs Care for Patients with Cognitive Impairment and Dementia?

    Mar 28, 2012

    An evaluation of the care provided to patients with cognitive problems found that those treated by primary care physicians often do not receive the fundamental care processes that could identify reversible causes of impairment, and the work-up and treatment for new dementia is largely inadequate.

  • Journal Article

    94% Growth Predicted for the U.S. Nurse Practitioner Workforce

    Mar 26, 2012

    The nurse practitioner (NP) workforce has been growing rapidly in recent years, but future projections have been varied. A new study forecasts dramatic growth by 2025, easing concerns about a potential looming nursing shortage and suggesting that NPs will fill a substantial amount of future need for care.

  • Journal Article

    Using Health IT to Improve HIV/AIDS Care in Uganda

    Mar 24, 2012

    Missed appointments compromise the ability to plan for and deliver quality care. By implementing Electronic Medical Records and same day patient tracing, researchers were able to reduce missed appointments and increase efficiency in an community-based care clinic.

  • Journal Article

    The Role of Risk Perception in Vaccination

    Mar 21, 2012

    When faced with a pandemic like H1N1, the thinking affecting the decision to be vaccinated can be complicated. The fear of getting sick is a major motive in vaccination, but research has found factors associated with changes in this perceived risk.

  • Journal Article

    How Can Provider 'Report Cards' Better Encourage Improved Performance?

    Mar 19, 2012

    Public reports of provider performance can help or hinder consumers’ search for a good doctor — but better methods can tip the odds in consumers’ favor.

  • Journal Article

    Preventing Alcohol Use in Middle School Students with an After-School Program

    Mar 15, 2012

    Many school-based programs to prevent adolescent alcohol and drug use exist, but most are mandatory and during class time. A voluntary after-school program focused specifically on alcohol and drug use may be effective in deterring alcohol use among early adolescents.

  • Journal Article

    Lessons From the Dutch Cannabis Coffeeshop System

    Mar 14, 2012

    The Dutch policy of officially tolerating cannabis sales is seen as a model for legalization elsewhere in the world. An analysis of the data looked at consumption, markets and user harm since 1976, and found both good and bad implications for public health in the Dutch system.

  • Journal Article

    Poor Quality Data Hurts Physicians' Confidence in E-Prescribing

    Mar 12, 2012

    Electronic prescribing is looked to as a cost-saving and error-preventing tool for health care. In offices where e-prescribing was implemented, prescribers used information about formularies and drug benefits, but missing information reduced confidence in these resources and led to paper-based workarounds.

  • Journal Article

    Rules Allowing Small Businesses to Opt Out of Health Reform Should Have Minor Impact on Insurance Cost

    Mar 8, 2012

    An analysis of two rules that allow small businesses to avoid participating in health reform concludes they will have only a minor impact because relatively few businesses are likely to take advantage of the options.

  • Journal Article

    Development of a Prognostic Model for Six-Month Mortality in Older Adults With Declining Health

    Mar 1, 2012

    Estimation of six-month prognosis is essential in hospice referral decisions, but accurate, evidence-based tools to assist in this task are lacking. PROMPT, a new prognostic model incorporating health-related quality of life, demonstrates promising performance and potential value for hospice referral decisions.

  • Journal Article

    Does Neighborhood Food Environment Predict Youth Diets?

    Feb 29, 2012

    It's widely assumed that living near fast-food restaurants and convenience stores encourages overconsumption, while supermarkets encourage healthier diets. However, an analysis found no robust link between food environment and consumption in youths, indicating a more complicated relationship than some theories suppose.

  • Journal Article

    Why Does Spending for Prescription Drugs Vary Across the Country?

    Feb 28, 2012

    Although Medicare is a federal program, spending on prescription drugs varies from region to region. Are the sources of spending differences due to variations in regional health, or are the types of treatments offered causing the differences?

  • Journal Article

    A NLP Application for Measuring Colonoscopy Procedure Quality

    Feb 27, 2012

    Detection is key in improving cancer outcomes, but colonoscopy quality is often inadequate and varies widely among physicians. Quality is measured by expensive manual review of free-text patient charts. Researchers built a natural language processing (NLP) application to evaluate quality measurements.

  • Project

    Hospital Quality and Safety Toolkit by RAND and UHC Featured on AHRQ Homepage

    Feb 23, 2012

    The Agency for Healthcare Research and Quality (AHRQ) has released a free toolkit designed to guide hospitals in using the AHRQ Patient Safety Indicators and Inpatient Quality Indicators to improve hospital performance. A RAND Health team, in partnership with UHC, developed and field-tested the toolkit.

  • Multimedia

    What Would Removing the Individual Mandate from the ACA Mean For Costs and Coverage?

    Feb 22, 2012

    New RAND research finds that eliminating the requirement that all Americans have health insurance would sharply lower the number of people gaining coverage, but would not dramatically increase the cost of buying policies through new insurance exchanges. RAND Economist Christine Eibner discusses the ramifications.

  • Research Brief

    How Would Eliminating the Individual Mandate Affect Health Coverage and Premium Costs?

    Feb 21, 2012

    Overturning the individual mandate of the Affordable Care Act would sharply lower the number of people gaining coverage, but would not dramatically increase the cost of buying policies through new insurance exchanges.

  • Report

    Ending Individual Mandate Would Cut Health Coverage, but Not Dramatically Hike Insurance Price

    Feb 16, 2012

    Eliminating a key part of the Affordable Care Act that requires all Americans to have health insurance would sharply lower the number of people gaining coverage, but would not dramatically increase the cost of buying policies through new insurance exchanges.

  • Journal Article

    Does Junk Food in Schools Increase Childhood Obesity?

    Feb 15, 2012

    Despite growing concern that junk food availability in schools has contributed to the childhood obesity epidemic, research shows that the availability does not significantly increase BMI or obesity among a group of fifth-graders — even though they are likely to buy junk food.

  • Journal Article

    How Does Physician Prescribing Behavior Impact Patient Health?

    Feb 15, 2012

    Pharmaceutical advertising and rising drug costs have focused attention on physician prescribing behavior. Researchers examined how doctors were prescribing drugs, what drove their choices, and the impact of their prescribing behavior on patient outcomes.

  • Journal Article

    Nutrition Standards for Away-From-Home Foods in the USA

    Feb 13, 2012

    Away-from-home foods are less healthy, and many localities are adopting regulations to improve the quality of away-from-home foods. Is there a rationale for developing nutritional performance standards for away-from-home foods, and what are the barriers to implementing consumer standards?

  • Journal Article

    Community-Based Delivery of Treatment for Adolescent Substance Use

    Feb 13, 2012

    Substance abuse treatment programs are widely used, but the efficacy of specific therapies used in programs is largely unstudied. MET/CBT-5 was evaluated in adolescents undergoing treatment for cannabis-related issues, and significant differences in outcomes were found compared to standard therapy.

  • Report

    Studying the Influence of New Media on Adolescent Sexual Health

    Feb 10, 2012

    The ubiquity of the internet and digital media has also increased the amount of explicit material available to adolescents. The effects of new media on adolescent sexual health are being researched, but researchers will need to bridge gaps in theory and methods when studying this area.

  • Journal Article

    Financial Burden of Prescription Drugs Is Dropping, but Costs Remain a Challenge for Many Families

    Feb 8, 2012

    The financial burden Americans face paying out-of-pocket costs for prescription drugs has declined, although prescription costs remain a significant challenge for people with lower incomes and those with public insurance.

  • Journal Article

    Can Training and Texts Help Teens With Asthma?

    Feb 8, 2012

    Asthma in children holds many dangers for children, especially minorities. Many of these risks come from poor adherence to treatment, but a brief educational session with tailored, reinforcing text messages sent to adolescents' cell phones improved adherence and health outcomes.

  • Report

    Preventing Emergency Hospital Readmissions

    Feb 3, 2012

    The rates of emergency readmission to hospitals are frequently used to measure avoidable adverse outcomes after initial admission - not only are readmissions costly and dangerous, but they highlight areas of care needing improvement. However, hospitals may mask the true statistics in their coding and reporting.

  • Journal Article

    HIV Conspiracy Beliefs and Sexual Risk Among Black Males Living with HIV

    Feb 1, 2012

    African Americans have high levels of medical mistrust, including conspiracy beliefs related to HIV, and black men have the highest rates of HIV and AIDS diagnoses in the US. Conspiracy beliefs were associated with high-risk sexual behavior, showing the impact of medical mistrust on outreach and education efforts.

  • Journal Article

    Does Outdoor Exercise Equipment Make Parks More Attractive to Users?

    Jan 29, 2012

    Communities around the world are investing in outdoor exercise equipment in parks to increase physical activity, yet the impact of such improvements is unclear. Research shows that adding equipment to parks seems to attract more new park users and result in a higher expenditure of energy.

  • Journal Article

    What Causes Low Minority Satisfaction With Doctors?

    Jan 23, 2012

    Ethnic minority groups in the UK consistently report less positive experiences with their primary care than do whites. Minority concentration in low-rated practices explains some of the difference, but some groups report less satisfaction than do whites at the same offices.

  • Journal Article

    Prescription Medication Abuse and Illegitimate Internet-Based Pharmacies

    Jan 20, 2012

    Abuse of prescription drugs represents a growing problem. This article discusses the challenge to federal and private efforts to combat the problem and outlines strategies for physicians to recognize and minimize the effects of the availability of these medications on the Internet.

  • Journal Article

    Off-label Use of Atypical Antipsychotics: An Update

    Jan 18, 2012

    Antipsychotic drugs are used to treat conditions unapproved by the FDA, but what is the evidence of their efficacy for these uses? Researchers analyzed years of medical literature to compile the findings of studies evaluating off-label treatments, as well as details of side effects.

  • Report

    Promoting and improving adult vaccination in the United States

    Jan 13, 2012

    Vaccine-preventable disease takes a heavy toll on U.S. adults, despite the widespread availability of effective vaccines. This report lays out a blueprint for improving access to adult vaccinations and encouraging more adults to seek vaccination.

  • Journal Article

    How Does Race Affect the Cancer Caregiving Experience?

    Jan 13, 2012

    Cancer care has increasingly moved from hospital to outpatient settings, transferring significant aspects of patient care from medical professionals to family. A survey of African American and white caregivers found significant racial differences in preparedness, social support and time spent providing care.

  • Journal Article

    Coexistent Obesity and Anemia in Mexican Children

    Jan 11, 2012

    According to a Mexican nutrition survey, childhood obesity and anemia rates are near 20%, but it is less clear how often the two conditions affect the same children. Significant age and gender associations were found for both conditions, highlighting the need for nutrition education.

  • Journal Article

    Flu Shots Recommended for All Adults - But Who Knows?

    Jan 9, 2012

    In 2010, the US Centers for Disease Control (CDC) began universally recommending annual influenza vaccination to all people aged 6 months and older. Healthy young adults, in particular, are impacted by this new recommendation — but how widely has awareness spread since the policy change?

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