RAND Research Topic: Health Care Access 2012-05-21T23:09:05Z Copyright (c) 2012, The RAND Corporation RAND Corporation http://www.rand.org/topics/health-care-access.html Emergency Departments, Medicaid Costs, and Access to Primary Care—Understanding the Link http://www.rand.org/commentary/2012/05/16/NEJM.html May 16, 2012 May 16, 2012 The fact that many ED (emergency department) visits could be managed in primary care settings does not mean that such care is available, write Arthur L. Kellermann and Robin M. Weinick. Expanding Consumer-Directed Health Plans Could Help Cut Overall Health Care Spending http://www.rand.org/pubs/external_publications/EP201200104.html May 7, 2012 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. Would the Affordable Care Act Lead to Reductions in Employer-Sponsored Coverage? http://www.rand.org/blog/2012/05/would-the-affordable-care-act-lead-to-reductions-in.html May 4, 2012 May 4, 2012 As the U.S. Supreme Court considers the constitutionality of the Affordable Care Act's (ACA) individual mandate, one of the questions being debated is what effect the mandate would have on employer-sponsored health insurance coverage. A factor to consider in this is the effect the ACA would have on small businesses, which employ the majority of America's private-sector workforce. Web-Based Tool for Parents of Children with Flu-Like Symptoms Piloted at DC-Area Hospitals http://www.rand.org/news/press/2012/03/15.html Mar 15, 2012 Mar 15, 2012 Researchers from the RAND Corporation and other institutions have begun pilot-testing a web-based tool designed to help parents and adult caregivers determine whether to seek urgent medical attention for a sick child with flu-like symptoms. Are There Differences in the Medicare Experiences of Beneficiaries in Puerto Rico Compared with Those in the U.S. Mainland? http://www.rand.org/pubs/external_publications/EP20120036.html Mar 1, 2012 Mar 1, 2012 The authors compare the experiences of elderly Medicare beneficiaries in Puerto Rico with their English-preferring and Spanish-preferring Medicare counterparts in the U.S. mainland. The Association of Health Insurance and Disease Impairment with Reported Asthma Prevalence in U.S. Children http://www.rand.org/pubs/external_publications/EP20120011.html Feb 1, 2012 Feb 1, 2012 This article tests the hypotheses that reported asthma prevalence is higher among insured than uninsured children and that insurance-based differences in asthma diagnosis, treatment, and health care utilization are associated with disease severity. How Will the Effects of the Affordable Care Act Be Monitored? http://www.rand.org/commentary/2012/01/04/JAMA.html Jan 4, 2012 Jan 4, 2012 Most will agree with the undeniable fact that a new era in US medicine and US health care begins in less than 2 years. The key question is what potential measures should be monitored to determine both anticipated and unanticipated effects of the new law on the health of the US population, writes Robert H. Brook. Wealth Effect and Dental Care Utilization in the United States http://www.rand.org/pubs/external_publications/EP201200101.html Jan 1, 2012 Jan 1, 2012 This article examines the relationship of wealth and income and the relative impact of each on dental utilization in a population of older Americans, using data from the Health and Retirement Study (HRS). Take-up of Public Insurance and Crowd-Out of Private Insurance Under Recent CHIP Expansions to Higher Income Children http://www.rand.org/pubs/external_publications/EP20120099.html Jan 1, 2012 Jan 1, 2012 The CHIP expansions to children in higher income families were associated with limited uptake of public coverage. Experimental Design of a Non-Contributory Social Security Program in Yucatan, Mexico http://www.rand.org/labor/centers/clasp/research/projects/social-security-program.html Dec 8, 2011 Dec 8, 2011 Given the worldwide trend of aging populations, it is important to learn about the long- and short-term effects of non-contributory social security programs. With the State of Yucatan, CLASP designed such a program for towns with more than 20,000 inhabitants. The project team is now evaluating its impact on the welfare of residents ages 70 and older. What Are the Public Health Implications of Prisoner Reentry in California? http://www.rand.org/pubs/research_briefs/RB9634.html Dec 7, 2011 Dec 7, 2011 Examines the health care needs of released California prisoners, communities most affected by reentry, safety net capacity, and provider experiences with ex-prisoners, given California's Public Safety Realignment Plan and federal health care reform. California Faces Challenges Meeting Health Needs of Offenders Released from Prison http://www.rand.org/news/press/2011/11/16.html Nov 16, 2011 Nov 16, 2011 With the health care safety net in California under stress from the state's continuing financial crisis, jurisdictions across the state face unprecedented challenges caring for the health and social service needs of people released from state prisons. California Faces Challenges Meeting Health Needs of Offenders Released from Prison http://www.rand.org/pubs/monographs/MG1165.html Nov 16, 2011 Nov 16, 2011 With the health care safety net in California under stress from the state's continuing financial crisis, jurisdictions across the state face unprecedented challenges caring for the health and social service needs of people released from state prisons. Use of Retail Medical Clinics Rises Tenfold Over Two-Year Period http://www.rand.org/pubs/external_publications/EP201100245.html Nov 22, 2011 Nov 22, 2011 Use of retail medical clinics located in pharmacies and other retail settings increased tenfold between 2007 and 2009. The determining factors in choosing one over a physician's office were found to be age, health status, income, and proximity to the clinic. Ensuring the ACA Helps Reduce Disparities—Not Exacerbate Them http://www.rand.org/commentary/2011/10/14/AHE.html Oct 14, 2011 Oct 14, 2011 Evidence from past efforts in the U.S. and abroad suggests that the full potential of health reform will not be realized without specific efforts to reduce disparities, write Robin M. Weinick, Malcom V. Williams, and Romana Hasnain-Wynia. Understanding Disparities in Health Care Access – and Reducing Them – Through a Focus on Public Health http://www.rand.org/pubs/external_publications/EP201100203.html Oct 1, 2011 Oct 1, 2011 Approaching disparities through a public health framework can provide the foundation for developing more robust evidence to inform additional policies for improving access and reducing disparities. Relative Affordability of Health Insurance Premiums Under CHIP Expansion Programs and the ACA http://www.rand.org/pubs/external_publications/EP201100157.html Oct 1, 2011 Oct 1, 2011 Affordability benchmarks and premium-contribution requirements for Children's Health Insurance Program expansions in three states vary substantially, underscoring the ambiguity and subjectivity of affordability standards. Why Are Many Emergency Departments in the United States Closing? http://www.rand.org/pubs/research_briefs/RB9607.html Sep 9, 2011 Sep 9, 2011 Between 1990 and 2009, the number of emergency rooms (ERs) in nonrural U.S. hospitals declined by 27 percent (from 2,446 to 1,779). Economic factors play a central role in an ER's ability to remain open. Spillover Effects of Community Uninsurance on Working-Age Adults and Seniors: An Instrumental Variables Analysis http://www.rand.org/pubs/external_publications/EP201100168.html Sep 1, 2011 Sep 1, 2011 Access to care and care quality for those with insurance are poorer in communities in which many individuals are uninsured. Insurance Expansion and Health Literacy http://www.rand.org/commentary/2011/08/09/JAMA.html Aug 9, 2011 Aug 9, 2011 The ongoing evolution of the health care system is leading US households toward greater responsibility for their own well-being. With this responsibility, however, comes an increasing need to be able to find, trust, use, and act on relevant information to make informed choices, write Laurie T. Martin and Ruth M. Parker.