Health Care Financing

Contents:

Health care systems may be financed in various ways, including through government funding, taxation, out-of-pocket payments, private insurance, and donations or voluntary aid. RAND research explores the effects of corporate and government health care financing policies on such groups as patients, businesses, hospitals, and physician-providers.

Research conducted by: RAND Health

Featured at RAND

The Public Option: Sorting Rhetoric from Reality

President Obama and several Congressional leaders have recently expressed support for the idea of allowing citizens to buy into a public insurance program as part of any health reform legislation. The intensity of the ensuing debate has been fascinating given the lack of specifics that have been offered by either side, writes Elizabeth A. McGlynn.

All Items (118)

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

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.

BLOG

Would the Affordable Care Act Lead to Reductions in Employer-Sponsored Coverage? — 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.

JOURNAL ARTICLE

Survey Results Show That Adults Are Willing to Pay Higher Insurance Premiums for Generous Coverage of Specialty Drugs — Apr 1, 2012

This study estimated how healthy people value insurance coverage of specialty drugs, defined as high-cost drugs that treat cancer and other serious health conditions like multiple sclerosis, by quantifying willingness to pay via a survey.

JOURNAL ARTICLE

Rules Allowing Small Businesses to Opt Out of Health Reform Should Have Minor Impact on Insurance Cost — Feb 8, 2012

Rules that allow some small employers to avoid regulation under the federal Affordable Care Act are unlikely to have a major impact on the future cost of health insurance unless those rules are relaxed to allow more businesses to opt out.

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

Impacts of Rising Health Care Costs on Families with Employment-Based Private Insurance: A National Analysis with State Fixed Effects — Jan 1, 2012

Rising health costs reduce employment-based private insurance availability and enrollment, and the financial protection provided by it, especially for middle-class families.

JOURNAL ARTICLE

Take-up of Public Insurance and Crowd-Out of Private Insurance Under Recent CHIP Expansions to Higher Income Children — Jan 1, 2012

The CHIP expansions to children in higher income families were associated with limited uptake of public coverage.

JOURNAL ARTICLE

Bundling Payments to Curb Health Care Costs Proves Difficult to Realize — Nov 7, 2011

Under bundled payments, doctors, hospitals, and other providers share one fee for treating all aspects of a procedure such as a hip replacement or a chronic disease like diabetes. The approach should eliminate unnecessary care and improve quality, but putting it into practice is proving to be more difficult than anticipated.

NEWS RELEASE

Bundling Payments to Curb Health Care Costs Proves Difficult to Realize — Nov 7, 2011

Under bundled payments, doctors, hospitals, and other providers share one fee for treating all aspects of a procedure such as a hip replacement or a chronic disease like diabetes. The approach should eliminate unnecessary care and improve quality, but putting it into practice is proving to be more difficult than anticipated.

JOURNAL ARTICLE

Can the Patient-Centered Outcomes Research Institute Become Relevant to Controlling Medical Costs and Improving Value? — Nov 1, 2011

Research sponsored by the Patient Centered Outcomes Research Institute can help patients make better decisions by comparing the effectiveness of alternative therapies, but it is constrained from considering the costs of therapies it compares.

JOURNAL ARTICLE

Consumers May Have More Control Over Health Care Costs Than Previously Thought — Sep 29, 2011

The historic RAND Health Insurance Experiment found that patients had little or no control over their health care spending once they began to receive a physician's care, but this has changed for those enrolled in consumer-directed health plans.

JOURNAL ARTICLE

Medicare's Bundled Payment Pilot for Acute and Postacute Care:: Analysis and Recommendations on Where to Begin — Aug 31, 2011

Medicare's National Pilot Program on Payment Bundling should use hip fracture and joint replacement as the conditions to include and use longer episodes, capturing a higher percentage of costs and hospital readmissions but adding little financial risk.

JOURNAL ARTICLE

A Decade of Health Care Cost Growth Has Wiped Out Real Income Gains for an Average US Family — Aug 31, 2011

This article translates aggregate numbers about health spending into concrete measures that consumers can relate to.

JOURNAL ARTICLE

Factors Associated with Closures of Emergency Departments in the United States — May 17, 2011

This study found that the number of emergency departments operating in the US from 1990 to 2009 declined by 27%. EDs with safety-net status, for-profit ownership, and low profit margin were at higher risk of closure.

NEWS RELEASE

How National Health Reform Will Affect a Variety of States — Apr 5, 2011

A series of new reports by the RAND Corporation outlines the impact that national health care reform will have on individual states, estimating the increased costs and coverage that are expected in five diverse states once reform is fully implemented in 2016.

NEWS RELEASE

Health Reform Will Add Coverage for 6 Million Californians; State Health Spending to Grow by 7 Percent — Apr 5, 2011

National health care reform will help 6 million California residents obtain health insurance and increase health care spending by state government by about 7 percent when it is fully implemented in 2016.

NEWS RELEASE

Health Reform Will Add Coverage for 170,000 in Connecticut; State Health Spending to Drop by 10 Percent — Apr 5, 2011

National health care reform will help 170,000 Connecticut residents obtain health insurance and decrease health care spending by state government by about 10 percent when it is fully implemented in 2016.

NEWS RELEASE

Health Reform Will Add Coverage for 1.3 Million in Illinois; State Health Spending to Grow by 10 Percent — Apr 5, 2011

National health care reform will help 1.3 million Illinois residents obtain health insurance and increase health care spending by state government by about 10 percent when it is fully implemented in 2016.

NEWS RELEASE

Health Reform Will Add Coverage for 125,000 in Montana; State Health Spending to Grow by 3 Percent — Apr 5, 2011

National health care reform will help 125,000 Montana residents obtain health insurance and increase health care spending by state government by about 3 percent when it is fully implemented in 2016.

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Researcher Spotlight

Dana P. Goldman

Affiliated Adjunct Staff

Dana P. Goldman

Dana P. Goldman was the founding director of the Bing Center for Health Economics at RAND and director of the RAND Roybal Center for Health Policy Simulation. He is a professor at the Pardee RAND Graduate School. Goldman's research interests combine applied microeconomics and medical issues,…

Rosalie Liccardo Pacula

Codirector, RAND Drug Policy Research Center

Rosalie Liccardo Pacula

Rosalie Liccardo Pacula is a senior economist at the RAND Corporation and a professor at the Pardee RAND Graduate School. She serves as codirector of the RAND Drug Policy Research Center. Her research has largely focused on whether state and local public policies are cost-effective and effective…

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