The debate within the U.S. government about reforming the health care system centers on ways to control rising costs and assure high-quality, affordable care. RAND Health and its health care reform initiative--RAND COMPARE (Comprehensive Assessment of Reform Efforts)--provide objective research and analysis on topics that can inform the health care reform debate, including financing; increasing access, insurance coverage, and quality; decreasing costs; and promoting wellness and prevention.
As health care reform expands the use of "report cards" to grade health care providers, greater attention to reporting methods may be needed to assure the quality of such efforts.
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.
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.
The Affordable Care Act marks a new era in US health care and US medicine. This commentary suggests ways to monitor the act's effect on the health of the US population.
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.
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.
This article examines potential effects of the Affordable Care Act's quality provisions on disparities and suggests disparities impact assessments to measure and monitor effects.
Analysis of the Massachusetts Health Care Reform Plan suggests national health care reform may require larger numbers of support personnel, rather than requiring greater numbers of physicians and nurses themselves.
This commentary argues that physicians must take the lead in identifying and eliminating waste in US health care.
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.
Although there has been considerable discussion of how the changes that the ACA makes in Medicare reimbursement might affect Medicare spending, on average, there has been little to no explicit recognition that the effects may vary geographically.
Combining the best elements of academic medical centers and community health centers could deliver high-quality, cost-effective care to low-income Americans while training the next generation of health care professionals.
The nature of employer-sponsored coverage may change substantially after implementation of the Patient Protection and Affordable Care Act, with an increase in the number of workers offered coverage through the health insurance exchanges.
Only 42 percent of the 354 million annual visits in the U.S. for acute care—treatment for newly arising health problems—are made to patients' personal physicians. The rest are made to emergency departments (28 percent), specialists (20 percent), or outpatient departments (7 percent).
The recently enacted federal health care reform law provides health insurance coverage to the largest number of Americans while keeping federal costs as low as reasonably possible. The only alternatives that would have covered more Americans at a lower cost to the federal government were all politically untenable.
This article discusses the range of health information technology initiatives included in the 2009 economic stimulus legislation that collectively are known as the Health Information Technology for Economic and Clinical Health (HITECH) initiative; these include proposed regulations on "meaningful use" of information technology and standards; funding of regional extension centers; and support for the development and use of clinical…
Pay-for-performance, transparency, and other innovative ways of compensating physicians will only work if, at the same time, the system for providing care has clear objectives and specific tools to help physicians achieve those objectives.
Cost savings can be achieved while improving health care quality by speeding payment reforms, implementing insurance reforms, and reforming coverage.
With substantial support across the political spectrum, the Obama administration has included in the American Recovery and Reinvestment Act more than $1 billion to support comparative effectiveness research.
RAND® is a registered trademark. Copyright © 1994-2012 RAND Corporation.