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.
With the complex process of implementing the ACA underway, RAND research is tracking the progress of implementation and assessing the potential consequences of choices facing federal and state governments, employers, families, and individuals.
In its second term, the Obama Administration can restrain further health care spending growth—without compromising quality—by employing four broad strategies: fostering efficient and accountable providers, engaging and empowering consumers, promoting population health, and facilitating high-value innovation.
Interventions to transform primary care practices into medical homes are increasingly common, but their effectiveness in improving quality and containing costs is unclear.
Our study offers important lessons for the planned implementation of choice in primary care in the English NHS.
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.
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.
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.
With Medicare spending projected to increase to 24 percent of all federal spending and to equal 6 percent of the gross domestic product by 2037, policy makers are again considering ways to curb the program's spending growth.
Assessing care continuity is important in evaluating the impact of health care reform and changes to health care delivery.
Many physician practices will face a set of critical decisions in the coming years that may contribute to the ultimate success or failure of the ACA.
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.
Amenable mortality—deaths that should not occur in the presence of timely and effective health care—were higher in the U.S. compared to France, Germany, and the U.K. between 1999 and 2007. Deaths from circulatory conditions like cerebrovascular disease and hypertension are the main reason amenable death rates remained high in the U.S.
Productivity gains that can be achieved by widely adopting health information technology are likely to come from the reengineering of health care and may require new measurement tools to accurately gauge their impact.
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.
The financial burden of prescription drugs has declined recently for the nonelderly. The decrease is probably due to increased use of generic drugs. The financial burden remains high among those with public insurance and those with low incomes.
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.
Emergency medicine is poised as a specialty to respond to health care changes and to lead the charge in transforming a disconnected, inefficient, and costly system.
A comprehensive systematic review of economic evaluations of complementary and integrative medicine (CIM) to establish the value of these therapies to health reform efforts.
Public involvement in health-care policy has been advocated as a means to enhance health system responsiveness, yet evidence for its impact has been difficult to ascertain.
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.