The U.S. health insurance model frequently costs more and provides less care than systems in other Western nations. RAND's health insurance research began in 1971 with the 15-year Health Insurance Experiment, the only community-based experimental study of how cost-sharing arrangements affect people’s use of health services, their quality of care, and their health status. Subsequent research has continued to inform the U.S. policy debate.
Report
In 2003, Congress added a prescription drug benefit to the Medicare program known as Part D and a Low-Income Subsidy (LIS) for some Part D beneficiaries. About 29 percent were eligible for the LIS in 2006 but there is considerable uncertainty around this estimate.
Research Brief
Describes a study showing that increasing copayments for prescription drugs causes patients newly diagnosed with hypertension, high cholesterol, and diabetes to delay starting treatment, which in turn increases their risk for heart attack and stroke.
Commentary
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.
Report
This dissertation consists of three stand-alone essays that focus on the economics of preserving health among vulnerable population, specifically chronic ill and elderly population.
Project
RAND Health can assess the health care systems and capacities of counties and population centers. As communities become increasingly diverse and the economic climate shifts, policymakers need dependable data and analysis to help understand and plan for the health of residents.
Journal Article
Examines whether low-income parents of children enrolled in the New York State Children's Health Insurance Program (SCHIP) choose managed care plans with better quality of care.
Journal Article
This was an observational study of the health care use, costs, and quality of care of 27,211 members of a large health insurer who were identified through claims as having asthma, diabetes, or congestive heart failure, were considered to be at high risk for incurring significant claims costs, and were eligible to join a disease management program involving health coaching. Findings illuminated the serious problem of selection into Disease management (DM) programs and suggest that the effectiveness levels found in prior evaluations using methodologies that don't address this may be overstated.
Journal Article
The authors conducted a retrospective cohort study of older adults with employer-provided drug coverage from 1997 to 2002 from 31 different health plans. For all study conditions, higher copayments were associated with delayed initiation of therapy.
Journal Article
Discusses two critical policy options related to child health insurance: reauthorization and potential expansion of the State Children's Health Insurance Program (SCHIP), and expansion of health insurance to all children.
Journal Article
Nearly 30 percent of Americans age 65 and older supplement their Medicare health insurance through the Medigap private insurance market.
Journal Article
The proportion of American men with organ confined, low risk prostate cancer has increased significantly during the last 2 decades.
Journal Article
Using data from 335,249 Medicare beneficiaries who responded to the 2007 Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, along with data from 22 cognitive interviews, the authors investigated the reliability and validity of an instrument designed to assess beneficiaries' experiences with their prescription drug plans.
Journal Article
Health insurance characteristics shift at age 65 as most people become eligible for Medicare. The authors measure the impacts of these changes on patients who are admitted to hospitals through emergency departments for conditions with similar admission rates on weekdays and weekends.
Journal Article
Determine whether Medicare enrollment at age 65 has an effect on the health trajectory of the near-elderly uninsured.
Journal Article
The purpose of this article is to examine variation in resource utilization across and within patient stays in the context of Medicare's per diem payment system for hospice.
Journal Article
Unlike other malignancies, there is no literature supporting the accuracy of medical claims data for identifying surgical treatments among patients with kidney cancer. The authors sought to validate externally a previously published Medicare-claims-based algorithm for classifying surgical treatments among patients with early-stage kidney cancer.
Journal Article
In this paper, the authors test the proposition that body weight is influenced by insurance coverage using two approaches.
Journal Article
The Centers for Medicare and Medicaid Services pays for services provided through traditional fee-for-service (FFS) Medicare and managed care plans (Medicare Advantage [MA]). It is important to understand how financing and organizational arrangements relate to quality of care. Compares care experiences and preventive services receipt in traditional Medicare and MA for healthy and sick beneficiaries.
Journal Article
Determines whether Patient activation status (PAS) is predictive of Medicare beneficiary health care experiences with health providers and insurance plans after case-mix adjustment.
Journal Article
The authors test whether insurers that experience larger enrollment increases due to Medicare Part D negotiate lower drug prices with pharmacies. Overall, the authors find that 100,000 additional insureds lead to 2.5-percent lower pharmacy prices negotiated by the insurer, and 5-percent reductions in pharmacy profits earned on prescriptions filled by enrollees of that insurer.
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