Healthcare Insurance

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.

Research conducted by: RAND Health; RAND Institute for Civil Justice

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Cost and Coverage Implications of the Affordable Care Act

scalpel cutting dollar

The ACA's goal of expanding access to health coverage has implications for health care costs at many levels: how it will affect individual decisions to obtain insurance, employer decisions about offering coverage, and government spending.

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News Release

Strategies Could Curb Medicare Costs, but Also Drive Seniors Out of the Program — May 6, 2013

Doctor examining female senior patient with elbow pain

The rising cost of Medicare can be cut through strategies such as increasing premiums and raising the eligibility age, but those moves could drive many elderly Americans from the program, leaving them with limited access to health services.

Commentary

Governors Missing the Point on Medicaid — Apr 29, 2013

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While a governor or legislator may disagree with Medicaid expansion for philosophical reasons, the claims that the expansion will be a burden on states' economies seem misguided given the full range of projected economic impacts on the states, writes Carter C. Price.

Content

The Affordable Care Act: Four Key Policy Areas — Apr 23, 2013

Obama signing the ACA

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.

Research Brief

How the Great State of Arkansas May Fare Under the Affordable Care Act — Apr 4, 2013

This infographic presents findings from a RAND analysis of the economic and other effects of the Affordable Care Act on the state of Arkansas.

Commentary

Helping Obama—and Other Americans—Weigh Which Health Insurance Exchange to Pick — Apr 1, 2013

a health insurance claim form and a silver pen

Multistate plans are most likely to appeal to out-of-state students, interstate migrants, out-of-state workers, seasonal movers (e.g., “snowbirds”), and similar groups that require improved access to health care across state lines.

Report

A Two-Step Procedure to Estimate Participation and Premiums in Multistate Health Plans — Mar 20, 2013

The authors identified and characterized population groups that would likely be interested in enrolling in the multistate plans established by the Affordable Care Act and developed a methodology to project participation and estimate premiums.

Blog

Are You a 'Wise' Health Care Consumer? — Feb 5, 2013

To be wise purchasers of health care services, consumers need access to accurate and understandable information about health plans and providers. They wrongly assume that more expensive providers are better than less expensive ones, despite inconsistent evidence that there is any link between health care cost and quality.

Blog

In Brief: Amelia M. Haviland on Consumer-Directed Health Plans — Jan 23, 2013

In this video, Amelia Haviland presents the results of several new RAND studies on cost and quality in consumer-directed health plans, and explores how switching plans affects the quality of care.

Commentary

Health Care Costs Are Killing Us — Jan 4, 2013

At a time when our country is teetering on the edge of a “fiscal cliff,” no challenge in health care is more important than reducing health care spending, writes Arthur L. Kellermann.

Report

The Economic Impact of the ACA on Arkansas — Jan 3, 2013

Arkansas flag

For Arkansas, the Affordable Care Act will result in an increase in GDP of around $550 million and the creation of about 6,200 jobs. The new law will also increase health insurance coverage by 400,000 newly insured individuals.

Commentary

Health Care Cost Growth Is Hurting Middle-Class Families — Jan 3, 2013

Unfortunately, nearly every actor in our health care delivery system—hospitals, physicians, other health care providers, insurance companies and the manufacturers of drugs and devices—is currently focused on maximizing revenue growth, write Arthur Kellermann and David Auerbach.

Journal Article

Modeling Employer Self-Insurance Decisions After the Affordable Care Act — Jan 1, 2013

Self-insurance rates will increase among small firms only under the hypothetical situation that generous stop-loss policies are available to them after implementation of the ACA. Even if many small firms choose to self insure under this situation, it will not increase the premiums charged in the insurance exchanges by more than a few tenths of a percent.

Journal Article

Price Shopping in Consumer-Directed Health Plans — Jan 1, 2013

With the exception of office visits, prices for most common health services don't differ between consumer-directed health plans and traditional plans.

Journal Article

Access to Leave Benefits for Primary Caregivers of Children with Special Health Care Needs: A Double Bind — Jan 1, 2013

We examined whether access to benefits varies by level of childcare responsibilities among employed parents of children with special health care needs (CSHCN).

Blog

Creating More Savvy Consumers Through Public Reporting — Dec 27, 2012

Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys are designed to capture patients' experiences in a systematic way that facilitates reporting the results publicly to help other consumers make more savvy care decisions. Consumer choices may influence providers to improve the care they offer so that they can effectively compete in the market.

Multimedia

Skin in the Game: How Consumer-Directed Health Plans Can Affect the Cost and Use of Health Care — Dec 10, 2012

In this December 2012 Congressional Briefing, Amelia Haviland presents the results of several RAND studies on cost and quality in consumer-directed health plans, including how a switch to such plans may affect the quality of health care for participating families.

Past Event

Skin in the Game: How Consumer-Directed Health Plans Can Affect the Cost and Use of Health Care — Dec 10, 2012

If half of Americans with employer-sponsored insurance enrolled in consumer-directed plans, annual health care costs would fall by an estimated $57 billion. Is this the answer to growing health care costs?

Research Brief

Flattening the Trajectory of Health Care Spending: Engage and Empower Consumers — Nov 15, 2012

Cost-sharing leads consumers to reduce both highly beneficial and less beneficial care, so they must be empowered with useful information to make informed decisions. Public cost and quality reports must be accurate, accessible, and understandable.

Content

Four Strategies to Contain America's Growing Health Care Spending — Nov 15, 2012

pills and coins

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.

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