RAND Research Topic: Managed Health Care

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.

Expanding Consumer-Directed Health Plans Could Help Cut Overall Health Care Spending

May 7, 2012

Ways to Improve Health Care Provider 'Report Cards'

Mar 5, 2012

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.

Ways to Improve Health Care Provider 'Report Cards'

Mar 5, 2012

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.

Focus on the Rising Cost of Health Care

Oct 5, 2011

A substantial body of RAND research has focused on evaluating policies to lower health care costs; promoting health and preventing disease; and improving health system value and quality of care.

Managed Health Care Survey Categorizes Critical Elements of Public Sector Arrangements

Jul 22, 2011

This RAND Health survey captures key differences between managed and "unmanaged" care as well as differences among managed care arrangements, and it includes six domains predicted to have an impact on access, service utilization, costs, and quality.

Differential Item Functioning By Survey Language Among Older Hispanics Enrolled in Medicare Managed Care

Apr 30, 2011

Failure to account for language differences in CAHPS survey items may result in misleading conclusions about disparities in health care experiences between Spanish and English speakers.

The Impact of Patient Choice of Provider on Equity: Analysis of a Patient Survey

Mar 31, 2011

More educated, affluent patients were no more likely to be offered a choice than other population groups, but there does appear to be a social gradient in who chose to travel beyond the local area for treatment. If these results were replicated across England, there is at least the potential risk that when local hospitals are failing, patient choice could result in inequitable access to high quality care, rather than enhancing equity as the policy's architects had hoped.

Usual Care Psychotherapy for Depression in a Large Managed Behavioral Health Organization

Dec 31, 2009

Many depressed patients are receiving recommended psychotherapy but better tools are needed to monitor and improve the quality of usual psychotherapeutic care.

Risk-adjusted Capitation Rates for Children: How Useful Are the Survey-Based Measures?

Dec 31, 2009

National health surveys can provide information, including measures of special health care needs, that can improve risk-adjustment models and help provide appropriate payments to managed-care plans serving vulnerable children.

Managed Care Quality of Care and Plan Choice in New York SCHIP

May 31, 2009

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.

Who Gets Disease Management?

Apr 30, 2009

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.

Managed Care's Price Bargaining with Hospitals

Feb 28, 2009

Research has shown that managed care (MC) slowed the rate of growth in health care spending in the 1990s, primarily via lower unit prices paid.

Quality Assessments By Sick and Healthy Beneficiaries in Traditional Medicare and Medicare Managed Care

Dec 31, 2008

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.

Competition and the Mental Health System

Dec 31, 2008

This article describes three notable features of the competitive mental health care market and their policy implications.

Nonprice Competition and Quality of Care in Managed Care: The New York SCHIP Market

May 31, 2008

Finds a negative association between nonprice competition and quality of care in managed care plans in the New York SCHIP market. Pricing policy is likely a constraint on quality production, though it may not be interpreted as a causal relationship.

Falling Short: Continued Challenges in Meeting the Mental Health Needs of Children with Special Health Care Needs

May 31, 2008

High levels of unmet need persist for children with special health care needs in the face of substantial resources that have been committed to improving their care, including the integration of behavioral health into Medicaid managed care.

Language and Regional Differences in Evaluations of Medicare Managed Care By Hispanics

Mar 31, 2008

Uses the Consumer Assessments of Healthcare Providers and Systems survey to examine the experiences of Hispanics enrolled in Medicare managed care. Hispanics face barriers to care; however, their experiences with care vary by language and region.

Clinician- and Organization-Level Factors in the Adoption of Evidence-Based Care for Depression in Primary Care

Dec 31, 2007

Barriers and propensity interact in affecting depression services. In comparison with similar clinicians in practices with few barriers, high-propensity clinicians working in practices with more barriers are less likely to provide depression education and are likely to provide fewer follow-up calls and fewer follow-up visits. High-propensity clinicians are more likely to offer antidepressants in practices with more barriers.

Pay for Performance in Behavioral Health

Dec 31, 2007

Presents the results of a targeted national effort to identify pay-for-performance programs in behavioral health. Many programs struggled to obtain accurate data on quality and outcomes of care, and public reporting of results was not widespread.