MCO

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Research conducted by: RAND Health

All Items (197)

Journal Article

Medicare HMO Impact on Utilization at the End of Life — Jan 1, 2008

Medicare beneficiaries who died while enrolled in independent practice association model HMOs, including the Kaiser model, had many fewer hospital days during the two years before death than beneficiaries who died with fee-for-service coverage.

Journal Article

Survey Response Style and Differential Use of CAHPS Rating Scales By Hispanics — Jan 1, 2008

Hispanics report health care that is similar to or less positive than for non-Hispanic whites, yet have more positive ratings of care. Higher Hispanic ratings may be partially attributed to differences in response style rather than superior care.

Journal Article

Medicare Capitation Model, Functional Status, and Multiple Comorbidities: Model Accuracy — Jan 1, 2008

Examines financial implications of the Centers for Medicare & Medicaid Services Hierarchical Condition Categories risk-adjustment model on Medicare payments for individuals with comorbid chronic conditions. Some payments were underpredicted.

Journal Article

Clinician- and Organization-Level Factors in the Adoption of Evidence-Based Care for Depression in Primary Care — Jan 1, 2008

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.

Journal Article

Pay for Performance in Behavioral Health — Jan 1, 2008

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.

Journal Article

Mental Health and Substance Abuse Insurance Parity for Federal Employees: How Did Health Plans Respond? — Dec 4, 2007

The intent of parity regulation is to equalize private insurance coverage for mental and physical illness (an equity concern) and to eliminate wasteful forms of competition due to adverse selection (an efficiency concern). In 2001, a presidential directive requiring comprehensive parity was implemented in the Federal Employees Health Benefits (FEHB) Program. In this study, the authors examine how health plans responded to the parity directive.

Journal Article

Insurers' Competitive Strategy and Enrollment in Newly Offered Preferred Provider Organizations (PPOs) — Dec 1, 2007

While early growth in preferred provider organizations (PPOs) coincided with growth of managed care generally, recent expansion has come primarily at the expense of other managed care plans.

News Release

RAND and Health Dialog Form Strategic Alliance to Create New Tools to Evaluate Quality and Efficiency of Health Care — Aug 6, 2007

RAND and Health Dialog Form Strategic Alliance to Create New Tools to Evaluate Quality and Efficiency of Health Care

Journal Article

Hospital Competition, Managed Care, and Mortality After Hospitalization for Medical Conditions in California — Apr 1, 2007

Assesses the effect of hospital competition and HMO penetration on mortality after hospitalization for six medical conditions in California.

Journal Article

Gender Disparities in Managed Care It's Time for Action — Jan 1, 2007

Commentary on the set of four studies on gender differences in the quality of CVD and diabetes care in this issue of Women's Health Issues.

Journal Article

Does Quality of Care for Cardiovascular Disease and Diabetes Differ By Gender for Enrollees in Managed Care Plans? — Jan 1, 2007

PURPOSE: To assess gender differences in the quality of care for cardiovascular disease and diabetes for enrollees in managed care plans.

Journal Article

Processes and Outcomes of Substance Abuse Treatment Between Two Programs for Clients Insured Under Managed Care — Jan 1, 2007

The purpose of this research was to describe and compare substance abuse treatment in two programs under managed care: one RT and one OP.

Journal Article

Partially Capitated Managed Care Versus FFS for Special Needs Children — Jan 1, 2007

Little research has examined whether MCPs that incorporate case management are effective in coordinating services for CSHCN.

Journal Article

Balancing Participation and Expertise: A Comparison of Locally and Centrally Managed Health Care Quality Improvement Within Primary Care Practices — Jan 1, 2007

The authors evaluated two health care QI methods that emphasized either participation (local approach) or expertise (central approach).

Journal Article

Congestive Heart Failure Disease Management in Medicare-managed Care — Jan 1, 2007

Describes the use, structure, and content of initiatives from the Centers for Medicare and Medicaid Services to encourage Medicare managed care plans to introduce congestive heart failure (CHF) disease management programs.

Journal Article

Elderly Patients' Preferences and Experiences with Providers in Managing Their Drug Costs — Jan 1, 2007

Federal employee plans were more likely to augment managed care through contracts with managed behavioral health carve-out firms after parity.

Journal Article

Does Medicare Benefit the Poor? — Jan 1, 2006

Our analysis produces the result that Medicare is an extraordinarily progressive public program, in dollar terms or welfare terms.

Journal Article

A Descriptive Analysis of Average Productivity Among Health Maintenance Organizations, 1985 to 2001 — Jan 1, 2006

This paper examines the evolution of average productivity among HMOs for 4,419 Health Maintenance Organizations (HMOs) from 1985 to 2001.

Journal Article

Is Conventional Wisdom Wrong? Coverage for Substance Abuse Treatment Under Medicaid Managed Care — Jan 1, 2006

Conventional wisdom suggests that coverage for substance abuse treatment under Medicaid is generally poor.

Journal Article

Hospital Competition, Managed Care and Mortality After Hospitalization for Medical Conditions: Evidence from Three States — Jan 1, 2006

Assesses the effect of hospital competition and HMO penetration on mortality after hospitalization for six medical conditions in California, New York, and Wisconsin.

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Researcher Spotlight

José J. Escarce

Adjunct Health Researcher

José J. Escarce

Jose J. Escarce, M.D., Ph.D., is an adjunct health researcher at RAND. His research interests and expertise include health economics, managed care, physician behavior, racial and ethnic disparities in medical care, and technological change in medicine. Dr. Escarce has studied racial differences…

Q Burkhart

Statistical Project Associate

Q Burkhart

Q Burkhart is a statistical data analyst at the RAND Corporation. He performs a wide variety of analytic tasks, including analysis of data from complex sampling designs, nonresponse analysis, multiple imputation of missing data, sample draws, and technical writing. Burkhart is well-versed in…

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