Financing the efficient delivery of medical services while reducing costs for consumers as well as health care providers is among the most challenging domestic policy problems many countries face. RAND addresses health economics issues through innovative, high-profile research in an effort to improve the efficiency of health care organizations, reduce costs for providers and consumers, and improve financing in health care markets.
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.
A three-year pilot of a “medical home” model of primary care yielded few improvements in the quality of care and no reductions in hospitalizations, emergency department visits, or total costs of care.
In a large employee wellness program offered by PepsiCo, efforts to help employees manage chronic illnesses saved $3.78 in health care costs for every $1 invested in the effort. However, the program's lifestyle management components that encourage healthy living did not deliver returns that were higher than the costs.
If Medicare had the flexibility to reimburse EMS for managing selected 911 calls in ways other than transport to an ED, we estimate that the federal government could save $283–$560 million or more per year, while improving the continuity of patient care.
Some health issues, including preterm birth, unintentional injury, child obesity and certain child mental health problems, may cost less to prevent while also improving outcomes in later life.
Health risks such as tobacco use, excessive alcohol consumption and unhealthy body weight contribute to the development of chronic health problems.
Regions of the United States where doctors and hospitals are consolidated into large networks are more likely to have accountable care organizations, medical practice structures intended to improve medical care and cut costs.
The scorecard summarises key indicators of the burden of osteoporosis and its management in each of the member states of the European Union.
New interventional cardiac catheterization services offered by U.S. hospitals generally duplicate existing programs and do not help patients gain access to timely emergency cardiac care. Instead, the focus has been on competing with other hospitals.
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.
While there has been interest in using utilization measures to profile physicians, examinations of these measures are rare. This study found only a small number of commonly used utilization measures reliably capture real differences in utilization among physicians.
The Quality-Cost Framework describes the mechanisms by which health-related quality of care affects health care and health status–related costs.
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.
Research at a large firm found, on average, a 10% increase in an employee's out-of-pocket premium increases the probability of dropping coverage by approximately 1%, with married workers and lower-paid workers disproportionately more likely to drop coverage.
We evaluated more than 480,000 nondiscretionary visits made to emergency departments from 2009 through 2011, to estimate how the ACA provision affected private insurance coverage of such visits by young adults (19 to 25 years of age).
Based on insurance claims for nine common outpatient services in consumer-directed health plans (CDHPs), researchers found no evidence that those with lower expected medical expenses engaged in more price shopping. Consumers did not engage in more price shopping before reaching the CDHP deductible, either.
The monetary cost of dementia in the United States ranges from $157 billion to $215 billion annually, making the disease more costly to the nation than either heart disease or cancer. The greatest cost is associated with providing institutional and home-based long-term care rather than medical services.
Acute kidney injury (AKI) is an independent risk factor for mortality and is responsible for a significant burden of healthcare expenditure, so accurate measurement of its incidence is important.
If CIM is to be considered in broader healthcare strategies, its economic impact must be determined.
Patients treated by sets of physicians who share high numbers of patients tend to have lower costs.
Greater hospital spending is associated with lower risk-adjusted inpatient mortality for major medical conditions in the United States.