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.
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.
Despite wide investments nationally in electronic medical records and related tools, the cost-saving promise of health information technology has not been reached because the systems deployed are neither interconnected nor easy to use.
The costs of knee and hip replacement in designated centers of excellence do not differ from costs in other hospitals. But hip replacements performed in such centers had lower complication rates. Complication rates for knee replacement did not differ.
Use of and spending on complementary and alternative medicine have flattened out. Including providers of these services in new delivery systems such as accountable care organizations could help slow growth in national health care spending.
A systematic review found that evidence is mixed and inconsistent regarding both the direction and magnitude of the association between health care costs and quality.
With the exception of office visits, prices for most common health services don't differ between consumer-directed health plans and traditional plans.
Policymakers in countries around the world are faced with rising health care costs and are debating ways to reform health care to reduce expenditures.
Commercial health plans and Medicare are using cost profiles to identify which physicians account for more health care spending than others, while devising strategies to reward those who provide quality care at a lower cost. Doctors with less than 10 years of experience had 13.2 percent higher overall costs than those with 40 or more years of experience.
Comparative effectiveness research conducted over the past decade has had a limited impact on the way medical care is delivered, but many opportunities exist to help doctors and others in the medical system translate such research into better patient care.
Comparative effectiveness research will be hard to use appropriately because context and emotion often dominate a patient's rational decisionmaking and because therapies are provided in different health care environments, making small differences between therapies basically meaningless.
ACA-mandated payment reforms need to achieve more than a one-time cost saving.
Innovative payment reform initiatives occur in both the public and private sector, but the optimal role in such reforms of the public sector, specifically the Centers for Medicare and Medicaid Services, is up for debate
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.
Early treatment with IFNB-1b for a first clinical event suggestive of MS was found to improve patient outcomes while controlling costs.
Geriatricians were more efficient than other physicians in managing hospitalized elderly adults with medical DRGs frequently managed by geriatricians. This efficiency did not compromise patient outcomes.
Physician organizations (POs)—independent practice associations and medical groups—located in lower socioeconomic status (SES) areas may score poorly in pay-for-performance (P4P) programs.
The need is urgent to bring US health care costs into a sustainable range for both public and private payers.
Public reporting of health care costs is intended to motivate consumers to choose lower cost providers, and motivate providers to lower costs to retain market share. Measures should be chosen based on which pathway policymakers intend to influence.
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