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.
Journal Article
High drug prices are a major barrier to patients' access to drugs and compliance with treatment.
Journal Article
The authors inferred quality at hospitals in greater Los Angeles from the revealed preference of pneumonia patients. The authors then decompose the joint contribution of quality and unobserved productivity to hospital costs, relying on heterogeneous tastes among patients for plausibly exogenous quality variation. They found that more productive hospitals provide higher quality, demonstrating that the cost of quality improvement is substantially understated by methods that do not take into account productivity differences.
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Determine whether acupuncture is a complement to or substitute for various medical services.
Journal Article
Uses data from California to compare actual prices paid by uninsured patients with prices paid by commercial and Medicare patients. Uninsured patients pay prices similar to those of Medicare patients, and hospital prices to the uninsured have risen.
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Found little evidence that there have been systematic changes in either the structure or use of HMO hospital networks in California between 1999 and 2003, suggesting that these factors played a limited role in explaining growth in health care costs.
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The authors consider the challenges to quantifying both the business case and the social case for addressing disparities, which is central to achieving equity in the U.S. health care system.
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Investigates the role of pain dynamics in dynamics of self-reported work disability and of employment patterns of older workers in the United States. In addition to high pain prevalence, there are many transitions in and out of pain at these ages.
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Finds that using life expectancy rather than age results in lower projections of future health care expenditures. This result suggests that increases in longevity might be less costly than models based on the current age profile of spending would predict.
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The pricing plans most people choose for their cell phones are simple: Pay one price and talk as much as you want. What if paying for your prescription drugs were as easy and appealing?
Journal Article
Medicare Part D represents a bold experiment to publicly fund, but privately sell and administer, prescription drug insurance. Since Part D should account for 1% of the U.S. economy in under 20 years, much is riding on Part D's success or failure.
Journal Article
The authors obtained follow-up health-status data on the great majority of those who left prematurely. The authors found the health-status findings were insensitive to the inclusion of the attrition cases.
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Gender disparities in expenditures are generally small at the end of life for lung cancer decedents. The bigger observed differences are by age. Higher expenditures for women on social-supportive services may reflect fewer informal supports.
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Evidence that disease management improves quality of care and disease control suggests that it has beneficial effects even if it does not save money. Industry representatives say value for money is a better criterion than return on investment.
Journal Article
Data from the Employment Cost Index show that health insurance costs relative to payroll increased 34 percent between 1996 and 2005 and that the increase was largest for businesses paying low wages; simultaneously, data from the Employee Benefits Survey show that benefit packages became less generous, yet cost growth was not paralleled by a commensurate decrease in employer offers.
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Uses the implementation of a new prospective payment system (PPS) for inpatient rehabilitation facilities to investigate the effect on marginal and average reimbursement on costs. The PPS led to a significant decline in costs and length of stay.
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Insurance gaps and delayed care are prevalent for low-income young adults who aged out of a public program for children with special health care needs, despite ongoing health problems. Greater transition support might improve access.
Journal Article
Most breast cancer care providers in Los Angeles County outside of staff- or group-model HMOs are not subject to explicit financial incentives based on quality-of-care measures. New approaches are needed to direct incentives toward these specialists.
Journal Article
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
A positive relationship between socio-economic status and health is found in many industrialized countries. This study analyzes competing explanations and finds strong evidence of causal effects from both spouses' health on household wealth.
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