Journal Article
The Importance of Understanding and Measuring Health System Structural, Functional, and Clinical Integration
We explore if there are ways to characterize health systems-not already revealed by secondary data-that could provide new insights into differences in health system performance.
Dec 10, 2020
Journal Article
Evaluation Report of the First Three Years (2017-2019) of the Medicare Advantage Value-Based Insurance Design Model Test
CMMI contracted with the RAND Corporation to evaluate the first three years of the MA VBID model test. This report serves as our second and final evaluation of the first three years of the model test.
Oct 21, 2020
Report
Consolidation by Any Other Name: The Emergence of Clinically Integrated Networks
In this report, the authors offer an initial assessment of clinically integrated networks (CINs), describe how health systems are using CINs strategically to compete in crowded health care markets, and identify why CINs require further study.
Aug 3, 2020
Journal Article
Understanding U.S. Health Systems: Using Mixed Methods to Unpack Organizational Complexity
Researchers need qualitative data to understand how health systems actually work and influence clinical practice.
Nov 26, 2019
Journal Article
Insurers' Perspectives on MA Value-Based Insurance Design Model
In this study, we explored insurers' perspectives on Medicare Advantage value-based insurance design, identified perceived barriers to joining the model test, and described ways to overcome them.
Nov 19, 2019
Report
Perspectives of Physicians in Small Rural Practices on the Medicare Quality Payment Program
Significant concerns have been raised about the ability of small rural practices to participate in the Centers for Medicare & Medicaid Services' Quality Payment Program. RAND researchers interviewed physicians to investigate these concerns.
Mar 5, 2019
Journal Article
First Annual Evaluation Report of the Medicare Advantage Value-Based Insurance Design Model Test: 2017, Year 1 of the Intervention
RAND researchers are evaluating a five-year model test to assess whether value-based insurance design can increase use of high-value services, reduce use of avoidable services, improve quality of care, and improve health outcomes and reduce spending.
2019
Report
Integrating Department of Defense and Department of Veterans Affairs Purchased Care: Preliminary Feasibility Assessment
An integrated approach to purchasing health care for U.S. Department of Defense and U.S. Department of Veterans Affairs could have important implications for access, quality, and costs but could face legislative, policy, or contractual challenges.
Nov 26, 2018
Research Brief
Preliminary Feasibility Assessment of DoD-VA Purchased Care Integration
An integrated approach to purchasing health care for U.S. Department of Defense and U.S. Department of Veterans Affairs could have important implications for access, quality, and costs but could face legislative, policy, or contractual challenges.
Nov 26, 2018
Report
Patient-Centered Medical Home Implementation in Indian Health Service Direct Service Facilities
In 2008, the Indian Health Service launched a patient-centered medical home (PCMH) initiative to improve the quality of care in its clinics. RAND researchers identified barriers and strategies to assist clinics on the path to PCMH recognition.
May 25, 2018
Journal Article
The Impact of Practice Guidelines on Opioid Utilization for Injured Workers
Guidelines designed to reduce the prescription of opioids following an injury did not reduce opioid use.
Dec 7, 2017
Journal Article
Implementation of Medical Homes in Federally Qualified Health Centers
A 3-year demonstration to strengthen the delivery of primary care in federally qualified health centers provides some empirical evidence in support of medical-home transformation..
Sep 13, 2017
Report
The Benefits and Drawbacks of Alternative Tax Subsidization Approaches for Health Insurance
This report reviews the features of tax-based approaches to subsidizing health insurance, including tax credits and tax deductions, and summarizes their associated benefits and drawbacks.
Jul 13, 2017
Report
Evaluation of CMS's Federally Qualified Health Center (FQHC) Advanced Primary Care Practice (APCP) Demonstration: Final Report
This report contains an independent evaluation of the Federally Qualified Health Center Advanced Primary Care Practice Demonstration for the Centers for Medicare and Medicaid.
Jun 26, 2017
Tool
Multiple Chronic Conditions in the United States
This chartbook updates previous versions with more recent data on the prevalence of multiple chronic conditions (2008-2014) and associated health care utilization and spending.
May 26, 2017
Report
Examining the Implementation of the Medicaid Primary Care Payment Increase
RAND researchers examined stakeholder experiences with an Affordable Care Act provision that qualifying providers of primary care services participating in the Medicaid program would receive enhanced federal payments for providing certain services.
Apr 4, 2017
Report
Implementing a Drug Formulary for California's Workers' Compensation Program
This report supports the California Division of Workers' Compensation's efforts to establish a drug formulary by comparing existing workers' compensation formularies and analyzing options for designing and implementing the formulary.
Aug 25, 2016
Report
Private Health Insurance Exchanges: Early Evidence and Implications for the Future
This report examines how private employer health exchanges function, how they may affect employers and employees, and the possible implications for the Affordable Care Act's Small Business Health Options Program Marketplaces.
May 9, 2016
Report
Authorities and Mechanisms for Purchased Care at the Department of Veterans Affairs
The Department of Veterans Affairs (VA) furnishes purchased care services through an array of programs, each with different requirements and processes. A strategy for purchased care is needed to design an effective purchased care program.
Dec 31, 2015
Report
Resources and Capabilities of the Department of Veterans Affairs to Provide Timely and Accessible Care to Veterans
The Department of Veterans Affairs health care system, with broad resources and capabilities, provides timely and high-quality care to most, but not all, patients. Meeting veterans' needs over the next five years will require additional capacity.
Dec 31, 2015
Journal Article
Policy Options to Expand Medicare's Low-Income Provisions to Improve Access and Affordability
For fifty years Medicare has enhanced the health and financial security of seniors.
Dec 10, 2015
Journal Article
Evaluating Consumer Preferences for Healthy Eating from Community Kitchens in Low-Income Urban Areas: A Discrete Choice Experiment of Comedores Populares in Peru
We sought to understand preferences for items prepared in Comedores Populares, government-supported food vendors serving low-income Peruvians, to determine whether it would be feasible to introduce healthier items, specifically fruits and vegetables.
Jul 30, 2015
Journal Article
Innovative Care Models for High-Cost Medicare Beneficiaries: Delivery System and Payment Reform to Accelerate Adoption
This paper illustrates how Medicare Advantage plans and accountable care organizations could benefit from adopting innovative care delivery models, and suggests policy changes to accelerate spread.
Jul 7, 2015
Journal Article
Impact of Out-of-Pocket Spending Caps on Financial Burden of Those with Group Health Insurance
Mandated uniform out-of-pocket caps for those with group insurance will benefit very few individuals, and will not result in substantial reductions in financial burden.
Mar 9, 2015
Journal Article
Comparing Employer-Sponsored and Federal Exchange Plans: Wide Variations in Cost Sharing for Prescription Drugs
Our primary objective was to examine the variability in drug coverage in the exchanges across plan types (health maintenance organization or preferred provider organization) and metal tiers (bronze, silver, gold, and platinum).
Mar 9, 2015