Jodi L. Liu

Temporary Safety-Net Policies Prevented Mass Insurance Loss During the Pandemic

Although it provided a foundation, the ACA alone could not have absorbed the effects of the pandemic's sudden job losses on health care coverage. Temporary expansions to the safety net enacted by Congress also were necessary to stem coverage loss. As the pandemic continues, policymakers will want to keep safety-net provisions as available policy options.

Medicare for All: Sounds Good, but What Does It Mean?

Traditional Medicare is popular and therefore can lend a good brand name to coverage expansion proposals, but its limits can be significant for some patients. Those proposing and evaluating “Medicare for All” proposals should consider whether and how these limits are addressed.

Misconceptions About 'Medicare for All'

Medicare for All is a talking point for both major U.S. political parties. Would it be free? Would people have to switch doctors? Would waits be long? Misconceptions abound about single-payer proposals and their likely effects. Here are the facts.

Committed to Improving Health Care Policy: Q&A with Jodi Liu

Jodi Liu, an associate policy researcher at RAND, studies how to deliver high-quality care and how to pay for it. She discusses her assessment of a single-payer health care proposal in New York State and the supply-and-demand challenges that might arise if an Alzheimer's treatment became available.

Potential Benefits for Most New Yorkers but No Free Lunch: Tough Decisions for Single-Payer Health Care in New York

A single-payer plan in New York would shift health care spending to the state instead of private insurers. As with any far-reaching legislation, there are trade-offs. It's important that policymakers consider the impact of the single-payer plan in totality.

Savings from a Single-Payer Health System Would Not Be Automatic

Polls have shown increasing public support for a single-payer system in the United States. Yet there is no agreement on how to set up and pay for a single-payer system or even how much it would cost.

Extending Marketplace Tax Credits Would Make Coverage More Affordable for Middle-Income Adults

Paying for health care coverage is a challenge for Americans facing rising premiums, deductibles, and copayments. The ACA's tax credits that make marketplace insurance more affordable for lower-income individuals should be extended to middle-income adults aged 50–64.

The Disneyland Measles Outbreak: 'Anti-Vaxxers' Aren't the Only Issue

The recent measles outbreak that began in Disneyland is the latest reminder that Americans have ceded ground in the fight against the potentially deadly disease. So-called 'anti-vaxxer' parents have received a lot of attention following the outbreak, but they may comprise less of the population than you think.

Report

Environmental Scan on Consolidation Trends and Impacts in Health Care Markets

To inform the development of No Surprises Act reports to Congress, this report summarizes recent patterns of and trends in horizontal and vertical consolidation of hospitals, physician practices, and health insurers.

Journal Article

Trends In Hospital Prices Paid By Private Health Plans Varied Substantially Across The US

We describe how commercial hospital payment rates changed relative to Medicare rates during 2012–19 and how trends differed by hospital referral region.

Journal Article

Projected Coverage and Subsidy Impacts If the American Rescue Plan's Marketplace Provisions Sunset in 2023

An estimated 3 million people currently insured in the individual market would lose coverage and become uninsured if the American Rescue Plan's premium tax credit provisions are not extended beyond 2022.

Report

Temporary Safety-Net Policies and Pandemic-Related Insurance Loss in New York State

Researchers assess the importance of temporary provisions relative to long-standing policies in stabilizing health insurance enrollment in New York state despite heavy job loss during the coronavirus disease 2019 pandemic.

Report

Practice Expense Data Collection and Methodology: Phase II Final Report

In this report, the authors address how the Centers for Medicare & Medicaid Services might improve the methodology used in practice expense (PE) rate-setting, update data that inform PE rates, or both.

Research Brief

Reducing Hospital Spending: Three Policy Options

This Research Brief summarizes the spending impact of policy options to reduce hospital prices paid by private health plans, outlining design choices and effectiveness levels for each approach.

Report

Impact of Policy Options for Reducing Hospital Prices Paid by Private Health Plans

The authors analyze the spending impact of policy options to reduce hospital prices paid by private health plans, with various design choices and effectiveness levels for each approach.

Journal Article

Section 1332 Waiver Evaluation Report: Evaluating the Minnesota Reinsurance Program

This report documents findings from the evaluation of Minnesota's waiver, through which the state implemented the Minnesota Premium Security Plan.

Journal Article

Section 1332 Waiver Evaluation Report: Evaluating the Oregon Reinsurance Program

This report documents findings from the evaluation of Oregon's waiver, through which the state implemented the Oregon Reinsurance Program (ORP).

Journal Article

Section 1332 Waiver Evaluation Report: Evaluating the Alaska Reinsurance Program

This report documents findings from the evaluation of Alaska's waiver, through which the state implemented the Alaska Reinsurance Program (ARP).

Report

Practice Expense Methodology and Data Collection Research and Analysis: Interim Phase II Report

In this report, the authors address how the Centers for Medicare and Medicaid Services can improve the methodology or update data used for setting practice expense payment rates under the Medicare Physician Fee Schedule.

Journal Article

Accounting for the Burden and Redistribution of Health Care Costs: Who Uses Care and Who Pays for It

The dollar value of health care received declines as income rises as does health care received as a percent of income.

Research Brief

Effects of a Public Option on Health Insurance Costs and Coverage

This brief describes how a public option for health care—that is, a government-sponsored health insurance plan with publicly determined provider payment rates—would affect insurance costs and coverage.

Report

Public Options for Individual Health Insurance: Assessing the Effects of Four Public Option Alternatives

There is growing interest in a "public option" for individual market insurance to improve affordability and enrollment. The authors estimate how adding a federal public option could affect enrollment, premiums, and government spending.

Report

Medicare for 50-to-64-Year-Olds: Assessing the Effects of Allowing Older Adults to Buy Into the Medicare Program

In this report, the authors analyze how allowing adults ages 50 and older to buy into the Medicare program could affect health insurance coverage, individual market premiums, and federal health care spending.

Report

Assessing the Preparedness of the Australian Health Care System Infrastructure for an Alzheimer's Disease-Modifying Therapy

This report assesses the magnitude of the potential health system challenges in the diagnosis and treatment of early-stage Alzheimer's disease in Australia, given the hypothetical availability of a disease-modifying therapy.

Report

Options for Reinvesting Savings from Restored Federal Cost-Sharing Reduction Payments: Examining the Effects of Two Policy Alternatives on Spending and Enrollment in the Individual Health Insurance Market

The authors of this report examine the impact of providing additional health insurance subsidies or financing reinsurance from the savings resulting from restored federal cost-sharing reduction payments to insurers under the Affordable Care Act.

Report

Evaluation of California's Global Payment Program: Final Report

The Global Payment Program seeks to improve health care for California's uninsured by using federal funds to make prospective payments for inpatient, outpatient, and nontraditional services. This report presents the final evaluation of the program.

Report

Assessing the Preparedness of the Canadian Health Care System Infrastructure for an Alzheimer's Treatment

The authors use a simulation model that quantifies the capacity of the Canadian health care system to diagnose and treat people with early-stage Alzheimer's disease should a disease-modifying therapy become available.

Report

National Health Spending Estimates Under Medicare for All

This report draws from previous RAND research on single-payer health care to estimate the 2019 spending effects of a Medicare for All plan similar to some proposals being discussed in Congress.

Journal Article

Expanding Enrollment Without the Individual Mandate: Options to Bring More People Into the Individual Market

The options analyzed would increase individual market enrollment by 400,000 to 3.2 million in 2020. Net increases in total enrollment (300,000 to 2.4 million) are smaller because of offsetting decreases in employer-sponsored insurance.

Report

Assessing the Preparedness of the Health Care System Infrastructure in Six European Countries for an Alzheimer's Treatment

This research analyzes the preparedness of the health care systems in six European countries to ensure timely diagnosis and treatment of patients if an Alzheimer's disease-modifying therapy becomes available.

Infographic

How Prepared Are European Health Care Systems to Deliver a Future Alzheimer's Treatment? An Assessment of Health Care Infrastructure in France, Germany, Italy, Spain, Sweden, and The United Kingdom

A therapy for early-stage Alzheimer's disease could be available by 2020, but millions of European patients might have to wait a year or more for initial appointments in the multistep process if health care system capacity is not increased.

Report

Evaluation of the Global Payment Program: Midpoint Report

The Global Payment Program seeks to improve health care for California's uninsured by providing funds for both traditional and non-traditional services, settings, and providers. This is the report of the midpoint evaluation of the program.

Journal Article

Extending Marketplace Tax Credits Would Make Coverage More Affordable for Middle-Income Adults

Middle-income adults ages 50-64 would have more affordable coverage if the ACA's tax credits were extended to all income groups; this would improve the individual market risk pool because premiums for this group would exceed the cost of their care.

Report

An Assessment of the New York Health Act: A Single-Payer Option for New York State

This report assesses how the state-sponsored single-payer health program New York Health would affect health care utilization and costs in New York, estimating its effects on key outcomes and comparing them with future outcomes under the status quo.

Research Brief

Estimating the Effects of a Single-Payer Proposal in New York State

The New York Health Act could expand insurance coverage in New York without increasing overall health spending, if administrative costs are reduced and growth in provider payment rates is restrained. The program would be financed by new taxes.

Report

Practice Expense Methodology and Data Collection Research and Analysis

This report proposes alternative methodologies for determining the practice expense (PE) component of the Medicare Physician Fee Schedule in order to avoid misvalued payment rates. A main concern is the allocation of indirect practice costs.

Report

Assessing the Preparedness of the U.S. Health Care System Infrastructure for an Alzheimer's Treatment

This report assesses the preparedness of the U.S. health care system to handle the potential caseload when a disease-modifying therapy for Alzheimer's disease might become available.

Infographic

When Alzheimer's Drugs Arrive, How Prepared Will We Be to Meet Demand? An Assessment of U.S. Health Care Infrastructure

Drugs to halt the progression of Alzheimer's disease may be available by 2020, but millions of U.S. patients might have to wait more than 14 months for initial appointments in the multistep process unless health care system capacity is increased.

Journal Article

Options to Expand Health Insurance Enrollment in the Individual Market

Policymakers have many options to expand coverage in the individual market. We considered federal investments that would enhance, extend, or increase the tax credits available to enrollees, as well as reinsurance approaches that would lower premiums.

Report

The Effects of Iowa's Proposed Stopgap Measure on Health Insurance Costs and Coverage

This report uses RAND's COMPARE microsimulation model to estimate the effects of a 1332 waiver application from the state of Iowa. The waiver is designed to stabilize Iowa's Affordable Care Act individual market through a series of modifications.

Journal Article

What Is Single-Payer Health Care? A Review of Definitions and Proposals in the U.S.

Single-payer systems are heterogeneous. Acknowledgment of what is considered single-payer and the characteristics that are variable is important for nuanced policy discussions on specific reform proposals.

Report

Financing Health Care in Oregon: Four Policy Options

This presentation describes four options for financing health care for residents of the state of Oregon and compares the projected impacts and feasibility of each option.

Research Brief

MACRA's Effects on Medicare Payment Policy and Spending

Estimates how sensitive physician behavior is to the design of alternative payment models under the Medicare Access and CHIP Reauthorization Act (MACRA).

Report

The Effects of the American Health Care Act on Health Insurance Coverage and Federal Spending in 2020 and 2026

The authors used RAND's COMPARE microsimulation model to analyze the American Health Care Act, a bill proposed in the U.S. House of Representatives on March 6, 2017, that would have repealed and replaced many provisions of the Affordable Care Act.

Journal Article

The Medicare Access and CHIP Reauthorization Act: Effects on Medicare

The Medicare Access and Chip Reauthorization Act (MACRA) will decrease Medicare spending on physician services by an estimated -$35 to -$106 billion and change spending on hospital services by +$32 to -$250 billion between 2015 and 2030.

Report

A Comprehensive Assessment of Four Options for Financing Health Care Delivery in Oregon

This report compares the impacts and feasibility of four options for financing health care in Oregon: two state-based plans that would ensure coverage for all residents, a state-sponsored plan offered in Oregon's nongroup market, and the status quo.

Research Brief

Oregon's Options to Overhaul Health Care Financing: Health Care Reform 2.0?

This analysis of three options to reform health care payment in Oregon (two state-based plans that would ensure coverage for all state residents and a state-sponsored plan offered in Oregon's nongroup market) found benefits and trade-offs for each.

Journal Article

Hillary Clinton's Health Care Reform Proposals: Anticipated Effects on Insurance Coverage, Out-of-Pocket Costs, and the Federal Deficit

The Clinton health care proposal would increase the number of insured individuals and decrease consumers' health spending relative to current law. However, the policies with the largest coverage gains also increase the federal deficit the most.

Dissertation

Exploring Single-Payer Alternatives for Health Care Reform

Explores single-payer proposals and estimates health care spending under single-payer alternatives in the United States.

Research Brief

Testing the Connection Between Social Spending and Better Health: U.S. Edition

This brief discusses the implications of research findings that, in the United States, higher levels of social spending are strongly associated with better health.

Research Brief

Testing the Connection Between Social Spending and Better Health: European Edition

This brief discusses the implications of research findings that, within the European Union, higher levels of social spending are strongly associated with better health.

Report

Are better health outcomes related to social expenditure? A cross-national empirical analysis of social expenditure and population health measures

This cross-national analysis explores the association between social spending and population health outcomes. It widens the scope of the previous analysis, incorporating social capital and income inequality and looks at associations across US states.

Report

The RAND Health Care Payment and Delivery Simulation Model (PADSIM): Concepts, Methods, and Examples

This report describes RAND's Health Care Payment and Delivery Simulation Model (PADSIM), developed to more effectively analyze the impacts of current and future reforms to provider payment policy.

Journal Article

Development of the Quality Improvement Minimum Quality Criteria Set (QI-MQCS): A Tool for Critical Appraisal of Quality Improvement Intervention Publications

Valid, reliable critical appraisal tools advance quality improvement (QI) intervention impacts by helping stakeholders identify higher quality studies.

Journal Article

The Minimum Quality Criteria Set (QI-MQCS) for Critical Appraisal: Advancing the Science of Quality Improvement

This meeting abstract documents expert panel deliberations intended to develop a critical appraisal instrument to promote identification, dissemination and implementation of findings from high quality improvement initiative evaluations.

Journal Article

Beyond Neighborhood Food Environments: Distance Traveled to Food Establishments in 5 US Cities, 2009-2011

Accurate conceptualizations of neighborhood environments are important in the design of policies and programs aiming to improve access to healthy food. This article examines the relevance of different definitions of food environments.

Journal Article

Associations Between Eating Occasions and Places of Consumption Among Adults

The objective of this study was to determine whether places of consumption are associated with types of eating occasions.

Report

Specialty Payment Model Opportunities and Assessment: Oncology Model Design Report

This report shares research and analyses of claims data related to the design of a payment model for specialty oncology services for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare & Medicaid Services.

Report

Specialty Payment Model Opportunities and Assessment: Gastroenterology and Cardiology Model Design Report

Describes research related to the design of episode-based payment models for ambulatory gastroenterology and cardiology services for possible testing by the Centers for Medicare and Medicaid Services' Center for Medicare and Medicaid Innovation.

Report

The Economic Incidence of Health Care Spending in Vermont

Estimates the economic incidence of health spending in the state of Vermont for 2012 and as projected for 2017.

Report

Improving Dementia Long-Term Care: A Policy Blueprint

As baby boomers age, many will require long-term services and supports (LTSS) for dementia care. This blueprint outlines policy options and research directions to help decisionmakers improve the LTSS delivery system, workforce, and financing.

Research Brief

What to Do About Dementia? Policy Options for Crucial Long-Term Care

Policy options to improve dementia long-term care include those that increase public awareness and promote earlier detection, improve access to and quality of services, increase support to family caregivers, and reduce the cost burden.

Report

Small Ideas for Saving Big Health Care Dollars

A review of RAND research identified small ideas that could save the health care system $13 to $22 billion per year if successfully implemented. Ideas include changing payment policy for emergency transport and greater use of $4 generic drugs.