Sarah A. Nowak

Contact Information

Senior Physical Scientist; Professor, Pardee RAND Graduate School; Co-Director, Center for Scalable Computing and Analysis

Off Site Office

Education

Ph.D. and M.S. in biomathematics, University of California, Los Angeles; B.S. in physics, MIT

One Page Bio

Media Resources

This researcher is available for interviews.

To arrange an interview, contact the RAND Office of Media Relations at (310) 451-6913, or email media@rand.org.

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Overview

Sarah Nowak is a senior physical scientist at the RAND Corporation and a professor at the Pardee RAND Graduate School. Nowak specializes in mathematical modeling. One of her primary areas of research involves integrating agent-based modeling approaches with national surveys to examine how information individuals gather through their social networks impacts individual-level decision making as well as health outcomes at the population level. She has applied these methods to study how patients and providers make decisions about breast cancer screening. In addition, Nowak has been involved in a number of studies using microsimulation modeling to forecast the impact of health care reforms on health insurance coverage, families' health care costs, and costs to federal and state governments. Her other research interests include examining options to tailor Air Force medical capabilities for future conflict environments. Nowak received her Ph.D. and M.S. in biomathematics from the University of California, Los Angeles and B.S. in physics from the Massachusetts Institute of Technology.

Research Focus

Pardee RAND Graduate School Courses

Large-Scale Optimization with Applications

Commentary

All Health Policy Is Local: The Case of the Individual Mandate Penalty in New York
As with many Affordable Care Act policies, how New York is dealing with the absence of the individual mandate penalty is a potent reminder that all health policy is local.
Oct 30, 2018 The Health Care Blog
Understanding the Impact of the Elimination of the Individual Mandate Penalty
Starting in 2019, the Affordable Care Act's individual mandate penalty will be eliminated, effectively ending the law's requirement that most people have health insurance. While declines in coverage and increases in premiums are likely, the magnitudes of these effects are highly uncertain.
Aug 10, 2018 The Commonwealth Fund Blog
Modifying the ACA's Family Subsidy Rules to Help Ensure Affordability
The ACA encourages workers to retain employer coverage by restricting their eligibility for marketplace subsidies. Modifying the policy could help 700,000 people gain coverage and lower spending for 1.6 million who are insured but face high health care costs under current ACA policy.
Jan 12, 2016 The Commonwealth Fund Blog

Publications

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.
Nov 18, 2019
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.
Sep 10, 2019
Report
Effects of Alternative Insurer Responses to Discontinued Federal Cost-Sharing Reduction Payments: Broad Loading as an Alternative to Silver Loading
In this report, the authors assess the effects of disallowing the current practice of increasing only the premiums of silver-tiered individual market plans in response to discontinued federal payments of cost-sharing reductions (silver loading).
Jun 3, 2019
Report
Impacts of the Elimination of the ACA's Individual Health Insurance Mandate Penalty on the Nongroup Market in New York State
How will elimination of the Affordable Care Act's individual mandate penalty affect the nongroup insurance market in the state of New York? Researchers used RAND's COMPARE microsimulation model to estimate the effects.
Sep 20, 2018
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.
Aug 1, 2018
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.
Aug 1, 2018
Journal Article
The Effect of Eliminating the Individual Mandate Penalty and the Role of Behavioral Factors
Under alternative assumptions about consumer responses, we find that enrollment falls by 2.8 million to 13 million people nationwide and premiums for bronze plans increase by 3 percent to 13 percent when the mandate penalty is removed.
Jul 12, 2018
Journal Article
Journal Article
What Is the Impact on Enrollment and Premiums If the Duration of Short-Term Health Insurance Plans Is Increased?
Extending the duration of short-term individual health plans will have little effect on premiums or enrollment in the individual market.
Jun 14, 2018
Report
Report
Increasing Cost-Effective Readiness for the U.S. Air Force by Reducing Supply Chain Variance: Technical Analysis of Flying Hour Program Variance
Seeking to reduce the $4 billion that it spends annually on spare parts, the Air Force asked RAND researchers to identify the causes and gauge the effects of flying hour variance (the difference between predicted and actual numbers of flying hours).
Apr 10, 2018
Journal Article
Journal Article
Linking Reminders and Physician Breast Cancer Screening Recommendations: Results From a National Survey
Physicians are more likely to recommend mammograms when they are reminded to do so, despite variation in how much they trust mammogram guidelines.
Dec 18, 2017
Journal Article
Journal Article
Association Between Physicians' Experiences With Members of Their Social Network and Efforts to Reduce Breast Cancer Screening
Helping clinicians reflect on how their experiences influence their current screening patterns may be an important approach to improving their adherence to revised breast cancer screening guidelines.
Dec 7, 2017
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.
Oct 17, 2017
Journal Article
Journal Article
Physician Breast Cancer Screening Recommendations Following Guideline Changes: Results of a National Survey
Physicians' recommendations for when to start and end breast cancer screening vary, depending on their level of trust with the guideline-issuing organization.
May 23, 2017
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.
May 3, 2017
Report
A General Agent-Based Model of Social Learning
This report describes a general agent-based model (ABM) for studying social learning, and uses that general ABM to explore the relationship between micro-influence and macro-dynamics for broad classes of problems.
Mar 31, 2017
Journal Article
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.
Nov 4, 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
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.
Mar 22, 2016
Journal Article
Evaluating the CARE Act: Implications of a Proposal to Repeal and Replace the Affordable Care Act
Policymakers seeking to adopt the CARE Act, or to pursue a similar repeal-and-replace policy, may need to maintain some of the ACA's revenue-generating provisions, adopt alternative revenue-generating provisions, or reduce the generosity of tax credits to achieve budget neutrality.
2016
Report
Can the Cadillac Tax Be Made Less Regressive by Replacing It with an Exclusion Cap? Methods and Results
Examines the effects of the Affordable Care Act's Cadillac tax versus an alternative tax, based on an exclusion gap, on families in different income ranges.
Oct 8, 2015
Report
Alternatives to the ACA's Affordability Firewall
This report examines policy impacts of the Affordable Care Act's "affordability firewall," which limits subsidies to individuals lacking access to alternative sources of coverage that are "affordable," and investigates two potential modifications.
Oct 5, 2015
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.
Jan 8, 2015
Journal Article
Journal Article
Social Network Effects of Nonlifesaving Early-Stage Breast Cancer Detection on Mammography Rates
We estimated the effect of anecdotes of early-stage, screen-detected cancer for which screening was not lifesaving on the demand for mammography.
2014
Research Brief
Will the Affordable Care Act Make Health Care More Affordable?
For most lower-income people who obtain coverage as a result of the Affordable Care Act, health care spending will fall. But spending by some newly insured higher-income people will increase because they will be now paying insurance premiums.
Dec 11, 2013
Report
Assessment of the Air Force Materiel Command Reorganization: Report for Congress
Assesses the FY 2012 reorganization of the Air Force Material Command, which was undertaken as one of the initiatives to achieve mandated budget reductions by eliminating civilian manpower positions, thus achieving cost savings.
Nov 21, 2013
Report
Effects of the Affordable Care Act on Consumer Health Care Spending and Risk of Catastrophic Health Costs
This study examines likely effects of the Affordable Care Act on average annual consumer health care spending and risk of catastrophic medical costs and considers how these outcomes are affected by state decisions to expand Medicaid.
Oct 1, 2013
Report
The Affordable Care Act and Health Insurance Markets: Simulating the Effects of Regulation
The authors estimate the effects of the Affordable Care Act on health insurance enrollment and premiums for ten states and for the nation overall, with a focus on outcomes in the nongroup and small group markets.
Aug 29, 2013
Report
Report
Sustaining the U.S. Air Force Nuclear Mission
This report proposes a double-layered framework for efficiently integrating and managing the sustainment activities of the U.S. Air Force nuclear enterprise in the face of reduced funding and a smaller force structure.
Jul 31, 2013
Journal Article
Journal Article
The COMPARE Microsimulation Model and the U.S. Affordable Care Act
In anticipation of upcoming health care legislation, the RAND Corporation developed a microsimulation model to forecast the responses of individuals, families and firms to such legislation.
2013
Research Brief
Research Brief
How Will Health Care Reform Affect Costs and Coverage? Examples from Five States
Projects how the coverage-related provisions of the Patient Protection and Affordable Care Act will affect health insurance coverage and state government spending on health care in five states.
Apr 1, 2011
Report
Report
The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Illinois: An Analysis from RAND COMPARE
Projects how the coverage-related provisions of the Patient Protection and Affordable Care Act will affect health insurance coverage and state government spending on health care in Illinois through 2020.
Apr 1, 2011
Report
Report
The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Texas: An Analysis from RAND COMPARE
Projects how the coverage-related provisions of the Patient Protection and Affordable Care Act will affect health insurance coverage and state government spending on health care in Texas through 2020.
Apr 1, 2011
Report
Report
The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in California: An Analysis from RAND COMPARE
Projects how the coverage-related provisions of the Patient Protection and Affordable Care Act will affect health insurance coverage and state government spending on health care in California through 2020.
Apr 1, 2011
Report
Report
The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Montana: An Analysis from RAND COMPARE
Projects how the coverage-related provisions of the Patient Protection and Affordable Care Act will affect health insurance coverage and state government spending on health care in Montana through 2020.
Apr 1, 2011
Report
Report
The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Connecticut: An Analysis from RAND COMPARE
Projects how the coverage-related provisions of the Patient Protection and Affordable Care Act will affect health insurance coverage and state government spending on health care in Connecticut through 2020.
Apr 1, 2011