Journal Article
Trends in Low-Value Health Service Use and Spending in the US Medicare Fee-for-Service Program, 2014–2018
Among individuals with fee-for-service Medicare receiving any of 32 measured services, low-value care use and spending decreased marginally from 2014 to 2018.
Feb 18, 2021
Journal Article
Impact of Consumer-Directed Health Plans on Low-Value Healthcare
Switching to a consumer-directed health plan is associated with reduced overall outpatient spending, but not with reduced spending on low-value healthcare services.
2017
Journal Article
Effects of Employer-Offered High-Deductible Plans on Low-Value Spending in the Privately Insured Population
This study uses insurance claims data and changes in plan offerings within firms over time to estimate treatment effects of high-deductible plans on spending on 24 low-value services received in the outpatient setting.
Feb 12, 2021
Journal Article
Primary Care Physician Migration Patterns and Their Implications for Workforce Distribution
Using primary care physician practice locations, we described physician migration between 2008 and 2013. We found very little physician migration; however, among those who did change, net movement was away from rural counties and HPSAs.
2019
Journal Article
Does Removing Financial Incentives Lead to Declines in Performance? A Controlled Interrupted Time Series Analysis of Medicare Advantage Star Ratings Programme Performance
We performed an observational cohort analysis of Medicare Advantage plans that were eligible for the Star Ratings program.
Feb 12, 2021
Journal Article
Waste in the Medicare Program: A National Cross-Sectional Analysis of 2017 Low-Value Service Use and Spending
In this analysis, we provide updated national estimates of low-value service use and spending in Medicare in 2017.
Dec 29, 2020
Report
Advancing the Development of a Framework to Capture Non–Fee-for-Service Health Care Spending for Primary Care
This report describes work conducted to understand what non-fee-for-service payment data are being collected by states and other stakeholders to support more complete measurement of primary care spending as a proportion of total health care spending.
Jul 30, 2020
Journal Article
Primary Care Spending in the Fee-for-Service Medicare Population
Primary care spending represents a small percentage -- less than 3% -- of total fee-for-service Medicare spending, though it varies substantially across populations and states.
Apr 17, 2019
Report
Identification of Alternative Physician Assistant Recertification Models: An Analysis of the Landscape and Evidence Surrounding Approaches to Recertification in the Health Professions
Health professional recertification is meant to demonstrate and foster knowledge and competence. This report assesses recertification requirements for physician assistants, physicians, and advanced practice nurses in the U.S. and elsewhere.
Oct 3, 2018
Journal Article
Federally Qualified Health Center Clinicians And Staff Increasingly Dissatisfied With Workplace Condition
Providers and staff at federally funded safety net clinics reported declines in professional satisfaction, work environment, and practice culture.
Aug 11, 2017
Report
Evaluation of Policy Options for Increasing the Availability of Primary Care Services in Rural Washington State
To address a perceived shortage in rural primary care providers, RAND Corporation researchers projected the effects that various policy options could have on Washington State's rural primary care workforce through 2025.
Nov 15, 2016
Journal Article
Low-value Health Care Services in a Commercially Insured Population
Spending on low-value medical services totaled $32.8 million in 2013, suggesting potential for savings.
Sep 14, 2016
Journal Article
Retail Clinic Visits for Low-Acuity Conditions Increase Utilization and Spending
Retail clinics may be creating new demand that increases the cost of health care rather than reducing medical spending.
Mar 14, 2016
Research Brief
New Approaches for Delivering Primary Care Could Reduce Predicted Physician Shortage
If the prevalence of two innovative care delivery models — the patient-centered medical home and the nurse-managed health center — increases, projected U.S. physician shortages can be cut in half by 2025 without training a single additional physician.
Nov 27, 2013
Journal Article
Nurse-managed Health Centers and Patient-Centered Medical Homes Could Mitigate Expected Primary Care Physician Shortage
Numerous forecasts have predicted shortages of primary care providers, particularly in light of an expected increase in patient demand resulting from the Affordable Care Act. Yet these forecasts could be inaccurate because they generally do not allow for changes in the way primary care is delivered.
Nov 1, 2013
Journal Article
Physicians with the Least Experience Have Higher Cost Profiles Than Do Physicians with the Most Experience
Health plans and Medicare are using cost profiles to identify which physicians account for more health care spending than others.
Nov 1, 2012
Journal Article
Retail Clinic Visits and Receipt of Primary Care
Retail clinics may disrupt two aspects of primary care: whether patients go to a PCP first for new conditions and continuity of care. However, they do not negatively impact preventive care or diabetes management.
2013
Journal Article
Trends in Retail Clinic Use Among the Commercially Insured
Retail clinic use increased 10-fold from 2007 to 2009. By 2009, roughly 7 percent of all visits by commercially insured patients for 11 common acute-care conditions were to a retail clinic. Increased use was especially dramatic among young, healthy, and higher-income individuals.
Nov 1, 2011
Journal Article
Associations Between Physician Characteristics and Quality of Care
Patients are encouraged to select physicians on the basis of characteristics such as education, board certification, and malpractice history. But such characteristics are poor proxies for performance on clinical quality measures.
2010