Report
Assessing the Quality of Outpatient Pain Care and Opioid Prescribing in the Military Health System
Pain conditions are the leading cause of disability among active-duty service members. RAND conducted a comprehensive assessment of outpatient care for acute and chronic pain, including opioid prescribing, delivered by the Military Health System.
Mar 16, 2022
Report
New York State 1115 Demonstration Independent Evaluation: Interim Report
This report examines whether two components of New York State's Medicaid Section 1115 Waiver—the Managed Long-Term Care (MLTC) program and the 12-month continuous eligibility policy—have achieved their goals.
Dec 2, 2021
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.
Nov 1, 2021
Report
Claims-Based Reporting of Post-Operative Visits for Procedures with 10- or 90-Day Global Periods: Updated Results Using Calendar Year 2018 Data
The authors of this report summarize patterns of post-operative visits for surgical procedures furnished in 2018 and paid for by Medicare. This report follows an earlier report that summarized these patterns from July 1, 2017, through June 30, 2018.
Sep 14, 2021
Report
Claims-Based Reporting of Post-Operative Visits for Procedures with 10- or 90-Day Global Periods: Updated Results Using Calendar Year 2019 Data
The authors of this report summarize patterns of post-operative visits for surgical procedures furnished in calendar year 2019 and paid for by Medicare. This report follows two earlier reports that summarized these patterns for earlier periods.
Sep 14, 2021
Report
Using Claims-Based Estimates of Post-Operative Visits to Revalue Procedures with 10- and 90-Day Global Periods: Updated Results Using Calendar Year 2019 Data
This report describes how the Centers for Medicare & Medicaid Services could use claims-based data on post-operative visits to adjust the valuations of surgical procedures with 10- and 90-day global periods.
Sep 14, 2021
Report
Behavioral Health Care for National Guard and Reserve Service Members from the Military Health System
There are differences in Military Health System behavioral health care access and quality between reserve- and active-component personnel and between reserve-component personnel who live far from military treatment facilities and those who do not.
Sep 7, 2021
Report
Assessing Health and Human Services Needs to Support an Integrated Health in All Policies Plan for Prince George's County, Maryland
This report describes a health and human services needs assessment of Prince George's County, Maryland. Findings from this report can inform Prince George's County's pursuit of a Health in All Policies approach to policymaking.
Aug 26, 2021
Research Brief
Post 9/11 Trends in Medical Separation and Separation for Service Members with Posttraumatic Stress Disorder and Traumatic Brain Injury
Trends in military medical discharges and disability ratings can help the U.S. Department of Defense set goals for diagnosing, treating, and evaluating service members with posttraumatic stress disorder or traumatic brain injury.
May 10, 2021
Report
Trends in Department of Defense Disability Evaluation System Ratings and Awards for Posttraumatic Stress Disorder and Traumatic Brain Injury, 2002–2017
The authors conduct an empirical analysis of trends in diagnosis, treatment, and disability evaluation for posttraumatic stress disorder and traumatic brain injury among military service members between 2002 and 2017.
May 10, 2021
Research Brief
Improving Behavioral Health Care for Remote Service Members: Three Key Priorities
Service members who are geographically remote from a military treatment facility may face unique challenges accessing high-quality behavioral health care. RAND research identified three key priority areas for the U.S. Department of Defense.
Apr 5, 2021
Report
Behavioral Health Care in the Military Health System: Access and Quality for Remote Service Members
The authors evaluated access and quality of behavioral health care provided to service members who reside remotely from a military treatment facility and compared their care with that received by non-remote personnel.
Mar 31, 2021
Report
Claims-Based Reporting of Post-Operative Visits for Procedures with 10- or 90-Day Global Periods: Final Report
The authors of this report summarize patterns of post-operative visits where Medicare bundles payment for post-operative care into payment for surgical procedures. The results suggest fewer visits occur than Medicare assumes in its payment rates.
Feb 5, 2021
Report
Using Claims-Based Estimates of Post-Operative Visits to Revalue Procedures with 10- and 90-Day Global Periods
This report describes how CMS could use new claims-based data on post-operative visits to adjust the valuations of surgical procedures with 10- and 90-day global periods.
Feb 5, 2021
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.
2021
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).
2021
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).
2021
Journal Article
Trends In Home Care Versus Nursing Home Workforce Sizes: Are States Converging Or Diverging Over Time?
Since 2009, most states have increased the size of their home care workforces and decreased the size of their nursing home workforces, but there is substantial variation across states. More targeted efforts may be needed to ensure that people with disabling conditions can have their needs met in their desired setting across the nation.
2021
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.
Aug 4, 2020
Journal Article
Patterns of Postoperative Visits Among Medicare Fee-for-service Beneficiaries
To describe patterns of postoperative visits reported for Medicare fee-for-service (FFS) patients.
2020
Report
Using the Person-Event Data Environment for Military Personnel Research in the Department of Defense: An Evaluation of Capability and Potential Uses
Researchers seek to determine whether RAND's federally funded research and development centers can effectively use the Person-Event Data Environment (PDE) to support manpower and personnel research and identify potential improvements to the PDE.
Jul 6, 2018
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.
Apr 11, 2018
Report
The Impact of Health Reform on Purchased Care Access: National Health Reform and Modernization of the Military Health System Study
Newly insured patients through the Affordable Care Act coverage expansion may change how civilian providers interact with the TRICARE program. Some physicians may face financial incentives to drop TRICARE patients for newly insured patients.
Sep 27, 2017
Journal Article
Sex Differences in Recent First-Onset Depression in an Epidemiological Sample of Adolescents
Sex differences in the incidence of depression originate during childhood and increase during adolescence.
Jul 14, 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
Journal Article
Differences in Nursing Home Quality Between Medicare Advantage and Traditional Medicare Patients
Researchers found little difference in the quality of nursing home care provided to Medicare enrollees in managed care and those enrolled in traditional fee-for-service nursing homes.
Oct 18, 2016
Research Brief
Characteristics and Treatment Patterns of Service Members with Mild Traumatic Brain Injury
This research brief describes the first comprehensive study of care for mild traumatic brain injury, or concussion, in the Military Health System, including patient characteristics, care settings, co-occurring conditions, and long-term care needs.
Apr 18, 2016
Report
Understanding Treatment of Mild Traumatic Brain Injury in the Military Health System
This first population-based study of care received by service members with mild traumatic brain injury in the Military Health System profiles patients, their care settings and treatments, co-occurring conditions, and risk factors for long-term care.
Apr 18, 2016
Journal Article
Estimating Surgical Procedure Times Using Anesthesia Billing Data and Operating Room Records
Anesthesia and operating room (OR) times can be used to estimate surgical time, thereby improving the payment for surgical procedures in the Medicare fee schedule.
Mar 18, 2016
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
Report
Development of a Model for the Validation of Work Relative Value Units for the Medicare Physician Fee Schedule
The Centers for Medicare & Medicaid Services (CMS) uses the resource-based relative value scale to pay physicians and other practitioners for services. CMS asked RAND to develop a model to validate physician work values using external data sources.
Jan 16, 2015
Research Brief
RAND Modeling Offers Support for Transparent and Consistent CMS Physician Fee Schedules
The current process used by the Centers for Medicare & Medicaid Services for valuing physician work is based on physician survey responses. RAND researchers examined the feasibility of developing a model based instead on external data sources.
Jan 16, 2015
Report
Access to Behavioral Health Care for Geographically Remote Service Members and Dependents in the U.S.
Geospatial and longitudinal analyses helped determine how many military service members and dependents are geographically distant from behavioral health care and the resulting effect on use of care.
Jan 5, 2015
Research Brief
Far from Care: Increasing Access to Behavioral Health Care for Remote Service Members and Their Families
RAND researchers sought to identify how many U.S. military service members and their dependents are remote from behavioral health care and the effects of this distance on their access to and use of care.
Jan 5, 2015
Report
Improving Access to Behavioral Health Care for Remote Service Members and Their Families
Geospatial and longitudinal analyses helped determine how many military service members and dependents are geographically distant from behavioral health care and the resulting effect on use of care.
Jan 5, 2015
Journal Article
Geographic Variation in Receipt of Psychotherapy in Children Receiving Attention-Deficit/Hyperactivity Disorder Medications
In the more than 1500 counties studied, fewer than 25% of children prescribed ADHD drugs received talk therapy in the same year they received medication. The percentage of children who received both drugs and therapy varied across counties and did not always reflect the number of available psychologists.
2014
Tool
2013 Interactive Community Health Needs Assessment
This interactive web tool draws attention to specific findings in the community health needs assessment in a format that is user friendly and can help to inform the public.
Nov 6, 2013
Report
District of Columbia Community Health Needs Assessment
Analyzes existing demographic, health status, and hospital service use data for the District of Columbia, as well as current stakeholder perspectives, health policy, and investment priorities.
Jun 26, 2013
Journal Article
Impact of Socioeconomic Adjustment on Physicians' Relative Cost of Care
Ongoing efforts to profile physicians on their relative cost of care have been criticized because they do not account for differences in patients' socioeconomic status (SES).
May 1, 2013
Report
Monitoring Cancer Outcomes Across the Continuum: Data Synthesis and Analysis for the District of Columbia
This report synthesizes and analyzes available data regarding cancer-related outcomes among District of Columbia residents, highlighting key findings and data gaps across the continuum of cancer prevention, treatment, and outcomes.
Sep 6, 2012
Journal Article
Mixed-method Approach to Understanding the Experiences of Non-Deployed Military Caregivers
Caregivers affiliated with the National Guard and those with more months of deployment report significantly poorer emotional well-being, and more household and relationship hassles.
2012
Journal Article
A New Estimate of the Impact of OSHA Inspections on Manufacturing Injury Rates, 1998-2005
A prior study indicated that the effect of OSHA inspections on lost workday injuries had declined from 1979 through 1998. This study provides an updated estimate for 1998–2005.
2012
Report
Patient Incentives to Motivate Doctor Visits and Reduce Hypertension Disparities
Examines whether small financial incentives for patients can motivate physician visits and reduce racial/ethnic disparities in hypertension.
Nov 30, 2011
Report
Policy Options for Addressing Medicare Payment Differentials Across Ambulatory Settings
Building on prior RAND analyses, this report presents options for modifying Medicare payment policies to improve the value of services and to address payment differentials for similar services provided in various ambulatory settings.
Sep 30, 2011
Research Brief
Views from the Homefront: How Military Youth and Spouses Are Coping with Deployment
Reports the results of a longitudinal study of youth from military families and their caregivers concerning their emotional well-being and how well they are coping with servicemembers' extended deployments.
Jan 19, 2011
Report
Views from the Homefront: The Experiences of Youth and Spouses from Military Families
Examines the behavioral and emotional well-being of a sample of military families over a year as they cope with the stress of war and deployment, using surveys and in-depth interviews with youth and their nondeployed caregivers.
Jan 19, 2011
Journal Article
PartyIntents: A Portal Survey to Assess Gay and Bisexual Men's Risk Behaviors at Weekend Parties
Portal survey methods can be used to anonymously survey gay and bisexual men about HIV-risk behaviors before and after a weekend party–oriented vacation.
2011
Multimedia
A Prototype Interactive Mapping Tool to Target Low Health Literacy in Missouri
Describes a web-based mapping tool to help healthcare decisionmakers identify neighborhood-level ''hotspots'' of suboptimal health or healthcare that may be due to low health literacy.
Apr 29, 2010
Journal Article
Children on the Homefront: The Experience of Children from Military Families
Although studies have begun to explore the impact of the current wars on child well-being, none have examined how children are doing across social, emotional, and academic domains.
2010
Draft
Estimating and Mapping Health Literacy in the State of Missouri
Using predictive models and information about the demographic makeup of census areas, this paper generates estimates of health literacy for each geographic area and maps the results to identify 'hot spots' of low health literacy across Missouri.
2010
Journal Article
The Pennsylvania Certified Safety Committee Program: An Evaluation of Participation and Effects on Work Injury Rates
Since 1994, Pennsylvania, has provided a 5% discount on workers' compensation premiums for firms with a certified joint labor-management safety committee. This study found that injury rates at participating firms with good compliance records dropped more than at other firms.
2010
Report
Behavioral Health in the District of Columbia: Assessing Need and Evaluating the Public System of Care
Dec 31, 2009
Research Brief
Children's Health in Washington, D.C.: Access and Health Challenges Despite High Insurance Coverage Rates
Assesses children's health issues in Washington, D.C., including the health care delivery system and neighborhood health environments.
Oct 28, 2009
Report
Health and Health Care Among District of Columbia Youth
Assesses health and health care use among youth in Washington, D.C., using a unique combination of survey, administrative, and focus group data, and offers recommendations for addressing District children's health needs.
Sep 18, 2009
Report
Serving the Underserved: A Mid-Course Evaluation of Montgomery Cares
A summary of the 2008 findings from a planned five-year evaluation (2006-2011) of the Montgomery Cares initiative, a Montgomery County, Maryland-funded program designed to provide basic health care to low-income, adult, uninsured county residents.
Mar 20, 2009
Report
Assessing Health and Health Care in Prince George's County
Assesses the health care needs of the residents of Prince George's County, Maryland, and the capacity of the county's health care system to meet those needs.
Feb 6, 2009
Report
Ambulatory Care Sensitive Hospitalizations and Emergency Department Visits in Baltimore City
Provides an in-depth analysis of ambulatory care sensitive inpatient hospitalizations and emergency department visits among Baltimore City residents.
Jan 22, 2009
Report
Cellulitis-Associated Hospitalizations in Baltimore City
Describes hospitalizations associated with cellulitis, a skin infection frequently linked to methicillin-resistant staphylococcus aureus, in Baltimore City.
Jan 22, 2009
Journal Article
Developing Predictive Models of Health Literacy
The authors developed two models to estimate health literacy.
2009
Draft
A Baseline Assessment of the District of Columbia School Health Nursing Program
Describes findings from a baseline assessment of the District of Columbia School Health Nurse Program.
Dec 12, 2008
Draft
What Kinds of Injuries Do OSHA Inspections Prevent?
This study finds that OSHA inspections reduce both injuries that are related to OSHA standards and those that are not. Citations of the general personal protection equipment standard are most likely to be followed by reductions in injuries.
Sep 23, 2008
Draft
The Pennsylvania Certified Safety Committee Program: An Evaluation of Participation and Effects on Work Injury Rates
This evaluation of the voluntary Pennsylvania Certified Safety Committee program found that although compliance did reduce injuries, most participants did not comply and injury rates did not decline more at participating firms.
Sep 18, 2008
Draft
Assessing Health and Health Care in the District of Columbia: Phase 2 Report
Provides recommendations for improving the health care delivery system in the District of Columbia.
Jun 15, 2008
Draft
Assessing Health and Health Care in the District of Columbia
Study of health and the health care delivery system, including an assessment of emergency medical services, in the District of Columbia.
Jan 14, 2008