Journal Article
Association of Primary and Specialty Care Integration on Physician Communication and Cancer Screening in Safety-Net Clinics
This study aimed to describe strategies CHCs use to integrate care with specialists and examine whether more strongly integrated CHCs have higher rates of screening for colorectal and cervical cancers and report better communication with specialists.
2020
Journal Article
Health System Affiliation of Physician Organizations and Quality of Care for Medicare Beneficiaries Who Have High Needs
This article tests the hypothesis that health systems provide better care to patients with high needs by comparing differences in quality between system-affiliated and nonaffiliated physician organizations.
Dec 29, 2020
Journal Article
Racial and Ethnic Disparities in Care for Health System-Affiliated Physician Organizations and Non-Affiliated Physician Organizations
This article assesses racial and ethnic disparities in care for Medicare fee-for-service beneficiaries and whether disparities differ between health system-affiliated physician organizations (POs) and nonaffiliated POs.
Dec 29, 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
Provision of Social Services and Health Care Quality in US Community Health Centers, 2017
Some community health centers provide social services on-site and this was associated with better performance on measures of health care quality.
Jun 25, 2020
Journal Article
Access, Quality, And Financial Performance Of Rural Hospitals Following Health System Affiliation
Health system affiliation was associated with improved financial performance for rural hospitals but that it also could reduce local access to certain services and was not associated with improved health care quality for the two measures examined.
2019
Journal Article
Federally Qualified Health Center Strategies for Integrating Care with Hospitals and Their Association with Measures of Communication
Health centers differ in the use of strategies to integrate care with hospitals. Overall, integration activity is associated with better communication.
Nov 27, 2019
Journal Article
Specialty Care Access for Medicaid Enrollees in Expansion States
In a survey of community health center medical directors in 9 Medicaid expansion states and DC, nearly 60% reported difficulty obtaining new specialist visits and multiple access barriers on behalf of their patients.
Nov 27, 2019
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.
Aug 22, 2019
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.
Sep 7, 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
Medicare Advantage and Fee-for-Service Performance on Clinical Quality and Patient Experience Measures: Comparisons from Three Large States
Performance data for 9.9 million Medicare patients showed that Medicate Advantage outperformed Medicare Fee for Service across all 16 clinical quality measures examined.
2017
Journal Article
Utilization of Health Care Services Among Medicare Beneficiaries Who Visit Federally Qualified Health Centers
Fee-for-service Medicare beneficiaries who received their care at federally qualified health centers had fewer ambulatory visits and more visits to the ED compared to a matched comparison group of beneficiaries who received primary care from another source.
Mar 1, 2018
Journal Article
Using Health IT to Coordinate Care and Improve Quality in Safety-Net Clinics
This study examined factors associated with use of health information technology (HIT) capabilities for improved care coordination and quality of care in U.S. health centers.
2018
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
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
Journal Article
Association Between Patient-Centered Medical Home Capabilities and Outcomes for Medicare Beneficiaries Seeking Care from Federally Qualified Health Centers
The patient-centered medical home (PCMH) may benefit Medicare beneficiaries receiving care at federally qualified health centers; however certain PCMH capabilities, including identifying high-risk patients, effectively using care plans, and supporting self-care, may be particularly difficult for the centers to develop.
Jun 27, 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
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
National Patient-Centered Clinical Research Network (PCORnet) Phase I: Final Evaluation Report
PCORnet, the National Patient-Centered Clinical Research Network, seeks to conduct clinical trials and observational research quickly and at low cost. This report contains the results of a formative evaluation of PCORnet's implementation phase.
Dec 31, 2015
Journal Article
Radiologists' Perceptions of Computerized Decision Support: A Focus Group Study from the Medicare Imaging Demonstration Project
The purpose of this study was to discern radiologists' perceptions regarding the implementation of a decision support system intervention as part of the Medicare Imaging Demonstration project.
Nov 6, 2015
Report
Evaluation of CMS's Federally Qualified Health Center (FQHC) Advanced Primary Care Practice (APCP) Demonstration: Final Second Annual Report
This second of three reports follows the progress of a three-year project intended to support the transformation of federally qualified health centers into advanced primary care practices in support of Medicare beneficiaries.
Jul 29, 2015
Journal Article
Appropriateness of Advanced Diagnostic Imaging Ordering Before and After Implementation of Clinical Decision Support Systems
Computerized clinical decision support (CDS) systems that match patient characteristics against appropriateness criteria to produce algorithmic treatment recommendations are a potential means of improving care.
Jul 13, 2015
Report
Evaluation of CMS' FQHC APCP Demonstration: Final First Annual Report
RAND was asked to evaluate a demonstration of federally qualified health centers becoming advanced primary care practices for Medicare beneficiaries and to assess the effects on care provided. This is the first report in a series of three.
Apr 9, 2015
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.
Mar 17, 2015
Report
Specialty Payment Model Opportunities and Assessment: Oncology Simulation Report
This report shares results of a simulation analysis of a payment model for specialty oncology services that is being developed for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare and Medicaid Services.
Mar 17, 2015
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.
Mar 17, 2015
Report
Medicare Imaging Demonstration Final Evaluation: Report to Congress
RAND researchers tested whether exposing ordering clinicians to appropriateness guidelines for advanced imaging procedures would reduce or eliminate inappropriate orders. The study identified many opportunities to refine decision support systems.
Nov 10, 2014
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).
Apr 26, 2013
Journal Article
Systematic Review of Strategies to Manage and Allocate Scarce Resources During Mass Casualty Events
We analyze published evidence on strategies to optimize the management and allocation of scarce resources across a wide range of mass casualty event contexts and study designs.
2013
Journal Article
Nonmedical Interventions for Children with ASD: Recommended Guidelines and Further Research Needs
The creation of treatment guidelines and recommendations for future research represents an effort by leading experts to improve access to services for children with ASDs while acknowledging that the research evidence has many gaps.
Nov 1, 2012
Report
Dissemination and Adoption of Comparative Effectiveness Research Findings When Findings Challenge Current Practices
An analysis of factors that impede the translation of comparative effectiveness research (CER) into clinical practice and those that facilitate it, based on case studies of five recent CER studies.
Oct 10, 2012
Journal Article
Five Reasons That Many Comparative Effectiveness Studies Fail to Change Patient Care and Clinical Practice
Results from comparative effectiveness research seldom influence clinical practice.
Oct 1, 2012
Journal Article
A Conceptual Framework and Protocol for Defining Clinical Decision Support Objectives Applicable to Medical Specialties
We developed a conceptual framework and protocol that combines evidence review with expert opinion to elicit clinically meaningful objectives for CDS directly from specialists.
Sep 1, 2012
Report
Developing a Framework for Establishing Clinical Decision Support Meaningful Use Objectives for Clinical Specialties
This report describes a protocol for eliciting high-priority targets for electronic clinical decision support for individual clinical specialties, a central requirement of the federal electronic health record incentive program.
Apr 2, 2012
Report
Medical Care Provided Under California's Workers' Compensation Program: Effects of the Reforms and Additional Opportunities to Improve the Quality and Efficiency of Care
This book examines changes to California's workers' compensation affecting medical care provided to injured workers and identifies areas in which more changes could improve quality and efficiency of care.
Aug 22, 2011
Journal Article
Diminishing Efficacy of Combination Therapy, Response-Heterogeneity, and Treatment Intolerance Limit the Attainability of Tight Risk Factor Control in Patients with Diabetes
Evaluate the attainability of tight risk factor control targets for three diabetes risk factors and to assess the degree of polypharmacy required.
2010
Journal Article
Variation in the Net Benefit of Aggressive Cardiovascular Risk Factor Control Across the US Population of Patients with Diabetes Mellitus
This study examined the benefits of aggressively controlling blood pressure and cholesterol in diabetes patients and found that the potential benefits depend on a patient's underlying risk for cardiovascular disease.
2010