Access to health care usually refers to the ease with which an individual can gain entry to or receive needed medical services. RAND research addresses multiple dimensions of access, including: financial access, usually facilitated through health insurance; potential access, usually aided by having a regular health care provider; and realized access, when an individual actually receives needed medical care. Many RAND studies have also examined disparities in access across different population groups and the effect of disparities on health.
Accessibility, especially the ability to access health care after regular office hours, appears to be the major predictor of having a medical home among Latino children.
We quantify the use of clinical decision support (CDS) and the specific barriers reported by ambulatory clinics and examine whether CDS utilization and barriers differed based on clinics' affiliation with health systems.
Testimony presented before the U.S. House of Representatives Committee on Veterans' Affairs on September 15, 2022.
This cross-sectional study evaluates the association of a cap on monthly out-of-pocket spending on high-cost drugs with use of these drugs and out-of-pocket spending in California in 2015 and 2016.
This feasibility study protocol describes our plans to develop, implement, and evaluate web-based and consultative training for Children's Advocacy Center Victim Advocates to enhance early engagement in evidence-based youth mental health services.
Evaluation of a nurse-led, home-based serious illness care program (Advanced Illness Care) at UPMC, a health system in Pittsburgh, PA.
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.
We provide the first evidence on associations between individual characteristics and the propensity to experience an involuntary care disruption resulting from the COVID-19 pandemic.
Coronavirus disease 2019 (COVID-19) has disrupted the delivery of health care services, including dental care. The objective of this study was to quantify and describe US adults who delayed dental care due to the COVID-19 pandemic.
We provide new evidence on causal factors behind geographic variation in health care utilization by examining changes in health care use for the near-elderly as they transition from being uninsured into Medicare.
The Equity-First Vaccination Initiative aims to reduce racial/ethnic disparities in COVID-19 vaccination rates in the United States. Five demonstration sites are using hyper-local, community-led strategies to increase vaccine confidence and access.
In 2020, the Immediate Office of the Secretary of the Department of Health and Human Services sought to identify measures that could improve the ability of the United States and other countries to learn from international comparisons of health system performance. RAND Corporation researchers worked with 15 experts in quality measurement, clinical care, and health economics to generate and prioritize potential measure constructs.
New York State's Medicaid Section 1115 Waiver seeks to enroll a majority of Medicaid beneficiaries into managed care, increase access and service quality, and expand coverage to more low-income New Yorkers. This final interim evaluation report examines whether two components of the 1115 Demonstration Waiver—the Managed Long-Term Care (MLTC) program and the 12-month continuous eligibility policy—have helped achieve the program's goals.
Stakeholders reported that BIP participation had a range of impacts on the HCBS ecosystem, often beyond the structural reforms. Our findings highlight BIP impacts to monitor over the long term and to consider in evaluations of future rebalancing efforts.
This cross-sectional study of substance use disorder treatment facilities examined the national share of facilities that offer medication treatment for opioid use disorder (MOUD) and population-based measures of geographic accessibility of facilities offering MOUD.
The use of telehealth services has increased during the COVID-19 pandemic. What role can telehealth play in a post-pandemic health care system? The authors of this Perspective discuss how the ongoing use of telehealth services could affect the realization of policy goals, and offer recommendations for how policymakers might deploy telehealth services to achieve post-pandemic policy goals.
During the COVID-19 pandemic, visit volume at a sample of FQHCs declined modestly for primary care visits and remained stable for behavioral health visits because telehealth visits replaced in-person visits.
The coronavirus disease 2019 pandemic–related recession and resulting job loss raised significant concerns that the U.S. uninsured population could increase, perhaps by millions. However, worrisome predictions about coverage loss have not materialized. RAND researchers (1) assess the importance of temporary provisions in stabilizing health insurance enrollment despite heavy job loss and (2) run simulations using New York state as a case study.
Interviews and a survey indicate that WhyWeRise, a social marketing campaign promoting community engagement with mental health issues, reached at least 30 percent of Los Angeles County youth ages 14–24 and mobilized them to improve societal support for those experiencing mental health challenges. Those exposed to the campaign were more likely than those unexposed to feel empowered to change how their communities deal with mental health issues.
In this cross-sectional study with random assignment of clinicians and simulated-patient callers, many women, especially pregnant women, faced barriers to accessing treatment. Given the high out-of-pocket costs and lack of acceptance of insurance among many clinicians, access to affordable opioid use disorder treatment is a significant concern.
