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.
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.
This study found that during the initial phase of the COVID-19 epidemic in March and April of 2020, patients significantly reduced use of preventive and elective care and increased use of telemedicine but not enough to offset reductions in in-person care.
We identified five current cancer coverage state laws and interviewed experts on their perceptions of the relevance of the laws and how well they meet the current needs of cancer care given rapid changes in therapies.
Posttraumatic stress disorder and traumatic brain injury can have significant negative effects on veterans' mental and physical health, yet many veterans have difficulty accessing high-quality care. A rigorously developed, shared definition of high-quality care will help clinical providers and veteran-serving organizations better meet the needs of veterans with these conditions.
Rebalancing long-term services and supports toward increased home- and community-based services will engage and affect multiple stakeholder groups, including governmental and nongovernmental stakeholders. This study describes stakeholder engagement in a LTSS rebalancing initiative.
This exploratory qualitative study describes industry and community stakeholder perceptions of the impacts of cumulative hospital, practice, and insurance mergers, acquisitions, and affiliations in Pittsburgh, Pennsylvania.
In 2016, New York City policymakers came together with federal and private funders to support a program, Connections to Care (C2C), intended to provide quality mental health support within high-risk communities. RAND researchers conducted an evaluation of C2C, examining its implementation across 15 community-based organizations, its impact on access and utilization of mental health care, mental health symptoms, and other outcomes, and its costs.
This article measures the use of and willingness to use telehealth modalities across the U.S. population.
Structural reforms required by the Medicaid Balancing Incentive Program gave states an opportunity to modernize their HCBS systems through health information technology. Barriers to technology adoption persist, underscoring the need for continued support in future rebalancing efforts.
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.
A rigorously developed, shared definition of high-quality care for veterans with posttraumatic stress disorder and mild traumatic brain injury will help clinical providers and veteran-serving organizations better meet the needs of this population.
This mixed-methods study describes the distribution of the surgical and anesthesia workforce and qualitatively explores how such workforce and other factors influence rural hospitals' provision of surgical services.
Exploration of implementation models for tele–mental health.
Despite stronger financial incentives for community health workers, the entrepreneurial model led to substantially less effort (fewer household visits) than the free delivery model. Our results call into question the notion that an entrepreneurial model necessarily increases community health worker effort relative to free distribution.
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.
The panel achieved consensus on definitions of optimal access and access management, on eight urgent and important priorities for guiding access management improvement, and on 1–3 recommendations per priority. Each recommendation is supported by referenced, panel-approved suggestions for implementation.
In the six jurisdictions with the highest rate of opioid-related mortality in 2016, the most prominent barrier to accessing buprenorphine treatment was the difficulty of finding clinicians.
This analysis found a significant association among higher long-term unemployment, higher mental health clinician shortage areas, and higher county-level rates of neonatal abstinence syndrome.
This study examined the Child Trauma Response Team and its efforts to reduce PTSD symptoms among children exposed to domestic violence.
Newborns exposed to opioids before birth can experience withdrawal symptoms known as neonatal abstinence syndrome (NAS). From 2009 to 2015, the average NAS rate per 1,000 hospital births across eight states rose from about six to more than 25.
