Health care coverage protects individuals against the financial risk that might result from spending on health care services. In the United States, coverage may take the form of insurance offered by private companies and made available to individuals through employers or purchased directly. The government also provides coverage for certain populations via programs such as Medicare or Medicaid. RAND research on health care coverage dates from the RAND Health Insurance Experiment (HIE). Conducted in the 1970s and early 1980s, the HIE remains the only long-term, experimental study of cost sharing and its effect on health care utilization and spending, quality of care, and health. Since then, RAND studies have examined multiple dimensions of coverage, including the effects of premium costs on health care use, the cost and potential health effects of new insurance products such as high-deductible health plans, the challenges faced by small businesses in providing coverage to employees, the groups most at risk for being uninsured, state experiments with insuring the uninsured, coverage for behavioral health, and coverage for prescription drugs.
A culture-centered approach to health literacy programs enhances meaningful and effective health communication.
Researchers present a subset of results from May and October 2020 surveys fielded through the RAND American Life Panel to assess changes in levels of trust in the Centers for Disease Control and Prevention during the coronavirus disease 2019 pandemic. Non-Hispanic white and Hispanic respondents reported significant declines in trust, while the changes were not statistically significant for non-Hispanic black or respondents of other races.
Medicare’s value-based purchasing programs do not currently include health equity measures. This work identified 10 existing approaches to health equity measurement and convened a technical expert panel to identify the most promising approaches.
Examines physicians use of telemedicine during COVID-19 to quantify physician-level substitution between in-person interactions with patients and virtual interactions.
We study the effect of state recreational marijuana laws on workers' compensation benefit receipt among adults 40–62 years old.
We performed an observational cohort analysis of Medicare Advantage plans that were eligible for the Star Ratings program.
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.
Minimum wage increases lead to reductions in employer-sponsored insurance coverage in families with incomes below 300% of the federal poverty level.
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.
In response to the coronavirus disease 2019 (COVID-19) pandemic and subsequent policies, the Los Angeles County Department of Mental Health launched a campaign to promote awareness of county mental health resources and communicate messages of hope and support. RAND evaluators found that the campaign successfully reached residents, fostered a feeling of support among those it reached, and conveyed how to seek mental health help.
In this paper, we find that over a longer time horizon, OxyContin reformulation stimulated illicit drug markets to grow and evolve.
This article reviews the literature on associations between patient experience and business outcomes, including patient allegiance and retention, complaints, lawsuits, provider job satisfaction, and profitability.
Longitudinal data highlight profound inequities that have been exacerbated by COVID-19. Existing policies appear inadequate to address the widening gap.
In this Perspective, the authors provide a brief background on (1) the important role that home care workers play in the United States, particularly during the coronavirus disease 2019 pandemic; (2) how they gathered these workers' perspectives through journaling; and (3) how journaling can serve as a valuable source of support and a flexible data collection method, especially when circumstances are changing rapidly, as in a public health crisis.
We find ecological evidence consistent with racial/ethnic disparities in buprenorphine distribution. Our finding that initiatives to increase the number of waivered prescribers are insufficient to achieve equitable buprenorphine access.
This report provides an independent assessment of the breadth, scope, and impact of health services and primary care research funded by the U.S. Department of Health and Human Services and U.S. Department of Veterans Affairs from FYs 2012 to 2018. The authors identify research gaps and offer recommendations for maximizing the outcomes and value of future investments in health services and primary care research by federal agencies.
Here we explore the important case of using General Population Surveys to estimate frequent heroin use.
Opportunities exist to improve hospice care for symptom palliation and training for caregivers when their family members are at home or in an ALF setting. Efforts to improve care for cancer patients in the NH and ALF setting are especially needed.
Most people with co-occurring substance use and mental health disorders never get the high-quality care they need to recover. To address this issue, RAND researchers created a toolkit to support the delivery of effective, evidence-based pharmacotherapy for clients with co-occurring alcohol and/or opioid use and mental health disorders in mental health clinics.
The United States is at a time of promise for historic transformation in mental health care. This report describes the landscape of mental health in the United States and identifies opportunities for transformative change. The result is an analysis of key problems and the research evidence for solutions, with recommendations to promote change to improve the lives of the millions of Americans living with mental illness.
