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.
This study draws from an evaluation of how older adults are served by California's public mental health delivery system, and a review of state planning documents and academic literature, to describe gaps and deficiencies in the workforce that serves older adults.
The growing use of medication treatment for opioid use disorder in the West Virginia Medicaid expansion population provides an opportunity to reduce overdose deaths.
This study presents the results of a proof-of-concept modeling effort that utilized individual patient-level data from ten randomized studies and the categorization of these study's participants by chronic pain impact level to estimate the effectiveness and cost-effectiveness of adding recommended nonpharmacologic therapies for CLBP to usual care.
Early indications suggest that value-based incentives are leading to changes; however, incentives remain small, potentially limiting their effectiveness in driving the significant changes needed to derive large improvements in performance.
This report assesses the magnitude of the potential health system challenges in the diagnosis and treatment of early-stage Alzheimer's disease in Australia, given the hypothetical availability of a disease-modifying therapy. It uses a simulation model to compare the expected number of patients with the capacity of the health system and assess three possible constraints: visits to dementia specialists, biomarker testing, and infusion delivery.
Following the authors' earlier work in the United States and Europe, they use a simulation model that quantifies the capacity of the Canadian health care system to diagnose and treat people with early-stage Alzheimer's disease (AD) should a disease-modifying therapy become available. The report shows the impact of capacity constraints on the number of people progressing from mild cognitive impairment due to AD to Alzheimer's dementia.
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.
Although many states have passed some type of law affecting naloxone availability, only laws allowing direct dispensing by pharmacists appear to be useful. Communities in which access to naloxone is improved should prepare for increases in nonfatal overdoses and link these individuals to effective treatment.
Insufficient sleep in adolescents may increase risk for sexual risk-taking and may set the stage for accelerated health risk trajectories into adulthood.
The relationship between business cycles and health is theoretically complex. In a seminal paper, Ruhm (2000) outlined a series of economic mechanisms through which business cycles may influence health.
This policy brief draws on recent study findings, state planning documents, and a review of the literature to describe gaps and deficiencies in the behavioral health workforce that serves older adults in California.
Fewer than 10% of West Virginia Medicaid enrollees received medication for opioid use disorder after a non-fatal overdose, making it an opportunity to increase treatment for opioid use disorder and co-occurring mental health conditions.
This paper assesses community perceptions of crime and the police before and after the implementation of an intervention aimed at eliminating overt drug markets through focused deterrence and police-community partnerships emphasizing racial reconciliation.
To help inform accurate valuation of procedures with global periods, Medicare required select practitioners to report on their post-operative visits beginning July 1, 2017. Analysis of 1.4 million procedures with 10- or 90-day global periods, linked to 931,640 post-operative visits, found that the proportion of expected post-operative visits provided was low for all procedures, suggesting the need to revalue procedures with global periods.
This study used the RUAM to determine the appropriateness of spinal mobilization and manipulation for different types of patients with CLBP, and the key patient characteristics associated with appropriateness.
Individuals returning to the community from jail often face difficulties accessing the varied health, social, and other services required to improve reentry and reduce recidivism. This report describes a pilot study, the Co-Design of Services for Health and Reentry (CO-SHARE), that engaged returning individuals and service providers who support reentry to collaborate on improving health and reentry services in Los Angeles County.
This study examines the associations between college attendance and subsequent alcohol and marijuana use behaviors at multiple ages during young adulthood and adulthood, while rigorously controlling for baseline differences by college type.
This paper utilizes comparative case methods and qualitative case data from a sample of urban congregations, and examines a range of factors to identify case scenarios associated with congregations involved in different levels of HIV activity.
Among persons with or at-risk for symptomatic knee OA, there is evidence of depression subtypes characterized by distinct clusters of depressive symptoms that have differential effects on reports of pain and disability overtime.
This study examined the Child Trauma Response Team and its efforts to reduce PTSD symptoms among children exposed to domestic violence.
