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.
In this report, RAND researchers describe the methods and findings of a survey that they conducted to evaluate the reach and impact of Los Angeles County's 2021 WhyWeRise social marketing campaign, which was focused on raising awareness of the county resources available to support residents' mental health and communicating messages of resilience, support, and hope.
This social marketing campaign conducted by the Los Angeles County Department of Mental Health focuses on prevention of and early intervention for mental health challenges, with WeRise events held each spring. Surveys suggest that these efforts reached a racially, culturally, and economically diverse group of county residents, fostered a feeling of support among those exposed to the campaign, and boosted residents' awareness of local resources.
Policymakers in Connecticut are considering various state-funded policy options to improve insurance coverage among undocumented and legally present recent immigrants in the state — almost 60 percent of whom lack health insurance. The authors use the RAND Corporation's COMPARE microsimulation model to estimate the impacts of each policy scenario on premiums, state spending, and hospital spending on uncompensated care.
In early 2020, as the COVID-19 pandemic emerged, widespread social-distancing efforts suspended much of the delivery of nonurgent health care. Telehealth proved to be a viable alternative to in-person care, at least on a temporary basis, and utilization skyrocketed. Researchers investigated changes in telehealth utilization and health center staff experiences with implementation.
Testimony presented before the Texas House of Representatives Select Committee on Health Care Reform on August 4, 2022.
This article provides guidance through two thought experiments that provide a hypothetical upper bound on U.S. consumption of fentanyl.
RAND Corporation and MedStar researchers examined the intersection of patient safety and racism, focusing on patient safety and health equity from clinician leaders' perspectives. An overarching emphasis of the work concerned the impact of racism and other related factors (i.e., bias) on patient safety events and potential interventions or changes (such as creating a culture of speaking up about racism in care) that can help prevent such events.
Shelter-in-place policies during the COVID-19 pandemic were associated with reductions in the use of preventive care, elective care, and the number of weekly visits to physician offices, hospitals and other health care-related industries.
Participants had highly favorable attitudes about the Chronic Care and Medicine Dispensing and Distribution (CCMDD) program for HIV treatment. Patient-level barriers to care included inadequate education about CCMDD and inability to get refills. Organizational-level barriers included challenges with communication and transportation, errors in medication packaging and tracking, rigid rules, and inadequate infrastructure.
This report presents findings from a study commissioned by Wounded Warrior Project and conducted by the RAND Corporation to identify the long-term outcomes of traumatic brain injury (TBI) for veterans, the future needs of this population, effective treatments for TBI, and the availability of community-based resources. The information in this report can be used to better understand which approaches may offer the best care for veterans with TBI.
Microsimulation (Future Adult Model) predicted 30-year improved diet quality impacts across 12 demographic groups. Diet improvement reduced prevalence of heart disease by 7.6% to 13.8% across groups and reduced healthcare costs by $10B in year 30.
Information on the race and ethnicity of individuals enrolled through the Health Insurance Marketplace is critical for assessing past enrollment efforts and determining whether outreach campaigns should be modified. This report presents the results of imputing race and ethnicity for HealthCare.gov Marketplace enrollees from 2015 through 2022 with an approach that uses surnames, first names, and addresses to estimate race and ethnicity.
Complementary and integrative health providers, such as chiropractors and naturopathic doctors, have been an underutilized public health asset in the response to the COVID-19 pandemic. This report seeks to inform how they can be better integrated into future responses to public health emergencies.
The authors used the RAND Corporation's COMPARE microsimulation model to estimate the impacts of policy options that would increase the affordability of health insurance in Connecticut. For each policy scenario, they calculated enrollment, premiums, consumer spending, and state spending and considered whether the results differed by race, ethnicity, or income group.
The authors estimated the impacts of policy options to increase the affordability of insurance in Connecticut with the assumption that subsidy enhancements enacted under the American Rescue Plan Act of 2021 would not continue past 2022.
In 2020, there were 60,000 overdose deaths involving synthetic opioids in the US, where data lags and limited cross-agency coordination impedes understanding of transitioning illicit drug markets. Better data from Canada can offer some understanding.
This report describes the development of key factors in framework design for the Health System–Community Pathways Program (HCPP), which aims to increase representation of African American/Black communities in the health care system workforce and improve the quality of their educational and work experiences. The HCPP framework of key factors is informed by an environmental scan, interviews and focus groups, and an expert discussion panel session.
We provide data on the authority of providers at different emergency medical services licensure levels to administer naloxone. We also describe relevant policies regarding which administration routes and dosages are permitted for each licensure level.
This report provides additional detail on the objectives of and use cases for APCDs, the current APCD landscape, and implementation challenges that constrain the use of APCDs for some valuable applications.
This tool provides summary information on studies about mental health emergency hotlines in the United States. This information—including hotline name and modality and study design, sample size, population, and findings—could be valuable to policymakers and administrators as they consider investments in new call centers in the ramp-up for 988, the national mental health emergency hotline number that will go live in July 2022.
