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 brief describes how a public option for health care—that is, a government-sponsored health insurance plan with publicly determined provider payment rates—would affect insurance costs and coverage.
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 paper discusses patient involvement in specific research projects.
The COVID-19 pandemic strikes at a moment when our national response to the opioid crisis was beginning to coalesce. COVID-19 threatens to dramatically overshadow and reverse this progress.
This report provides an initial assessment of the possible short-term economy-wide effects of social distancing. These results should be taken as rough order-of-magnitude estimates meant to help inform decisionmakers during the coronavirus disease 2019 crisis.
In May 2019, the Los Angeles County Department of Mental Health and the Shay Moral Injury Center at Volunteers of America hosted a three-day conference, "Moral Injury and Pathways to Recovery." RAND evaluated the reach and impact of the conference and its goals to deepen knowledge about moral injury and effective recovery strategies and to strengthen collaborative connections.
Los Angeles County, in partnership with the Los Angeles Sparks basketball team, conducted a mental health campaign in 2019 aimed at women veterans. The campaign was integrated into Sparks games and included events with resources for women veterans. Although the campaign sometimes struggled to reach individuals, it successfully provided new information about how to improve mental health and access resources among those it did reach.
A stakeholder group of individuals living with dementia made valuable contributions to a research summit on the disease.
Children with in utero opioid exposure had a predicted probability of being diagnosed with a pediatric complex chronic condition similar to that among children with tobacco exposure and those with neither exposure (20.4%,18.7%, and 20.2%, respectively). Our findings were consistent when we examined a subgroup of opioid-exposed children identified as having neonatal opioid withdrawal symptoms.
This study sheds light on the distribution of buprenorphine-waivered prescribers over the past decade. Growth has been rapid in communities affected by the opioid crisis, but slower in rural communities, and those with lower levels of education.
We study the effects of a cash transfer program in Nigeria in which households were offered a payment of $14 conditioned on uptake of health services.
To support health care resource allocation decisionmaking during the COVID-19 crisis, the authors created the Core Guidance Checklist from a discussion process with bioethicists, health system leaders, clinicians, patient advocates, and representatives of affected communities. It is intended for use by decisionmakers within health systems, as well as state-level policymakers, to improve resource allocation policy development and implementation.
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.
The United States is facing a mental health crisis, but a large proportion of those who need treatment never get it. Task sharing — a process in which workers not traditionally considered part of the mental health workforce are trained to provide evidence-based mental health support — can be part of the solution. This guide offers practical steps for implementing task sharing in community-based organizations.
This article defines specific tasks that providers, government, business, and individuals could take now to help us address the COVID epidemic.
The national growth in opioid supply explains 75% of the national rise in opioid treatment admissions and the diversion component is a critical driver of the opioid epidemic.
Passage of morphine equivalent daily dose guidelines was associated with significant decreases in high dose opioid prescribing among workers' compensation claimants with chronic non-cancer related pain.
Will Modicare provide financial protection and improve health? Evidence from other health insurance reforms, including a regional predecessor to Modicare in India, provide some important clues.
We conducted a systematic legal review of state laws that mandate or recommend that healthcare providers prescribe naloxone to patients with indicators for opioid overdose risk. By targeting higher-risk patients during clinical encounters, naloxone prescribing requirements could increase naloxone prescribed, destigmatize naloxone use, and reduce overdose harms.
Summarizes findings from a small pilot study which was conducted to evaluate the feasibility of data collection processes and refine the testing plan in advance of a larger national field test.
