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 gathered expert consensus on the effectiveness and implementability of various state-level naloxone strategies.
This feasibility study protocol describes our plans to develop, implement, and evaluate web-based and consultative training for Children's Advocacy Center Victim Advocates to enhance early engagement in evidence-based youth mental health services.
We review and synthesize papers estimating drug R&D costs incurred by industry. We find a substantial range of per-drug costs, from $113 million–$6 billion. We discuss the data sources, methods, and assumptions used in each study and suggest areas for future research and data collection.
Evaluation of a nurse-led, home-based serious illness care program (Advanced Illness Care) at UPMC, a health system in Pittsburgh, PA.
Mixed methods study of transitions from hospital to home for palliative care/hospice.
We engaged experts using an online modified Delphi approach to develop consensus on the appropriateness of strategies for managing cancer pain in individuals with co-occurring advanced cancer and opioid use disorder.
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.
The Equity-First Vaccination Initiative aims to reduce racial/ethnic disparities in COVID-19 vaccination rates in the United States. Five demonstration sites are using hyper-local, community-led strategies to increase vaccine confidence and access.
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 this perspective piece, we explore the implications of poor quality electronic health data on the use of population health management algorithms for patients, clinicians, and policymakers.
International reference pricing would have lowered 2020 US spending on select prescription drugs by 52% ($83.5 billion).
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.
Over a simulated forty-year career, male physicians earned an average adjusted gross income of $8,307,327 compared with an average of $6,263,446 for female physicians—an absolute adjusted difference of $2,043,881 and relative difference of 24.6 percent.
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.
We study the interrelationships between health, residential segregation, and disaster-related material losses (income loss, job loss, economic/property damages) due to the worst ever man-made disaster of its kind, the Deepwater Horizon oil spill.
