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.
We conducted a retrospective cohort study of patients hospitalized on a medicine service in a high-LTACH use region and discharged to either an LTACH or SNF and followed for one year.
Insulin prices have increased dramatically over the past decade in the United States. The authors compared international prices for insulins using a price index approach. They describe the shares of volume and sales for all insulins and different categories of insulin in the United States and 32 comparison countries in 2018.
We identified five current cancer coverage state laws and interviewed experts on their perceptions of the relevance of the laws and how well they meet the current needs of cancer care given rapid changes in therapies.
We review the change over time in state-level policy environments around substance use in pregnancy and contrast the policy response with the principles and guidance from professional societies and federal agencies.
In this report, the authors offer an initial assessment of clinically integrated networks (CINs) based on interviews with health system executives, describe how health systems (large and small) are using CINs strategically to compete in crowded health care markets, and identify why CINs bear watching by the Federal Trade Commission and the larger health care community.
A stakeholder group of persons living with dementia influenced the agenda and outcomes of a national research summit on care, services, and supports for persons living with the disease.
This study estimates the societal costs of implementing CHOICE, a voluntary after-school alcohol and other drug prevention program for adolescents, in Boys and Girls Clubs across Southern California with and without an implementation support system called Getting To Outcomes.
Research on the costs of telemedicine programs shows that they are not self-sustaining and require grants and other resources to operate. However, given the significant changes to state telemedicine policies that have occurred in the past few years, this research base is outdated. RAND researchers describe telemedicine-related costs incurred by health centers participating in the Sustainable Models of Telehealth in the Safety Net initiative.
We describe the COVID-19 preparedness of nursing homes across the nation.
This paper provides policymakers with evidence for a new approach to reduce criminal activity among those whose alcohol use leads them to repeatedly threaten public health and safety.
In this brief, the authors present methods for creating critical care surge capacity in hospitals in response to the COVID-19 pandemic and estimate patient capacity, given the number of doctors, nurses, respiratory therapists, ventilators, and beds.
In this report, the authors present strategies for creating critical care surge capacity and estimate the number of patients accommodated, given the number of available critical care doctors and nurses, respiratory therapists, ventilators, and hospital beds. They also document the development of a user-friendly tool that allows decisionmakers to estimate current critical care capacity and rapidly explore strategies for increasing it.
Explores deep generative modeling in network science towards informing key public policy questions.
Posttraumatic stress disorder and traumatic brain injury can have significant negative effects on veterans' mental and physical health, yet many veterans have difficulty accessing high-quality care. A rigorously developed, shared definition of high-quality care will help clinical providers and veteran-serving organizations better meet the needs of veterans with these conditions.
Because of the rapid expansion of palliative care as a medical specialty, there has been a growing awareness of and emphasis on the importance of developing quality measures specific to palliative care, especially measures that capture the patient's experience of care. This report summarizes background information on the importance of and need for development of quality measures for palliative care based on patient-reported experience.
Important opportunities exist to improve quality of hospice care in nursing homes and assisted-living facilities. Quality improvement and regulatory interventions targeting these settings are needed to ensure that all hospice decedents and their family receive high-quality, patient- and family-centered hospice care.
Digital health technology offers enormous potential to improve rheumatology care but this potential has so far been largely unrealized.
The goal of this study was to explore the types of issues that arise in routine practice in early stage measurement-based care (MBC) implementation.
This study disentangled the effects of moral hazard from health plan selection. Our estimates imply that 53% of the additional medical spending observed in the most generous plan in our data relative to the least generous is due to adverse selection.
We herein provide suggestions on preoperative, intraoperative, and postoperative strategies aimed at reducing the risk of perioperative stroke and at improving the outcomes of patients who experience a perioperative stroke.
We conducted a retrospective cohort study of patients hospitalized on a medicine service in a high-LTACH use region and discharged to either an LTACH or SNF and followed for one year.
Insulin prices have increased dramatically over the past decade in the United States. The authors compared international prices for insulins using a price index approach. They describe the shares of volume and sales for all insulins and different categories of insulin in the United States and 32 comparison countries in 2018.
We identified five current cancer coverage state laws and interviewed experts on their perceptions of the relevance of the laws and how well they meet the current needs of cancer care given rapid changes in therapies.
We review the change over time in state-level policy environments around substance use in pregnancy and contrast the policy response with the principles and guidance from professional societies and federal agencies.
In this report, the authors offer an initial assessment of clinically integrated networks (CINs) based on interviews with health system executives, describe how health systems (large and small) are using CINs strategically to compete in crowded health care markets, and identify why CINs bear watching by the Federal Trade Commission and the larger health care community.
A stakeholder group of persons living with dementia influenced the agenda and outcomes of a national research summit on care, services, and supports for persons living with the disease.
This study estimates the societal costs of implementing CHOICE, a voluntary after-school alcohol and other drug prevention program for adolescents, in Boys and Girls Clubs across Southern California with and without an implementation support system called Getting To Outcomes.
Research on the costs of telemedicine programs shows that they are not self-sustaining and require grants and other resources to operate. However, given the significant changes to state telemedicine policies that have occurred in the past few years, this research base is outdated. RAND researchers describe telemedicine-related costs incurred by health centers participating in the Sustainable Models of Telehealth in the Safety Net initiative.
We describe the COVID-19 preparedness of nursing homes across the nation.
This paper provides policymakers with evidence for a new approach to reduce criminal activity among those whose alcohol use leads them to repeatedly threaten public health and safety.
In this brief, the authors present methods for creating critical care surge capacity in hospitals in response to the COVID-19 pandemic and estimate patient capacity, given the number of doctors, nurses, respiratory therapists, ventilators, and beds.
In this report, the authors present strategies for creating critical care surge capacity and estimate the number of patients accommodated, given the number of available critical care doctors and nurses, respiratory therapists, ventilators, and hospital beds. They also document the development of a user-friendly tool that allows decisionmakers to estimate current critical care capacity and rapidly explore strategies for increasing it.
Explores deep generative modeling in network science towards informing key public policy questions.
Posttraumatic stress disorder and traumatic brain injury can have significant negative effects on veterans' mental and physical health, yet many veterans have difficulty accessing high-quality care. A rigorously developed, shared definition of high-quality care will help clinical providers and veteran-serving organizations better meet the needs of veterans with these conditions.
Because of the rapid expansion of palliative care as a medical specialty, there has been a growing awareness of and emphasis on the importance of developing quality measures specific to palliative care, especially measures that capture the patient's experience of care. This report summarizes background information on the importance of and need for development of quality measures for palliative care based on patient-reported experience.
Important opportunities exist to improve quality of hospice care in nursing homes and assisted-living facilities. Quality improvement and regulatory interventions targeting these settings are needed to ensure that all hospice decedents and their family receive high-quality, patient- and family-centered hospice care.
Digital health technology offers enormous potential to improve rheumatology care but this potential has so far been largely unrealized.
The goal of this study was to explore the types of issues that arise in routine practice in early stage measurement-based care (MBC) implementation.
This study disentangled the effects of moral hazard from health plan selection. Our estimates imply that 53% of the additional medical spending observed in the most generous plan in our data relative to the least generous is due to adverse selection.
