RAND Health Care has been analyzing major issues related to public and private financing of health care since the program? inception in 1968. An early landmark study in this body of work is the RAND Health Insurance Experiment, still the largest health policy study in U.S. history. RAND work in this research area includes the organization and regulation of health care markets, the effects of population health on public financing, cost-effective allocation of private and public financing, and distributional issues in health and health care associated with health care financing, among others.
Adding community-to-clinic tailored navigation to a community-based colorectal cancer screening promotion program may be highly cost-effective.
We find that Medicare Advantage beneficiaries with chronic conditions respond to changes in copays, although these responses are small. Reductions in copays lead to reduced use of specialists, suggesting that lowering copays could be a way to reduce specialist care.
This study was a cross-sectional mixed-methods analysis of in-depth multimodal data from 31 POs affiliated with 22 purposefully selected health systems in 4 states. Data were analyzed from June 2019 to September 2020.
Because employer-sponsored spending comes from employee wages and benefits, employers have a fiduciary responsibility to administer benefits in the interest of participants. The lack of transparency of prices in the health care market limits the ability of employers to knowledgeably develop or implement benefit design decisions. This report is designed to allow an easy comparison of hospital prices using a single metric.
An estimated 3 million people currently insured in the individual market would lose coverage and become uninsured if the American Rescue Plan's premium tax credit provisions are not extended beyond 2022.
Biosimilar drugs could drive down prices for expensive medicines, with savings estimated at $38.4 billion from 2021 to 2022.
We describe how commercial hospital payment rates changed relative to Medicare rates during 2012–19 and how trends differed by hospital referral region.
Most adults in this survey study were willing to use video visits for nonemergency care but preferred in-person care, suggesting that patient preferences will help define telehealth's role in US health care after the COVID-19 pandemic.
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.
The 10Plan is a self-pay plan for individuals currently uninsured or covered by a private nongroup health insurance plan. The authors built a microsimulation model to estimate health care spending under both the status quo and the 10Plan.
The 10Plan is a self-pay plan for individuals currently uninsured or covered by a private nongroup health insurance plan. Individuals would pay no premiums up front, face Medicare rates, pay a copayment for each encounter, and have the option to pay cash for services or borrow from the government at a low interest rate to pay for care. The authors built a microsimulation model to estimate health care spending under the status quo and the 10Plan.
Consumers of health care in the United States often lack information on the actual prices of the care they receive and can also lack access to information about the quality of their care. RAND researchers gathered information on how health care prices are set, price variation in health care markets, barriers to price and quality transparency for consumers, and the extent to which price and quality information is used in marketing efforts.
The Centers for Medicare & Medicaid Services (CMS) bundles payments for post-operative care within 10 or 90 days after many surgical procedures. Congress mandated that CMS collect data on the number and level of post-operative visits to enable CMS to assess the accuracy of global surgical package valuation. The authors of this report summarize patterns of post-operative visits for procedures furnished during calendar year 2018.
The Centers for Medicare & Medicaid Services (CMS) bundles payments for post-operative care within 10 or 90 days after many surgical procedures. Congress mandated that CMS collect data on the number and level of post-operative visits to enable CMS to assess the accuracy of global surgical package valuation. The authors of this report summarize patterns of post-operative visits for procedures furnished during calendar year 2019.
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.
As part of the evaluation of a federal initiative to integrate HIV medical and housing data at four local jurisdictions in the U.S., we estimated the financial costs of implementing data integration occurring from June 2016 to August 2018.
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.
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.
International reference pricing would have lowered 2020 US spending on select prescription drugs by 52% ($83.5 billion).
The authors analyze the spending impact of policy options to reduce hospital prices paid by private health plans, with various design choices and effectiveness levels for each approach. They estimate that price regulation could have the largest impact on hospital prices and spending but would likely face political challenges, while improving price transparency and competition could help reduce prices—but to a lesser extent than price regulation.
