RAND Health Care research on the organization and capacity of the health care system takes a broad perspective. Our work has examined how organization affects the system’s ability to provide high-quality care and to use resources efficiently and effectively. Many studies have focused on the link between health system organization and the ability of the public health system to respond to public health emergencies, whether natural or the result of hostile action.
Evidence shows that leaders who implement the patient-centered medical home care model encounter challenges in driving change. Understanding which changes and quality improvement practices further implementation is essential.
Our analyses provide evidence of the feasibility, reliability, and validity of proposed survey-based measures to assess the quality of home-based serious illness care from the perspective of patients and their families.
We interviewed 105 practice leaders from 294 sampled practices and used content analysis to identify themes about uses of patient experience data for practice improvement during PCMH transformation.
To advance understanding of primary care clinic productivity, the authors reviewed relevant literature and convened a diverse set of stakeholders to explore definitions of productivity, input, and output in primary care; identify relevant tools; and establish consensus on key aspects of primary care productivity.
RAND Corporation researchers developed and field-tested a survey to assess the experiences of individuals who receive care from programs that provide serious illness care to patients in their homes.
RAND Corporation researchers developed and field-tested a survey to assess the experiences of individuals who receive care from programs that provide serious illness care to patients in their homes. This is the Spanish version of the survey tool.
We developed and established the psychometric properties of survey measures describing normative and interpersonal integration.
During the COVID-19 pandemic, visit volume at a sample of FQHCs declined modestly for primary care visits and remained stable for behavioral health visits because telehealth visits replaced in-person visits.
The study sought to develop and test a patient-reported outcome measure (PROM) for suitability in digital remote asthma symptom monitoring to identify uncontrolled asthma.
A RAND team identified three goals for transforming the U.S. mental health care system and pinpointed 15 opportunities to drive systemic improvements in access, use, and quality that would help tens of millions of Americans.
As the COVID-19 pandemic disrupted in-person medical care, emergency regulatory changes were implemented to promote use of telehealth.
Book chapter reviewing the current state of telehealth use.
COVID-19 has affected telehealth utilization disproportionately. The increase in telemedicine use was greatest among patients in counties with low poverty levels, among patients in metropolitan areas, and among adults compared with children.
The Ohio Department of Medicaid introduced requirements to be delivered by Medicaid managed care organizations (MCOs). This study evaluated the impact of care management on reducing infant mortality in the largest Medicaid MCO in Ohio.
This study found that during the initial phase of the COVID-19 epidemic in March and April of 2020, patients significantly reduced use of preventive and elective care and increased use of telemedicine but not enough to offset reductions in in-person care.
An exploratory qualitative study to explore why and how health systems are engaging in care delivery redesign (CDR) activities.
We developed manager and staff surveys to collect data on organizational, social, and clinical process integration, at four organizational levels: practice site, physician organization, health system, and outside health systems.
This report offers lessons learned about telemedicine staffing and the coordinator role from the experience of nine community health centers in California that participated in the Sustainable Models of Telehealth in the Safety Net initiative. Experiences with the coordinator role might be informative for health care settings that are planning for or currently implementing clinic-based telemedicine programs.
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.
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.
