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.
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.
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the significant changes to state telemedicine policies that have occurred in the past few years, this research base is outdated.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.
To evaluate differences in end-of-life cost trajectories for cancer patients treated through Medicare versus by the Veterans Health Administration (VA).
RAND researchers evaluated the experiences of health centers that participated in the Sustainable Models of Telehealth in the Safety Net initiative, which aimed to support the growth of telemedicine. Although this evaluation occurred before the coronavirus disease 2019 pandemic dramatically altered the health care system, the findings are relevant to health centers that are trying to rapidly expand telemedicine in response to the pandemic.
Practices currently using behavioral health integration face barriers to implementing and sustaining behavioral health integration. Tailored, context-specific technical support to guide practices' implementation and payment models that improve the business case for practices may enhance the dissemination and long-term sustainability of behavioral health integration.
This article evaluates the feasibility and impact of telelactation via personal electronic devices on breastfeeding duration and exclusivity among rural women.
Although family caregivers provide a significant portion of health and support services to individuals in the United States with serious illnesses, they are often overlooked by existing health care systems. The report is intended to spur a conversation about potential ways to promote integration and provide a blueprint for the next steps to implementing to support for the integration of family caregivers into the patient's health care team.
Although use of telemedicine for the treatment of opioid use disorders is growing, there is limited research on how it is actually being deployed in treatment. We explored how health centers across the U.S. are using it.
This article tests the hypothesis that health systems provide better care to patients with high needs by comparing differences in quality between system-affiliated and nonaffiliated physician organizations.
This exploratory qualitative study describes industry and community stakeholder perceptions of the impacts of cumulative hospital, practice, and insurance mergers, acquisitions, and affiliations in Pittsburgh, Pennsylvania.
We explore if there are ways to characterize health systems-not already revealed by secondary data-that could provide new insights into differences in health system performance.
A randomized controlled trial in Nigeria evaluated an intervention that paid pregnant women to deliver in a health facility, which led to a 41% increase in facility deliveries. We found improvements in the quality of delivery care and in satisfaction with care.
RAND researchers examined the reasons medical practices obtained and maintained patient-centered medical home (PCMH) recognition. Financial incentives, being in a statewide effort, and the desire to improve care or experiences were the most common reasons practice leaders decided to obtain and maintain PCMH recognition.
We describe activities that health systems are pursuing to better leverage health IT to improve performance, in a qualitative thematic approach.
This article measures the use of and willingness to use telehealth modalities across the U.S. population.
Structural reforms required by the Medicaid Balancing Incentive Program gave states an opportunity to modernize their HCBS systems through health information technology. Barriers to technology adoption persist, underscoring the need for continued support in future rebalancing efforts.
RAND researchers describe promising practices identified by staff from nine health centers in California that were participating in the Sustainable Models of Telehealth in the Safety Net initiative. These practices show the potential to support the growth and sustainability of telemedicine programs in safety-net settings. However, there is not yet sufficient evidence to prove that such practices will be effective across settings.
This article assesses racial and ethnic disparities in care for Medicare fee-for-service beneficiaries and whether disparities differ between health system-affiliated physician organizations (POs) and nonaffiliated POs.
In 2019, a conference in Israel showcased new frontiers in technology in healthcare, highlighting research conducted in Israel as well as across the globe.
Overview of survey items used to assess patient experience and whether those items are on the CAHPS survey or not.
