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.
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.
Family caregivers provide a significant portion of health and support services in the United States to individuals with serious illnesses but are often overlooked by existing health care systems. The authors describe why, in light of COVID-19, it is more critical than ever to integrate family caregivers into patients' health care teams and highlight several solutions for accomplishing this goal.
Examines physicians use of telemedicine during COVID-19 to quantify physician-level substitution between in-person interactions with patients and virtual interactions.
The United States is at a time of promise for historic transformation in mental health care. This report describes the landscape of mental health in the United States and identifies opportunities for transformative change. The result is an analysis of key problems and the research evidence for solutions, with recommendations to promote change to improve the lives of the millions of Americans living with mental illness.
More than 46 million Americans live with a mental illness, yet only half of those Americans receive treatment. Even fewer people receive high-quality care that would give them the best treatment possible. This tool is designed by RAND researchers to help connect mental health systems, policy leaders, and decisionmakers with resources and evidence-based solutions that could help transform the complex mental health landscape in the United States.
To determine whether and how to respond to the evolving health care market, policy makers need to better understand how health systems are actually organized and the relationships among the entities that comprise them.
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.
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.
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.
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.
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 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.
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.
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.
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).
