Physician practice engagement with alternative payment models (APMs) would be enhanced by simpler APMs, a slower pace of change, greater support for new capabilities and timely data, and reexamination of practice response to APMs with financial risk.
This report, sponsored by the American Medical Association (AMA), describes how alternative payment models (APMs) affect physicians, physicians' practices, and hospital systems in the United States. Payment models discussed include fee for service, capitation, episode-based and bundled, shared savings, pay for performance, retainer-based, and combined payment models such as medical homes and accountable care organizations.
The options analyzed would increase individual market enrollment by 400,000 to 3.2 million in 2020. Net increases in total enrollment (300,000 to 2.4 million) are smaller because of offsetting decreases in employer-sponsored insurance.
Middle-income adults ages 50-64 would have more affordable coverage if the ACA's tax credits were extended to all income groups; this would improve the individual market risk pool because premiums for this group would exceed the cost of their care.
The dependent care expansion increased use of mental health care among a patients with significant mental health needs without lowering quality of care or increasing racial or ethnic disparities in access.
How will elimination of the Affordable Care Act's individual mandate penalty affect the nongroup insurance market in the state of New York? Researchers used RAND's COMPARE microsimulation model to estimate the effects, taking into account New York's unique health care landscape.
Prior to the ACA, Medicare Advantage (MA) enrollment growth led to small reductions in inpatient for the entire population over age 65. After the ACA, this impact diminished, contrary to the hypothesis that the MA ACA payment would amplify this effect.
Extending the duration of short-term individual health plans will have little effect on premiums or enrollment in the individual market.
This report reviews the features of tax-based approaches to subsidizing health insurance, including tax credits and tax deductions, and summarizes their associated benefits and drawbacks. Different approaches could affect consumer premium payments, health insurance enrollment, federal costs, total health spending, and work incentives.
Efforts to create high-functioning primary care teams should take advantage of the knowledge and skills of clinical pharmacy specialists
This report compares the projected impacts and feasibility of four options for financing health care for Oregon residents. The Single Payer option and the Health Care Ingenuity Plan would achieve universal coverage, while the Public Option would add a state-sponsored plan to the Affordable Care Act Marketplace. Under the Status Quo option, Oregon would maintain its expansion of Medicaid and subsidies for nongroup coverage through the Marketplace.
While the ACA's Dependent Coverage Expansion has increased insurance coverage, it has also widened race/ethnic disparities because it benefits only those young adults whose parents have private coverage.
This analysis of the dependent coverage expansion under the ACA suggests that historical trends rather than the insurance expansion itself account for increases in substance use among people ages 19-25 since 2010.
Examines the effect of health insurance coverage expansions on auto liability claims and costs.
This report uses RAND's COMPARE microsimulation model to estimate the effects of a 1332 waiver application from the state of Iowa. The waiver is designed to stabilize Iowa's Affordable Care Act individual market through a series of modifications. We estimate that the application would increase the federal deficit, but would decrease federal spending per enrollee on the ACA-compliant market.
The authors analyzed a version of the American Health Care Act (AHCA), a bill proposed in the U.S. House of Representatives on March 6, 2017. The bill would have repealed and replaced many provisions of the Affordable Care Act (ACA). The authors used RAND's COMPARE microsimulation model to assess how the AHCA would affect such outcomes as health insurance enrollment, consumer out-of-pocket costs, and the federal deficit relative to the ACA.
For the years 2013 and 2014, the Affordable Care Act authorized enhanced payments for qualifying providers of primary care services participating in the Medicaid program that would be funded entirely by federal dollars. RAND researchers conducted a nine-state independent case study into stakeholder experiences planning for, implementing, and evaluating the impact of the policy to inform the design of similar, future payment policies.
This presentation describes four options for financing health care for residents of the state of Oregon and compares the projected impacts and feasibility of each option. The Single Payer option and the Health Care Ingenuity Plan would achieve universal coverage; the public option would add a state-sponsored plan to the Affordable Care Act (ACA) marketplace.
The American Health Care Act would increase uninsurance among veterans and demand for Department of Veterans Affairs care by a greater margin than simply returning to pre–Affordable Care Act levels of coverage.
The authors estimated how an influx of newly insured patients through the Affordable Care Act's coverage expansion may change the way that civilian providers choose to interact with the TRICARE program. The report culminates in lists and maps of counties where civilian physicians are most likely to face financial incentives to substitute newly insured patients for current TRICARE patients.
