Quality of care is the extent to which all individuals receive the right care, at the right time, every time. RAND has been conducting research on measuring and assessing quality of health care for 40 years, and RAND teams developed many of the quality measures being used around the world today. In 2005, RAND analysts produced the first national report card on quality of care in the United States.
To ensure fair comparison of serious illness programs, quality measure scores should be case-mix adjusted for variables that influence patients' reports about care quality, but are not under the control of the program administering care.
Increases in vertical integration were not associated with changes in medication adherence rates. However, adherence rates after vertical integration declined for non-Whites, patients over 80 years old, and patients with greater comorbidities.
This population-based cross-sectional study found that although quality of care and patient experience were slightly higher with higher-premium plans, quality varied widely within each premium category.
Mental health services provide essential supports to people living with psychiatric disorders. However, in the United States as a whole and in New York City in particular, the use of mental health services is low and care is not equitably distributed. To advance policy strategy for addressing gaps in the mental health services system, RAND researchers investigate the availability and accessibility of mental health services in New York City.
Many states separate, or "carve out," Medicaid financing of behavioral health services from that for other types of health care, but there has been a recent trend in some states toward "carve-ins," whereby financing for behavioral health services is combined with the larger pool of Medicaid-covered services. To inform California's consideration of a carve-in approach, the authors examine the experiences of other states that have implemented it.
This study aimed to examine the content of the recommendations given to providers aimed at improving provider-patient interactions, characterize these recommendations, and examine their actionability.
To inform the development of No Surprises Act (NSA) reports to Congress, this report summarizes recent patterns of and trends in horizontal and vertical consolidation of hospitals, physician practices, and health insurers; what is known about the impacts of consolidation on health care prices, health care spending, quality of care, patient access, and health care wages; and the potential impact that NSA provisions might have on consolidation.
In this model, CMS pays participating organizations for assessing each of their eligible Medicare beneficiary's risk of having a heart attack or stroke over the next 10 years and for reducing CVD risk among high-risk beneficiaries.
RAND Corporation and MedStar researchers examined the intersection of patient safety and racism, focusing on patient safety and health equity from clinician leaders' perspectives. An overarching emphasis of the work concerned the impact of racism and other related factors (i.e., bias) on patient safety events and potential interventions or changes (such as creating a culture of speaking up about racism in care) that can help prevent such events.
As part of a national effort to develop palliative care quality metrics for use in accountability programs, we sought to develop survey items assessing patients' experiences of outpatient palliative care, incorporating the patient's voice.
The COVID-19 pandemic highlighted a need to transform the decisionmaking culture in long-term care to make it more inclusive of residents, staff, and others who are affected by infection-control policies in these facilities.
RAND Health Care researchers used public and private data, such as data from health care claims, to understand telehealth's effect on health care delivery and how it affects care quality, access, and equity.
Urinary incontinence (UI) is a highly prevalent condition among women. In this report, the authors present an environmental scan of studies that assess the dissemination and implementation of nonsurgical treatment of UI for women in primary care. The scan was conducted in support of the Agency for Healthcare Research and Quality's Managing Urinary Incontinence initiative.
Regardless of language preference, Hispanic people with Medicare experience disparities in patient care relative to non-Hispanic White English-preferring counterparts.
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.
This paper investigates adoption of behavioral nudges by health system-affiliated physician organizations (POs), types of nudges being used, PO leader perceptions of nudge effectiveness, and implementation challenges.
This paper presents evidence that the quality of health care interactions changed in important ways during the early months of the Covid-19 pandemic.
Policies to prevent the spread of COVID-19 in long-term care facilities have failed to balance community safety and resident well-being. Input from a range of stakeholders—including facility leadership, residents, consumer advocates, researchers, and clinicians—highlighted a need for cultural change in long-term care and opportunities to make policy decisionmaking more inclusive.
Knowledge, not ignorance, of race and ethnicity is necessary to combat algorithmic bias. RAND researchers describe two applications in which imputation of race and ethnicity can help mitigate potential algorithmic biases in health care: equitable disease screening algorithms using machine learning and equitable pay-for-performance incentives.
We sought to examine whether quality of care for work-associated carpal tunnel syndrome is associated with healthcare expenditures or disability. Quality of care was associated with health care expenditures, but not with disability.
