The U.S. health care system has well-known problems: high costs and high numbers of uninsured. Perhaps less publicized is the system's struggle to deliver high-quality care—that is, care that's likely to improve health and is consistent with current medical science.
Improving care is a long-term, complex challenge. In a series of studies spanning decades, RAND Health has confronted this challenge by helping to establish the scientific basis for defining and measuring quality of care.
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There are many challenges in measuring quality of care for seriously ill patients. Potential solutions to improve community-based programs that treat these patients include engaging in communication, shared decisionmaking, and advance care planning.
Following three possible recommendations for medical care for people with an opioid addiction may cut deaths among such patients by as much as one-third. Deaths were much lower among patients who were not prescribed opioids or common types of anxiety medications, those who received psychosocial counseling, and those who had quarterly visits with a physician.
RAND researchers used the RAND Health Care Payment and Delivery Simulation Model (PADSIM) to estimate how sensitive physician behavior is to the design of alternative payment models under the Medicare Access and CHIP Reauthorization Act (MACRA).