Letter from the Editor

A study by Price et al. in this issue of RAND Health Quarterly estimates the coverage and financial impacts of the Affordable Care Act in the Pennsylvania. The authors' main analyses hinge on Pennsylvania's decision to implement the optional expansion of Medicaid to cover all individuals with family income under 138 percent of the federal poverty limit. Given the 2012 Supreme Court decision on the Affordable Care Act, each state must decide whether to expand its Medicaid program. The authors' analysis highlights the range of benefits and costs that states must weigh before finalizing this important decision.

This issue also includes studies that illustrate the international breadth and potential impact of health care research. These studies focus on a range of issues, including the use of external reference pricing in pharmaceuticals in Europe and Canada, the challenges of expanding the Kurdistan Regional Government's health care system, and the assessment of organizations' interest in becoming Academic Health Science Centres in England. The key findings from these studies have sometimes surprising relevance to the United States and other health systems. For example, after decades of implementation in Europe and elsewhere, reference pricing is increasingly mentioned as a possible tool to improve the value of health care in the United States.

Other studies in this issue answer important questions related to the evaluation of an Army program to increase the physical and mental capabilities of Special Forces personnel; parental and provider perspectives on oral health care for children in Washington, D.C.; the role of emergency departments in health care delivery; the adoption of health information technology by the military health system; and the impacts of workplace wellness programs.

Andrew W. Mulcahy, Ph.D., M.P.P., Editor

RAND Health Quarterly is produced by the RAND Corporation. ISSN 2162-8254.