Letter from the Editor

This issue of RAND Health Quarterly opens with a focus on innovation. Garber et al. identify policy options that could improve value in the U.S. health care system by changing how new medical technologies are discovered and developed. Some of the policy options target innovators (for example, prizes for inventions and a public-interest investment fund), while others address the markets for technologies after they are developed (for example, changes to Medicare payment policies). Liu et al. note that narrow, targeted ideas to improve the health care system are often easier to implement than broader, systemic change. They identify a series of small ideas—including changes in payment policy for emergency transport and increased use of $4 generic drugs—that could save the U.S. health care system between $13 billion and $22 billion per year.

Several studies tackle policy questions related to mental health in the military context, including issues related to the development of a toolkit to evaluate suicide prevention programs; an analysis of mental health, physical health, and financial survey data from the Wounded Warrior Project; and a study linking psychological fitness and resilience. A series of four related studies describe an effort to catalog, compare, and assess Department of Defense programs to support servicemembers and family members coping with stress, mental health problems, traumatic brain injuries, and other conditions.

Other studies focus on policy issues related to mental health more generally. Burnam et al. describe an evaluation of the California Mental Health Services Authority statewide prevention and early intervention program for individuals with mental illness. Van Stolk et al. explore different approaches to improve employment and health outcomes for people with common mental health problems.

The remaining studies in this issue estimate the impacts of proposals allowing individuals to stay on individual and nongroup insurance plans through the implementation of the Affordable Care Act, summarize the impacts of neuroscience and mental health research over the past 20 years, describe regulations and policies related to standards of care and quality improvement internationally, and estimate gender gaps in cholesterol testing rates in California.

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