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Health Care Access

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Access to health care refers to the ease with which an individual can obtain needed medical services. RAND research has examined the social, cultural, economic, and geographic factors that influence health care access worldwide; the effects of changes in access; and the relationship between access and health for specific U.S. populations—including racial and ethnic minorities, people with limited English proficiency, the uninsured, the elderly, children, and veterans.

Essay

How Private Health Care Providers Could Better Serve Veterans

Nov 7, 2018

Almost a third of U.S. veterans live 40 miles or more from the nearest VA medical center, so the VA is trying to make it easier for them to use private providers closer to home. But it will take significant efforts to better prepare civilian doctors to deliver high-quality care to veterans.
Report

Spending Estimates Under Medicare for All

Apr 10, 2019

Under a Medicare for All plan similar to some proposals being discussed in Congress, total health expenditures would be an estimated 1.8 percent higher in 2019, relative to the status quo. While this is a small change in national spending, the federal government's health spending would increase substantially, rising by an estimated 221 percent.

Explore Health Care Access

Blog

RAND's Response to a Past Pandemic: HIV/AIDS

In the 1980s, HIV/AIDS killed 90 percent of those infected. RAND was at the forefront of the research response, providing key data on costs of care, barriers to access, and the disease's effects on quality of life. RAND continues to pursue ways to ease HIV's impact in the United States and Africa.

May 19, 2020
Journal Article

Journal Article

Examining the Association Between Religiosity and Medical Mistrust Among Churchgoing Latinos in Long Beach, CA

The present study examined the association between religiosity and medical mistrust in a sample of Latino adults attending Catholic and Pentecostal churches in Long Beach, CA.

May 19, 2020
Commentary

How to Help Refugees and Host Countries Combat COVID-19

Having escaped conflict and persecution, refugees now risk illness and death from COVID-19. That risk is heightened by a policy regime that focuses largely on refugees in camps, not the almost two-thirds who live in urban areas. But the crisis could provide an opportunity to reform a broken system for the benefit of refugees and host countries alike.

May 18, 2020
Blog

Preparing for a Post-Vaccine World, Domestic Abuse, the Future of War: RAND Weekly Recap

This weekly recap focuses on why we need a blueprint for a post-vaccine world, helping domestic abuse victims during COVID-19, the pandemic's historic economic effects, and more.

May 15, 2020
Commentary

Want to Stem the Rising Mental Health Crisis? Look Beyond the Usual Suspects for Help

As the COVID-19 pandemic and its economic effects spread, concerns about mental health impacts continue to grow. Many communities and policymakers are desperate to stem the tide of unaddressed mental health needs, and with the right investments in training, task-shifting models have enormous potential to bolster available, accessible mental health services.

May 12, 2020
Commentary

Needed: A Blueprint for a Post-Vaccine World

When a COVID-19 vaccine is developed, many in rich countries may be able to afford it while the poor and uninsured may not. The time to plan for equitable access, financing, intellectual property rights, and global production is now.

May 11, 2020
Blog

Reopening America, China's 'Mask Diplomacy,' State Police Powers: RAND Weekly Recap

This weekly recap focuses on a RAND tool that estimates the public health and economic effects of reopening America, China's “mask diplomacy,” using police powers for pandemic response, and more.

May 8, 2020
Commentary

COVID-19 Crisis Could Spur Post-Soviet Fixes

Much of the post-Soviet space remains afflicted with authoritarian rule, inefficient economies, corruption, and regional tensions. The COVID-19 crisis could prod countries to address key issues, but they will need help. Targeted Western aid could help willing countries make progress.

May 8, 2020
Commentary

Non-Emergency Medical Transportation in the Time of COVID-19

More widespread availability of rideshare for non-emergency medical transport may save lives, reserve emergency resources for those who need them, and provide safe pathways to primary care for the chronically ill. It could also save livelihoods, providing employment in a time of economic hardship.

May 5, 2020
Commentary

Emergency Homeless Services During the COVID-19 Crisis

The recently passed $2 trillion stimulus package includes a suite of measures designed to support households that are affected by the COVID-19 outbreak. But policymakers may want to consider what protections the package offers to a particularly high-risk group: people experiencing homelessness.

Apr 7, 2020
Commentary

The Public Charge Rule's Likely Hazard to Our Nation's Health During COVID-19

The Public Charge rule makes immigrants who receive Medicaid and other publicly-funded benefits potentially ineligible for green cards, and, in some cases, subjects them to deportation. Fear and reluctance to seek assistance among immigrants is likely to worsen during the COVID-19 epidemic.

Apr 6, 2020
Commentary

What If the Supreme Court Strikes Down the ACA During the Pandemic?

With COVID-19 spreading across the United States, the fate of the Affordable Care Act is once again up in the air, hanging on the outcome of a Supreme Court case. Should the law be overturned, upwards of 20 million people could lose their health insurance during one of the deadliest pandemics in modern history.

Apr 3, 2020
Report

2019 Evaluation of Los Angeles County's WhyWeRise Mental Health Campaign

Interviews and a survey indicate that WhyWeRise, a community engagement mental health campaign, reached at least 30 percent of Los Angeles County youth and mobilized them to improve societal support for those experiencing mental health challenges.

Apr 1, 2020
Journal Article

Journal Article

A Systematic Review of Church-Based Health Interventions Among Latinos

This article reviews interventions that have been tested in congregations with majority Latino populations in the U.S.

Mar 10, 2020
Journal Article

Journal Article

When Financial Incentives Backfire: Evidence from a Community Health Worker Experiment in Uganda

Despite stronger financial incentives for community health workers, the entrepreneurial model led to substantially less effort (fewer household visits) than the free delivery model. Our results call into question the notion that an entrepreneurial model necessarily increases community health worker effort relative to free distribution.

Feb 13, 2020
Journal Article

Journal Article

Eight Priorities for Improving Primary Care Access Management in Healthcare Organizations: Results of a Modified Delphi Stakeholder Panel

The panel achieved consensus on definitions of optimal access and access management, on eight urgent and important priorities for guiding access management improvement, and on 1–3 recommendations per priority. Each recommendation is supported by referenced, panel-approved suggestions for implementation.

Feb 12, 2020
Journal Article

Journal Article

Engagement of Providers and Advocates in a Rebalancing Initiative to Increase HCBS Access for Medicaid Beneficiaries

Rebalancing long-term services and supports toward increased home- and community-based services will engage and affect multiple stakeholder groups, including governmental and nongovernmental stakeholders. This study describes stakeholder engagement in a LTSS rebalancing initiative.

Jan 29, 2020
Journal Article

Journal Article

Access, Quality, And Financial Performance Of Rural Hospitals Following Health System Affiliation

Health system affiliation was associated with improved financial performance for rural hospitals but that it also could reduce local access to certain services and was not associated with improved health care quality for the two measures examined.

Jan 28, 2020
Journal Article

Journal Article

A Comprehensive Theory of Integration

This article presents a comprehensive theory describing how integrating structures, processes, and people within and across organizations might lead to integrated patient care and improved outcomes, including technical quality, efficiency, patient health, and both patient and provider experience.

Dec 3, 2019
Journal Article

Journal Article

Specialty Care Access for Medicaid Enrollees in Expansion States

In a survey of community health center medical directors in 9 Medicaid expansion states and DC, nearly 60% reported difficulty obtaining new specialist visits and multiple access barriers on behalf of their patients.

Nov 27, 2019

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RAND Topic:
Health Care Access

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