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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.

Research Brief

What Does High-Quality Care Mean for Veterans with Invisible Wounds?

Oct 22, 2020

Many veterans have difficulty accessing high-quality care for posttraumatic stress disorder and traumatic brain injury. As clinical providers and veteran-serving organizations aim to improve access, a shared definition of high-quality care for these conditions would help them better meet veterans' needs.
Report

What Role Will Telehealth Play After COVID-19?

Jan 22, 2021

The use of telehealth services has increased during the pandemic. When policymakers evaluate telehealth policy going forward, they will need to consider whether telemedicine can improve care quality, reduce costs, increase access, or achieve some combination of these goals.

Explore Health Care Access

Report

Measures and Methodology for International Comparisons of Health Care System Performance: Final Report

RAND researchers worked with 15 experts in quality measurement, clinical care, and health economics to generate potential measure constructs that could improve the U.S. ability to learn from international comparisons of health system performance.

Feb 24, 2021
Report

Health Service Utilization and Cost Outcomes from a Permanent Supportive Housing Program: Evidence from a Managed Care Health Plan

The authors assess the short-term effects of a permanent supportive housing (PSH) program—operated by a large not-for-profit managed care plan—in Southern California for adult enrollees experiencing homelessness who have chronic health conditions.

Feb 16, 2021
Journal Article

Characteristics of US Adults Delaying Dental Care Due to the COVID-19 Pandemic

Coronavirus disease 2019 (COVID-19) has disrupted the delivery of health care services, including dental care. The objective of this study was to quantify and describe US adults who delayed dental care due to the COVID-19 pandemic.

Feb 12, 2021
Journal Article

Association of Primary and Specialty Care Integration on Physician Communication and Cancer Screening in Safety-Net Clinics

This study aimed to describe strategies CHCs use to integrate care with specialists and examine whether more strongly integrated CHCs have higher rates of screening for colorectal and cervical cancers and report better communication with specialists.

Feb 12, 2021
Journal Article

Perspectives on Opportunities and Challenges for Medicare Advantage Plans to Address Social Determinants of Health Via the CHRONIC Care Act

The effect of the 2018 CHRONIC Care Act and how it may evolve before implementation begins in 2020 remains uncertain as we wait to see how MA plans will interpret eligibility criteria and services offered without any additional allotted funding.

Feb 12, 2021
Journal Article

Impact of a Medicaid Policy on Preventive Oral Health Services for Children with Intellectual Disabilities, Developmental Disabilities, or Both

The authors examined the impact of state policies allowing delivery of POHS in medical offices on receipt of POHS among Medicaid enrollees with IDD.

Feb 12, 2021
Journal Article

Low Rates of Pediatric Dental Coverage for Families Purchasing Marketplace Insurance Plans

Pediatric dental care is an essential health benefit that the Affordable Care Act requires most private health plans to cover. It is unknown how these different pediatric dental coverage offerings may affect uptake of coverage.

Feb 12, 2021
Journal Article

Impact of State-Level Training Requirements for Medical Providers on Receipt of Preventive Oral Health Services for Young Children Enrolled in Medicaid

Our objective was to test whether training requirements were associated with higher rates of preventive oral health services for Medicaid-enrolled children <6 years.

Feb 11, 2021
Journal Article

Telehealth Use Among Safety-Net Organizations in California During the COVID-19 Pandemic

During the COVID-19 pandemic, visit volume at a sample of FQHCs declined modestly for primary care visits and remained stable for behavioral health visits because telehealth visits replaced in-person visits.

Feb 4, 2021
News Release

Nearly All Telehealth Appointments at Clinics for Lower-Income Americans Were Audio-Only, Raising Questions About Quality and Equity

Telehealth use has surged during the pandemic at clinics that serve lower-income Americans, which allowed the clinics to maintain access to care. But most visits have been audio-only, which may pose challenges if payers consider dropping reimbursement for such services after the pandemic.

Feb 2, 2021
Journal Article

Delivery of Preventive Oral Health Services by Rurality: A Cross-Sectional Analysis

Using a multistate sample of Medicaid claims, we examined a child's odds of receiving preventive oral health services in a medical office by county rurality.

Feb 2, 2021
Journal Article

Changes in Pediatric Dental Coverage and Visits Following the Implementation of the Affordable Care Act

Comparing pre- and post-ACA periods, private dental insurance increased by 4.6% (P=0.013) and annual dental visits were unchanged (2.7%, P=0.071) comparing children likely or unlikely to be affected by the ACA.

Feb 2, 2021
Journal Article

Do Supply-Side Forces Explain Geographic Variation in Health Care Use?

We provide new evidence on causal factors behind geographic variation in health care utilization by examining changes in health care use for the near-elderly as they transition from being uninsured into Medicare.

Jan 26, 2021
Journal Article

Changes in Health Services Use Among Commercially Insured US Populations During the COVID-19 Pandemic

This study found that during the initial phase of the COVID-19 epidemic in March and April of 2020, patients significantly reduced use of preventive and elective care and increased use of telemedicine but not enough to offset reductions in in-person care.

Jan 26, 2021
Commentary

Getting COVID-19 Vaccines to Pennsylvania Residents

Pennsylvania state and county health departments have a number of options that could speed the delivery of COVID-19 vaccines to make sure Pennsylvania residents at high risk for severe COVID-19 outcomes are vaccinated as soon as possible.

Jan 19, 2021
News Release

Use of Telehealth Jumped as Pandemic Shutdown Began; Use Is Highest for Mental Health Services

Use of telehealth jumped sharply during the first months of the coronavirus pandemic shutdown, with the approach being used more often for behavioral health services than for medical care.

Jan 11, 2021
Commentary

Patients Log On to See Their Own Doctors During the Pandemic

Telehealth use has skyrocketed during the COVID-19 pandemic. Can this form of high-quality, low-cost care be maintained over the long term? As discussion of post-pandemic policies begins, lessons from patients' use of telehealth will provide valuable guidance.

Jan 7, 2021
Journal Article

Outcomes Are Worse in US Patients Undergoing Surgery on Weekends Compared With Weekdays

The aim of this study was to determine whether patients undergoing surgery on weekends are more likely to die or experience a major complication compared with patients undergoing surgery on a weekday.

Dec 31, 2020
Journal Article

Racial and Ethnic Disparities in Care for Health System-Affiliated Physician Organizations and Non-Affiliated Physician Organizations

This article assesses racial and ethnic disparities in care for Medicare fee-for-service beneficiaries and whether disparities differ between health system-affiliated physician organizations (POs) and nonaffiliated POs.

Dec 29, 2020

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RAND Topic:
Health Care Access

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