RAND Research Topic: Health Care Facilities

Assessment of Variation in Electronic Health Record Capabilities and Reported Clinical Quality Performance in Ambulatory Care Clinics, 2014–2017

2021-05-04T09:15:00Z

Between 2014 and 2017, clinics with EHRs having greater capabilities had better quality measures than other clinics, but clinics that gained EHR capabilities during this time had smaller increases in quality that were not statistically significant.

Inpatient Hospitalizations for Firearm Injury

2021-04-27T09:00:00Z

RAND researchers developed a database of state-level estimates of inpatient hospitalizations for firearm injury. This document describes the methods used to construct the estimates and provides technical documentation to facilitate database use.

Reducing Hospital Spending: Three Policy Options

2021-04-21T08:45:00Z

RAND researchers have estimated the effects of policy options to reduce hospital prices paid by private health plans, outlining design choices and effectiveness levels for each approach.

Nursing Home Responses to Performance-based Accountability

2021-04-09T08:45:00Z

We describe quality improvement changes that skilled nursing facilities reported making in response to CMS performance measurements and whether reported QI changes were associated with better performance on CMS performance measures.

The Role of Regional and State Initiatives in Nursing Home Advance Care Planning Policies

2021-04-07T08:00:00Z

We examined whether state and regional advance care planning initiatives play a role in the presence of "do not administer antibiotics" orders for nursing home residents at the end of life.

Priority-Setting to Address the Geriatric Pharmacoparadox for Pain Management

2021-02-25T08:30:00Z

Our objective was to explore the extent of consensus among expert stakeholders regarding what analgesic issues should be prioritized for comparative-effectiveness studies of beneficial and adverse effects of analgesic regimens in nursing home residents.

Private U.S. Health Plans Pay Hospitals 247 Percent of What Medicare Would Pay

2021-02-24T08:30:00Z

RAND researchers used data from 49 states and Washington, D.C., to assess hospital prices paid by private health plans. Data sources included $33.8 billion in spending from 3,112 community hospitals—more than half of community hospitals nationwide.

Policy Options for Reducing Hospital Prices Paid by Private Health Plans

2021-02-18T15:30:00Z

Hospital spending--the largest health spending category in the United States--accounts for one-third of national health expenditures. In 2018, U.S. hospital spending totaled $1.2 trillion. A new RAND report analyzes the effects on spending of three policy options.

Setting U.S. Hospital Prices Could Cut Overall Health Spending by Billions

2021-02-18T03:01:00Z

Price regulations face political obstacles and have been strongly opposed by medical providers. But setting prices for all commercial health care payers could reduce hospital spending by $61.9 billion to $236.6 billion a year if the rates were set at 100 to 150 percent of the amounts paid by Medicare.

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

2021-02-12T10:00:00Z

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.

Trends in Antibiotics Use Among Long-Term US Nursing-Home Residents

2021-02-10T09:30:00Z

The increased proportion of assessments recording antibiotics but no infection may not be clinically appropriate.

What Drives Greater Assimilation of Telestroke in Emergency Departments?

2021-02-10T09:30:00Z

Although many emergency departments (EDs) have telestroke capacity, it is unclear why some EDs consistently use telestroke and others do not. We compared the characteristics and practices of EDs with robust and low assimilation of telestroke.

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

2021-02-04T08:15:00Z

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.

Medicare Shared Savings Program and Readmission Rate Among Patients with Ischemic Stroke

2021-01-29T09:15:00Z

Our aim was to determine if the Medicare Shared Savings Program is associated with changes in readmissions and mortality for patients hospitalized with ischemic stroke, and whether it has a different impact on safety net hospitals and non-SNHs.

Impact of Hospital Readmissions Reduction Program Penalties on Hip and Knee Replacement Readmissions

2021-01-28T14:00:00Z

We examined whether hospitals at risk of relatively large penalties from this expansion experienced greater declines in joint replacement readmissions compared with hospitals at risk of smaller penalties.

Impact of Risk Adjustment for Socioeconomic Status on Risk-adjusted Surgical Readmission Rates

2021-01-28T13:45:00Z

This article assesses whether differences in readmission rates between safety-net hospitals (SNH) and non-SNHs are due to differences in hospital quality, and compares the results of hospital profiling with and without adjusting for socioeconomic status.

Ranking Trauma Center Quality

2021-01-28T10:30:00Z

This article explores whether trauma center quality metrics based on historical data can reliably predict future trauma center performance.

Improving The Accuracy Of Hospital Quality Ratings By Focusing On The Association Between Volume And Outcome

2021-01-28T09:45:00Z

The goal of this exploratory analysis was to examine the changes in hospital star rankings for aortic valve replacement when shrinkage targets based on hospital case volume are used instead of the standard CMS approach.

Penalties and Rewards for Safety Net Vs Non-Safety Net Hospitals in the First 2 Years of the Comprehensive Care for Joint Replacement Model

2021-01-22T09:00:00Z

We assessed whether safety net hospitals, which serve vulnerable patients, were more likely to be penalized and less likely to receive rewards compared with non-safety net hospitals that serve few vulnerable patients.

Measuring Childbirth Outcomes Using Administrative and Birth Certificate Data

2021-01-22T08:45:00Z

The aim of this study was to develop a risk-adjusted composite measure of severe maternal morbidity and severe newborn morbidity based on administrative and birth certificate data.