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Health Care Financing

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Health care systems may be financed in various ways, including through government funding, taxation, out-of-pocket payments, private insurance, and donations or voluntary aid. RAND research explores the effects of corporate and government health care financing policies on such groups as patients, businesses, hospitals, and physician-providers.

Report
Carve-In Models for Specialty Behavioral Health Services: Lessons for California
Many states separate, or "carve out," Medicaid financing of behavioral health services from that for other types of health care, but there has been a recent trend in some states toward "carve-ins": combining financing for behavioral health services with the larger pool of Medicaid-covered services. What lessons do other states' experiences offer for California?
Feb 11, 2022
Report
Understanding Prescription Drug Supply Chains
The typical stakeholders, relationships, and financial incentives involved in prescription drug supply chains vary depending on the characteristics of a drug and how it reaches patients. Differences in business practices complicate a universal description of drug supply chains.
Oct 27, 2021

Explore Health Care Financing

Journal Article
Higher Medicare Spending On Imaging And Lab Services After Primary Care Physician Group Vertical Integration
This study highlights how the growing trend of vertical integration, combined with differences in Medicare payment between hospitals and nonhospital providers, leads to higher Medicare spending.
Sep 20, 2022
Journal Article
Predicting Race And Ethnicity To Ensure Equitable Algorithms For Health Care Decision Making
We describe two applications in which imputation of race and ethnicity can help mitigate potential algorithmic biases: equitable disease screening algorithms using machine learning and equitable pay-for-performance incentives.
Aug 23, 2022
Commentary
Doubling NIH Funding for Women's Health Would Yield Substantial Return on Investment
The scientific evidence base generally is biased toward the male body as a result of a long history of generous funding for diseases that predominantly affect men and underfunding for those that predominantly affect women. But the cost of the science pales in comparison to the price we continue to pay for what we don't know about caring for women.
Jul 8, 2022
Journal Article
The Financial Ecosystem of Pharmaceutical R&D: An Evidence Base to Inform Further Dialogue
This study's overarching conclusion is that a drug's expected financial return ultimately determines whether it is developed up to launch.
Jun 24, 2022
Report
RAND Technical Expert Panel Medicare Advantage (MA) and Part D Contract Star Ratings, February 7, 2022 Meeting
On February 7, 2022, the RAND Corporation convened a Technical Expert Panel web meeting to gather input about the potential development of a measure to capture value-based care arrangements Medicare Advantage organizations have with their contracted providers.
Jun 17, 2022
Journal Article
Content and Actionability of Recommendations to Providers After Shadow Coaching
This study aimed to examine the content of the recommendations given to providers aimed at improving provider-patient interactions, characterize these recommendations, and examine their actionability.
Mar 4, 2022
Journal Article
Physician Compensation Arrangements and Financial Performance Incentives in US Health Systems
This study was a cross-sectional mixed-methods analysis of in-depth multimodal data from 31 POs affiliated with 22 purposefully selected health systems in 4 states. Data were analyzed from June 2019 to September 2020.
Feb 8, 2022
Journal Article
Value of Family Involvement in Substance Use Disorder Treatment: Aligning Clinical and Financing Priorities
Family support has important impacts on recovery from substance use disorders (SUDs). This paper illustrates how financing gaps limit SUD service systems from offering family services. We offer two sets of recommendations for funding family involvement in SUD services.
Jan 7, 2022
Journal Article
Coordination of Sustainable Financing for Evidence-Based Youth Mental Health Treatments: Protocol for Development and Evaluation of the Fiscal Mapping Process
This protocol describes a mixed-methods research project designed to (1) develop and (2) evaluate a novel Fiscal Mapping Process that guides strategic planning efforts to finance the sustainment of evidence-based treatments in youth mental health services.
Jan 7, 2022
Commentary
Rethinking the Impact of Audio-Only Visits on Health Equity
New pandemic-era flexibility that allowed audio-only health visits to be routinely reimbursed as telehealth may be leading to substandard care for those it was meant to serve. It may be time to consider limiting audio-only visits in the pursuit of health equity.
Dec 17, 2021
Commentary
Twelve-Month Continuous Eligibility for Medicaid Adults Can Stabilize Coverage with a Modest Cost Increase
Churning—frequent moving in and out of Medicaid due to income fluctuation—increases insurance coverage gaps, disrupts access to health care, increases unnecessary administrative burden, and leads to suboptimal health outcomes. Federal and state policymakers might consider continuous eligibility to help stabilize Medicaid enrollment.
Dec 8, 2021
Commentary
What Are the Practical Considerations for Outcome-Based Payment in the NHS?
Uncertainty can surround the effectiveness or cost-effectiveness of a new medicine, making it difficult to agree on a medicine's price. One solution to avoid unduly delaying or restricting patients' access is to link the medicine's price to the outcomes it produces in a patient. Despite some barriers, outcome-based payment could offer a “win” for patients, the NHS, and industry.
Dec 2, 2021
Report
Evaluating New York's Medicaid Section 1115 Waiver
New York State’s Medicaid Section 1115 Waiver seeks to enroll a majority of Medicaid beneficiaries into managed care, increase access and service quality, and expand coverage to more low-income New Yorkers. RAND researchers examined whether two components of the 1115 Demonstration Waiver have helped achieve the program’s goals.
Dec 2, 2021
Journal Article
Making Outcome-Based Payment a Reality in the NHS: Phase 2: Practical Considerations
This study examines implementing an outcome-based payment model in the NHS, the quality and completeness of data on patient outcomes, implications for collecting such data, and establishing steps for the implementation of a pilot OBP scheme.
Dec 1, 2021
Journal Article
Money and My Mind: Maternal Cash Transfers and Mental Health
This paper documents important mental health spillovers in the context of a program that offered pregnant women modest cash incentives to use pre- and perinatal health care services.
Nov 10, 2021
Report
Practice Expense Data Collection and Methodology: Phase II Final Report
In this report, the authors address how the Centers for Medicare & Medicaid Services might improve the methodology used in practice expense (PE) rate-setting, update data that inform PE rates, or both.
Nov 1, 2021
Journal Article
Value-Based Payment and Health Care System Preparedness and Resilience
This report explores issues related to VBP and health system preparedness and resiliency to inform discussions about policy options for jointly promoting value, efficiency, and preparedness in the health care system.
Oct 7, 2021
Report
Claims-Based Reporting of Post-Operative Visits for Procedures with 10- or 90-Day Global Periods: Updated Results Using Calendar Year 2018 Data
The authors of this report summarize patterns of post-operative visits for surgical procedures furnished in 2018 and paid for by Medicare. This report follows an earlier report that summarized these patterns from July 1, 2017, through June 30, 2018.
Sep 14, 2021

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