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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

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.
Report

Physicians Struggle to Keep Up with Changing Payment Models

Oct 24, 2018

Alternative payment models cause administrative burdens that take doctors away from patient care. Slowing the rate of change and simplifying payment models could help them focus on patients. And getting physicians' input on the design of new payment methods might improve their engagement.

Explore Health Care Financing

Journal Article

Accounting for the Burden and Redistribution of Health Care Costs: Who Uses Care and Who Pays for It

The dollar value of health care received declines as income rises as does health care received as a percent of income.

Jun 25, 2020
News Release

Limiting Out-of-Network Payments to Hospitals Could Produce Cost Savings Similar to Single-Payer Options

Placing limits on what hospitals can collect for out-of-network care could yield savings similar to more-sweeping proposals such as Medicare for All or setting global health spending caps. Because such an approach has the possibility to sharply cut hospital revenues, any cap would need to be set carefully as to not overly disrupt hospital operations.

Mar 12, 2020
Report

The Effects of Limiting Payments to Hospitals for Out-of-Network Care

There is growing interest among U.S. policymakers to use out-of-network payment limits to curb surprise medical bills and as a tool to control rising health care costs. How might such limits affect negotiated in-network prices and total payments for hospital care?

Mar 12, 2020
News Release

Burden of Health Care Payments Is Greatest Among Americans with the Lowest Incomes

Higher-income American households pay the most to finance the nation's health care system, but the burden of payments as a share of income is greatest among households with the lowest incomes.

Jan 27, 2020
Multimedia

The Burden of Health Care Costs

Katherine Carman, senior economist with the RAND Corporation, discusses the burden that health care costs impose on families, the different types of payments that people make towards health care, and the portion of taxes that supports health care.

Jan 27, 2020
Periodical

RAND Review: May-June 2019

This issue describes RAND research efforts to help schoolkids suffering from trauma; to help health care providers get better, more meaningful feedback; and to use technology to improve the lives of displaced people throughout the world.

Apr 29, 2019
News Release

Paying Patients to Use Lower-Price Health Providers Can Result in Savings

Paying people to use lower-price medical providers can help reduce health care spending. Examining a program that pays patients $25 to $500 for using a lower-price medical provider for each of 135 elective procedures, researchers found the effort led to a 2.1 percent reduction in the average price paid of all eligible services.

Mar 4, 2019
Multimedia

The Potential Impacts of Single-Payer Health Care

Controlling costs while improving health care access dominates policy debates in Congress. In this Congressional Briefing, Jodi Liu discusses what policymakers need to know about "Medicare-for-All" and other single-payer proposals, and their likely effects on cost and access.

Jan 23, 2019
News Release

Complex and Rapidly Changing Payment Models Challenge Physician Practices

Physician payment models are becoming more complex and the pace of change is increasing, creating challenges for physician practices that might hamper their ability to improve the quality and efficiency of care despite their willingness to change.

Oct 24, 2018
News Release

Single-Payer Health Plan in New York State Could Cover All Without Increasing Total Health Spending If Cost Growth Slows

A single-payer health care plan could expand coverage for all New York State residents, but would require significant new tax revenue. A plan outlined by the New York Health Act is likely to increase use of health services as more people receive coverage. But overall health care costs would decrease slightly over time if administrative costs are reduced and state officials slow the growth of payments to health care providers.

Aug 1, 2018
Report

How Would a Single-Payer Option Work for New York State?

A single-payer health care plan could expand coverage to all New York residents, but it would require significant new tax revenue. Overall health care costs would decrease slightly over time if administrative costs are reduced and state officials slow the growth of payments to providers.

Aug 1, 2018
Research Brief

New York's Proposed Single-Payer Plan Could Expand Coverage Without More Spending

The New York Health Act could provide insurance to all New York State residents without increasing overall spending if administrative costs are reduced and growth in provider payment rates is restrained. New taxes, instead of premiums and out-of-pocket payments, would finance the program.

Aug 1, 2018
Report

Financing Health Care in Oregon: Four Policy Options

This presentation describes four options for financing health care for residents of the state of Oregon and compares the projected impacts and feasibility of each option.

May 17, 2017
Research Brief

MACRA's Effects on Medicare Payment Policy and Spending

Estimates how sensitive physician behavior is to the design of alternative payment models under the Medicare Access and CHIP Reauthorization Act (MACRA).

May 3, 2017
Journal Article

The Medicare Access and CHIP Reauthorization Act: Effects on Medicare

The Medicare Access and Chip Reauthorization Act (MACRA) will decrease Medicare spending on physician services by an estimated -$35 to -$106 billion and change spending on hospital services by +$32 to -$250 billion between 2015 and 2030.

Apr 5, 2017
Multimedia

Repeal, Replace, Repair, or Improve? The Future of the ACA

In this March 2017 congressional briefing, RAND senior economist, Christine Eibner, discusses how individuals and employers will respond to major health care policy changes as the new administration reassesses the Affordable Care Act.

Mar 17, 2017
News Release

Oregon Has Options to Move Toward Universal Health Coverage; Repeal of the Affordable Care Act Would Make All Options ...

Oregon has options for reforming health care financing to expand coverage and meet broader goals, though they differ in their feasibility, tradeoffs and financing requirements.

Jan 19, 2017
Report

Oregon's Options for Financing Health Care

Federal health care reform had just begun in 2013 when Oregon authorized a study to improve how the state pays for health care. A comparison of the projected impacts and feasibility of four options can help Oregon's stakeholders choose the option that best suits their needs.

Jan 19, 2017
Research Brief

Oregon's Options to Overhaul Health Care Financing: Health Care Reform 2.0?

This analysis of three options to reform health care payment in Oregon (two state-based plans that would ensure coverage for all state residents and a state-sponsored plan offered in Oregon's nongroup market) found benefits and trade-offs for each.

Jan 19, 2017
Report

Evaluating the Impact of Policies to Regulate Involuntary Out-of-Network Charges on New Jersey Hospitals

To inform the debate in the New Jersey state legislature, this report analyzes the role of payments for involuntary out-of-network care for New Jersey hospitals' financial performance and simulates the effect of policies to limit such payments.

Nov 22, 2016

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