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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.

Commentary

ACA Subsidies for Higher-Income Families Are Key to Enrolling More Americans

Mar 1, 2021

The House Ways and Means Committee has proposed several insurance reforms in its emergency COVID-19 relief package, including increasing subsidizes and extending subsidies to people with higher incomes. The proposed combined approach is a far more efficient means of covering uninsured Americans than enhancing subsidies only for those who are currently eligible.
Report

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

Feb 18, 2021

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.

Explore Health Care Financing

Report

RAND Technical Expert Panel Medicare Advantage (MA) and Part D Contract Star Ratings, November 12, 2020 Meeting

On November 12, 2020, the RAND Corporation convened a Technical Expert Panel (TEP) web meeting to gather input about social risk factors and approaches for ensuring accurate performance measurement.

Mar 16, 2021
Report

RAND Technical Expert Panel Medicare Advantage (MA) and Part D Contract Star Ratings, November 19, 2020 Meeting

On November 19, 2020, the RAND Corporation convened a Technical Expert Panel (TEP) web meeting to gather input about stratified reporting of performance and approaches to reduce disparities in Medicare Advantage (MA) and Part D Contracts.

Mar 16, 2021
Blog

Vaccine Hesitancy, Sexual Misconduct in the U.S. Military, the Iran Nuclear Deal: RAND Weekly Recap

This weekly recap focuses on Black Americans’ vaccine hesitancy, sexual harassment and sexual assault in the U.S. military, rejoining the Iran nuclear deal, and more.

Mar 5, 2021
News Release

Bundled Payments for Surgical Procedures With Copay Waivers Creates Substantial Cost Savings

Providing patients discounts for using medical providers that agree to charge one set price for expensive procedures such as knee replacement surgery can result in savings for both patients and payers.

Mar 1, 2021
Research Brief

10Plan, How Would It Affect Health Care Spending by Consumers and the Federal Government

The 10Plan is a self-pay plan for individuals currently uninsured or covered by a private nongroup health insurance plan. The authors built a microsimulation model to estimate health care spending under both the status quo and the 10Plan.

Feb 25, 2021
News Release

Setting Hospital Prices Can Achieve Greater Savings Than Increasing Competition or Price Transparency

Among strategies to curb hospital prices among the commercially insured population in the United States, direct price regulations such as setting rates are likely to achieve greater savings than other approaches like increasing competition or improving price transparency.

Feb 18, 2021
Journal Article

Trends in Low-Value Health Service Use and Spending in the US Medicare Fee-for-Service Program, 2014–2018

Among individuals with fee-for-service Medicare receiving any of 32 measured services, low-value care use and spending decreased marginally from 2014 to 2018.

Feb 18, 2021
News Release

Low-Value Care Among Medicare Recipients Drops Only Marginally Despite Effort to Curb Practices

Examples of low-value health care include prescribing opioids for acute back pain and antibiotics for upper respiratory infections. Despite efforts to better educate clinicians and discourage wasteful care, spending on such services among Medicare recipients dropped only marginally from 2014 to 2018.

Feb 16, 2021
Report

Increasing Price Transparency in Health Care: Key Themes and Policy Options from a Technical Expert Panel

RAND researchers examine current price transparency efforts and their features, describe barriers to more widespread availability and use of price information, and discuss possible ways to overcome those barriers.

Feb 16, 2021
Journal Article

Care Management Reduced Infant Mortality for Medicaid Managed Care Enrollees in Ohio

The Ohio Department of Medicaid introduced requirements to be delivered by Medicaid managed care organizations (MCOs). This study evaluated the impact of care management on reducing infant mortality in the largest Medicaid MCO in Ohio.

Feb 12, 2021
Journal Article

Patterns of Postoperative Visits Among Medicare Fee-for-service Beneficiaries

To describe patterns of postoperative visits reported for Medicare fee-for-service (FFS) patients.

Feb 12, 2021
Report

Claims-Based Reporting of Post-Operative Visits for Procedures with 10- or 90-Day Global Periods: Final Report

The authors of this report summarize patterns of post-operative visits where Medicare bundles payment for post-operative care into payment for surgical procedures. The results suggest fewer visits occur than Medicare assumes in its payment rates.

Feb 5, 2021
Report

Using Claims-Based Estimates of Post-Operative Visits to Revalue Procedures with 10- and 90-Day Global Periods

This report describes how CMS could use new claims-based data on post-operative visits to adjust the valuations of surgical procedures with 10- and 90-day global periods.

Feb 5, 2021
Report

Responses to Comments on RAND Global Services Reports

RAND researchers respond to comments on three earlier reports related to post-operative visits bundled into Medicare payments for many procedures.

Feb 5, 2021
Report

The 10Plan: An Alternative Approach to Health Care Financing

The 10Plan would require individuals to pay a copayment for each encounter but no premiums up front. They'd have Medicare rates, and could pay cash or borrow from the government at a low interest rate to pay for services. How would health care spending and federal costs change under the plan?

Jan 25, 2021
Journal Article

Variability in Case Durations for Common Surgical Procedures

This is an exploratory study to quantify the facility-level variation in surgical case duration for common surgeries.

Jan 20, 2021
Journal Article

Measuring Public Preferences Between Health and Social Care Funding Options

Additional funding will be needed to meet the growing demand for health and social care in the UK. What is the most acceptable way to raise it? Options range from taxation to mandatory insurance, voluntary insurance and user charges. We sought to analyse the preferences of the UK general public.

Dec 31, 2020
Journal Article

Quality of Quality Measurement: Impact of Risk Adjustment, Hospital Volume, and Hospital Performance

Monte Carlo simulation was used to examine the accuracy of performance profiling as a function of statistical methodology, case volume, and the extent to which hospital or physician performance deviates from the average.

Dec 31, 2020

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