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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

Blog

COVID-19, Out-of-Network Hospital Payments, Russia's Economy: RAND Weekly Recap

This weekly recap focuses on COVID-19, limiting out-of-network hospital payments, Russia's sluggish economy, RAND's largest-ever fundraising campaign, and more.

Mar 13, 2020
News Release

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 11, 2020
Report

Report

RAND Medicare Advantage (MA) and Part D Contract Star Ratings Technical Expert Panel November 7th, 2019 Meeting

On November 7, 2019, the RAND Corporation convened a Technical Expert Panel (TEP) web meeting to gather input on analyses that could be conducted to further enhance the Medicare Advantage (MA) and Part D Contract Star Ratings program.

Feb 7, 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
Journal Article

Journal Article

Payment for Services Rendered: Updating Medicare's Valuation of Procedures

Medicare appears to be overpaying surgeons for post-operative care associated many medical procedures. Federal officials should incorporate ways to more objectively measure the amount of postoperative care surgeons provide to patients

Jan 24, 2020
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.

Dec 19, 2019
Journal Article

Journal Article

The Challenge of Determining Appropriate Care in the Era of Patient-Centered Care and Rising Health Care Costs

The goal of health care is to ensure that patients receive the right care for the right patient for the right problem at the right time from the right provider. Inappropriate care is costly. The challenge is to define and increase delivery of appropriate care.

Dec 12, 2019
Research Brief

Research Brief

Options for funding the NHS and social care in the UK: How the UK general public would prefer extra funds to be raised

What is the publicly preferred way to raise additional funds needed to meet growing demand for health and social care. Options are taxation, insurance, or user charges. We analyse the preferences of the UK general public using a choice experiment.

Oct 7, 2019
Report

Options for Reinvesting Savings from Restored Federal Cost-Sharing Reduction Payments: Examining the Effects of Two Policy Alternatives on Spending and Enrollment in the Individual Health Insurance Market

The authors of this report examine the impact of providing additional health insurance subsidies or financing reinsurance from the savings resulting from restored federal cost-sharing reduction payments to insurers under the Affordable Care Act.

Sep 10, 2019
Report

Report

RAND Medicare Advantage (MA) and Part D Contract Star Ratings Technical Expert Panel April 30, 2019 Meeting

On April 30, 2019, the RAND Corporation convened a Technical Expert Panel (TEP) web meeting to gather input on analyses that could be conducted to further enhance the Medicare Advantage (MA) and Part D Contract Star Ratings program.

Sep 6, 2019
Report

Report

Evaluation of California's Global Payment Program: Final Report

The Global Payment Program seeks to improve health care for California's uninsured by using federal funds to make prospective payments for inpatient, outpatient, and nontraditional services. This report presents the final evaluation of the program.

Aug 22, 2019
Journal Article

Journal Article

Medical Practice Consolidation and Physician Shared Patient Network Size, Strength, and Stability

Practice consolidation can increase the stability of physician networks, which may have positive implications for organizational effectiveness.

Aug 20, 2019
Report

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

For many surgeries and procedures, Medicare and most other insurers cover a bundle of services, including post-operative visits, during the global period. This survey was designed to capture the level of post-operative visits during this period.

Jul 31, 2019
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.

Jul 31, 2019
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.

Jul 31, 2019
Journal Article

How Are Medical Groups Identified as High Performing? The Effect of Different Approaches to Classification of Performance

To accurately identify "high-performing providers", a standard definition of high-performance and an agreed-upon approach to measurement are necessary.

Jul 24, 2019
Report

Effects of Alternative Insurer Responses to Discontinued Federal Cost-Sharing Reduction Payments: Broad Loading as an Alternative to Silver Loading

In this report, the authors assess the effects of disallowing the current practice of increasing only the premiums of silver-tiered individual market plans in response to discontinued federal payments of cost-sharing reductions (silver loading).

Jun 3, 2019
Periodical

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

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