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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.

Research Brief

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

Aug 1, 2018

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.
Report

Oregon's Options for Financing Health Care

Jan 19, 2017

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.

Explore Health Care Financing

Report

Integrating Department of Defense and Department of Veterans Affairs Purchased Care: Preliminary Feasibility Assessment

An integrated approach to purchasing health care for U.S. Department of Defense and U.S. Department of Veterans Affairs could have important implications for access, quality, and costs but could face legislative, policy, or contractual challenges.

Nov 26, 2018
Research Brief

Research Brief

Preliminary Feasibility Assessment of DoD-VA Purchased Care Integration

An integrated approach to purchasing health care for U.S. Department of Defense and U.S. Department of Veterans Affairs could have important implications for access, quality, and costs but could face legislative, policy, or contractual challenges.

Nov 26, 2018
Commentary

Medicare for All: Sounds Good, but What Does It Mean?

Traditional Medicare is popular and therefore can lend a good brand name to coverage expansion proposals, but its limits can be significant for some patients. Those proposing and evaluating “Medicare for All” proposals should consider whether and how these limits are addressed.

Nov 19, 2018
Report

Practice Expenses Associated with Comprehensive Primary Care Capabilities

To help the Centers for Medicare & Medicaid Services (CMS) reimburse primary care practices for investing in "comprehensive primary care" capabilities, the authors developed and piloted a method for estimating related practice expenses.

Nov 15, 2018
Commentary

Misconceptions About 'Medicare for All'

Medicare for All is a talking point for both major U.S. political parties. Would it be free? Would people have to switch doctors? Would waits be long? Misconceptions abound about single-payer proposals and their likely effects. Here are the facts.

Oct 27, 2018
News Release

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
Research Brief

The Effects of Alternative Payment Models on Physician Practices: Follow-Up Study

Physician practice engagement with alternative payment models (APMs) would be enhanced by simpler APMs, a slower pace of change, greater support for new capabilities and timely data, and reexamination of practice response to APMs with financial risk.

Oct 24, 2018
Report

Physicians Struggle to Keep Up with Changing Payment Models

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.

Oct 24, 2018
Q&A

Committed to Improving Health Care Policy: Q&A with Jodi Liu

Jodi Liu, an associate policy researcher at RAND, studies how to deliver high-quality care and how to pay for it. She discusses her assessment of a single-payer health care proposal in New York State and the supply-and-demand challenges that might arise if an Alzheimer's treatment became available.

Oct 23, 2018
Report

Evaluation of the Global Payment Program: Midpoint Report

The Global Payment Program seeks to improve health care for California's uninsured by providing funds for both traditional and non-traditional services, settings, and providers. This is the report of the midpoint evaluation of the program.

Sep 7, 2018
Report

Report

RAND Medicare Advantage (MA) and Part D Contract Star Ratings Technical Expert Panel May 31st 2018 Meeting

On May 31, 2018, the RAND Corporation convened a Technical Expert Panel (TEP) to gather input on analyses that could be conducted to further enhance the Medicare Advantage (MA) and Part D Contract Star Ratings program.

Aug 23, 2018
Commentary

Understanding the Impact of the Elimination of the Individual Mandate Penalty

Starting in 2019, the Affordable Care Act's individual mandate penalty will be eliminated, effectively ending the law's requirement that most people have health insurance. While declines in coverage and increases in premiums are likely, the magnitudes of these effects are highly uncertain.

Aug 10, 2018
Commentary

Potential Benefits for Most New Yorkers but No Free Lunch: Tough Decisions for Single-Payer Health Care in New York

A single-payer plan in New York would shift health care spending to the state instead of private insurers. As with any far-reaching legislation, there are trade-offs. It's important that policymakers consider the impact of the single-payer plan in totality.

Aug 6, 2018
News Release

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
Journal Article

Journal Article

Evaluation of the Social Impact Bond Trailblazers in Health and Social Care: Final Report

The Department of Health commissioned an independent evaluation of Social Impact Bond Trailblazers from PIRU, in partnership with RAND Europe, to explore their potential benefits and costs.

Jul 20, 2018
Journal Article

The Effect of Eliminating the ACA's Individual Mandate

Removing the financial penalties associated with the Affordable Care Act's individual mandate may cause enrollment to fall by 2.8 million to 13 million people. It could also result in a 3 to 13 percent increase in bronze plan premiums.

Jul 12, 2018
Commentary

Tax Funding of Health and Social Care Internationally: Does Hypothecation Help?

The case for raising much more money to pay for health care and social care in the United Kingdom over the next few years is strong. Earmarking taxes for public funding of health care or social care is worth consideration.

Jul 10, 2018
Journal Article

Journal Article

Identifying Options for Funding the NHS and Social Care in the UK: International Evidence

As part of a larger project identifying feasible options for the future funding of health & social care in the UK, this paper explores how 16 high-income countries have implemented changes to their funding systems to better meet the challenges ahead.

Jul 10, 2018

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