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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

Journal Article

Factors Influencing Physician Practices' Adoption of Behavioral Health Integration in the United States: A Qualitative Study

Practices currently using behavioral health integration face barriers to implementing and sustaining behavioral health integration. Tailored, context-specific technical support to guide practices' implementation and payment models that improve the business case for practices may enhance the dissemination and long-term sustainability of behavioral health integration.

Aug 5, 2020
Journal Article

Journal Article

CMS Reimbursement Reform and the Incidence of Hospital-Acquired Pulmonary Embolism or Deep Vein Thrombosis

CMS's refusal to pay for hospital-acquired conditions resulted in a lower incidence of hospital-acquired pulmonary embolism or deep vein thrombosis after hip or knee replacement surgery.

Aug 5, 2020
Journal Article

Journal Article

Quality Of End-Of-Life Care Is Higher In The VA Compared To Care Paid For By Traditional Medicare

The Medicare-reliant veterans were significantly more likely to receive high-intensity care, in the form of chemotherapy, hospital stays, admission to the intensive care unit, more days spent in the hospital, and death in the hospital. However, they were significantly less likely than VA-reliant patients to have multiple emergency department visits. Higher-intensity end-of-life care may be driven by financial incentives present in fee-for-service Medicare but not in the VA's integrated system.

Aug 5, 2020
Report

Practice Expense Methodology and Data Collection Research and Analysis: Interim Phase II Report

In this report, the authors address how the Centers for Medicare and Medicaid Services can improve the methodology or update data used for setting practice expense payment rates under the Medicare Physician Fee Schedule.

Aug 4, 2020
Report

Advancing the Development of a Framework to Capture Non–Fee-for-Service Health Care Spending for Primary Care

This report describes work conducted to understand what non-fee-for-service payment data are being collected by states and other stakeholders to support more complete measurement of primary care spending as a proportion of total health care spending.

Jul 30, 2020
Dissertation

Dissertation

Three Essays In Health Policy and Economics: Surprise Out-of-Network Medical Bills and Out-of-Network Health Care Provider Payment in the United States

Three essays addressing surprise out-of-network medical bills and out-of-network health care provider payment.

Jul 16, 2020
Commentary

Why States' 'Netflix Model' Prescription Drug Arrangements Are No Silver Bullet

Despite the buzz and catchy notion that subscription models are "Netflix for drugs," it's hard to come up with a theoretical case that supports subscription models over traditional price negotiation between payers and manufacturers over a per-dose or per-unit price.

Jul 1, 2020
Journal Article

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
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 12, 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

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