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.

  • Supporters of a "Medicare for All" plan gather on Capitol Hill in Washington, D.C., September 13, 2017, photo by Yuri Gripas/Reuters

    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.

  • A doctor approaching a maze

    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

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    Q&A

    Quick Takes: The Math of Medicaid Expansion

    Expanding Medicaid under the Affordable Care Act (ACA) is both contentious and complicated. RAND mathematician Carter Price has been using the COMPARE model to help those making decisions understand what their choices mean for their budgets and population health.

    Oct 21, 2013

  • spilled prescription tablets arranged in dollar sign

    News Release

    RAND Launches Initiative to Study Drug Discount Program

    The RAND Corporation is launching a new research initiative to provide objective and nonpartisan analysis about the impact and future of the 340B program, a major federal program that gives safety net hospitals and other health care providers access to discounted outpatient medications.

    Oct 21, 2013

  • News Release

    Factors Linked to Creation of Accountable Care Organizations Identified

    Regions of the United States where doctors and hospitals are consolidated into large networks are more likely to have accountable care organizations, medical practice structures intended to improve medical care and cut costs.

    Oct 7, 2013

  • group meeting of medical professionals

    Journal Article

    Factors Linked to Creation of Accountable Care Organizations Identified

    Regions of the United States where doctors and hospitals are consolidated into large networks are more likely to have accountable care organizations, medical practice structures intended to improve medical care and cut costs.

    Oct 1, 2013

  • pediatrician with patient and mother

    Journal Article

    Review of Experiences in Three Countries Informs England's Patient Choice Scheme

    The experiences of Finland, Norway, and Sweden in offering patient choice schemes highlight England's need to carefully monitor the impact of enhanced choice in primary care to ensure that related policies truly enhance access to and improve the quality of care, and not inadvertently benefit those who are more able to exercise choice.

    Sep 1, 2013

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    Journal Article

    Does the Racial/Ethnic Composition of Medicare Advantage Plans Reflect Their Areas of Operation?

    Investigating if the racial/ethnic composition of Medicare Advantage plans reflect the composition of their areas of operation revealed little evidence that health plans are selectively underenrolling blacks, Latinos, or Asians to a substantial degree.

    Aug 28, 2013

  • illustration of weighing medical costs

    Commentary

    Health Care Spending: What's in Store?

    Resolving the question of whether or not the U.S. has finally gotten a handle on health care spending is vitally important, because the choices we make going forward will have profound implications for our economy, the financial wellbeing of millions of American families, and ultimately America's standing in the world.

    Jul 16, 2013

  • payment slip

    Testimony

    Designing a Performance-Based Incentive Program for Physicians

    Value-based payment programs may encourage providers to innovate and redesign care delivery, potentially driving improvements in quality and efficiency.

    Jul 12, 2013

  • doctor checking the throat of a young boy

    Research Brief

    The Math of State Medicaid Expansion

    RAND researchers have analyzed how opting out of Medicaid expansion would affect insurance coverage and spending and whether alternative policy options—such as partial Medicaid expansion—could cover as many people at lower costs to states.

    Jun 7, 2013

  • doctor speaking with senior patient

    Testimony

    Improving Care for Medicare Beneficiaries with Physician Payment Reform

    Physician payment policy is shifting from one that incentivizes the delivery of more services without regard to quality or outcomes to one that incentivizes the delivery of high quality, resource conscious health care. Thoughtful incentive design can ease the transition process for both physicians and the Medicare program.

    Jun 5, 2013

  • News Release

    Expanding Medicaid Is Best Financial Option for States

    States that choose not to expand Medicaid under federal health care reform will leave millions of their residents without health insurance and increase spending on the cost of treating uninsured residents, at least in the short term.

    Jun 3, 2013

  • Nuns On The Bus rally and Texas Capitol visit about Medicaid

    Journal Article

    Expanding Medicaid Is Best Financial Option for States

    States that choose not to expand Medicaid under federal health care reform will leave millions of their residents without health insurance and increase spending on the cost of treating uninsured residents, at least in the short term.

    Jun 1, 2013

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    Journal Article

    Reliability of Utilization Measures for Primary Care Physician Profiling

    While there has been interest in using utilization measures to profile physicians, examinations of these measures are rare. This study found only a small number of commonly used utilization measures reliably capture real differences in utilization among physicians.

    Jun 1, 2013

  • News Release

    Health Reform Shields Young Adults from Emergency Medical Costs

    A new federal law allowing young adults to remain on their parents' medical insurance through age 25 has shielded them, their families, and hospitals from the full financial consequences of serious medical emergencies.

    May 29, 2013

  • doctor consoling elderly man

    Commentary

    A Health Care Entitlement Worth Ending

    The health care “entitlement” we need to reform is the notion that America's health care system is entitled to an ever-growing share of America's wealth, writes Arthur Kellermann.

    Feb 27, 2013

  • pediatrician with patient and mother

    Testimony

    Efforts to Reform Physician Payment by Tying Payment to Performance

    Public and private sector purchasers are actively working to design value-based payment programs to achieve the goals of improved quality and more efficient use of health care resources. How these programs are designed is a complex undertaking and one that will determine the likelihood of their success.

    Feb 14, 2013

  • Elderly Woman with Caregiver

    Journal Article

    Care Experiences of Managed Care Medicare Enrollees Near the End of Life

    Research based primarily on reports from an individual's surviving relatives often suggests that end-of-life care experiences are particularly poor. However, this examination of reports from patients found that those who died within a year of being surveyed reported slightly better experiences than other enrollees.

    Feb 4, 2013

  • U.S. currency, pills, syringes, stethoscope

    Commentary

    25 Small Ideas for Saving Big Health Care Dollars

    Given the size of the annual “health care spend”—$2.7 trillion—summing up the savings associated with very minor cost-saving policy changes is likely to achieve significant aggregate savings, writes Jeffrey Wasserman.

    Jan 30, 2013

  • couple discussing their finances

    Commentary

    Health Care Cost Growth Is Hurting Middle-Class Families

    Unfortunately, nearly every actor in our health care delivery system—hospitals, physicians, other health care providers, insurance companies, and the manufacturers of drugs and devices—is currently focused on maximizing revenue growth, write Arthur Kellermann and David Auerbach.

    Jan 8, 2013

  • Journal Article

    Should Payment Policy Be Changed to Allow a Wider Range of EMS Transport Options?

    In light of growing concerns about the high cost of emergency care and heavy use of EDs, assessing EMS transport options should be a high-priority topic for outcomes research.

    Jan 1, 2013

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