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.
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?
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.
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
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.
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.
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.
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.
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.
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.
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).
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.
The Centers for Medicare & Medicaid Services recently launched its Quality Payment Program (QPP), which changes how physicians are paid under Medicare. Researchers interviewed rural physicians to determine if their practices could successfully participate and how the program could be modified to support small rural practices.
Controlling costs while improving health care access dominates policy debates in Congress. In this Congressional Briefing, Jodi Liu discusses what policymakers need to know about "Medicare-for-All" and other single-payer proposals, and their likely effects on cost and access.