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Health Care Payment Approaches

Report

Physicians Need Support and Guidance to Further Advance Delivery Reforms

Physicians are engaging in new health care payment models intended to improve quality and reduce costs. They are finding that they need help with managing increasing amounts of data and figuring out how to respond to the diversity of programs and quality metrics from different payers.

Mar 19, 2015
Report

Specialty Payment Model Opportunities and Assessment: Oncology Simulation Report

This report shares results of a simulation analysis of a payment model for specialty oncology services that is being developed for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare and Medicaid Services.

Mar 17, 2015
Report

Specialty Payment Model Opportunities and Assessment: Gastroenterology and Cardiology Model Design Report

Describes research related to the design of episode-based payment models for ambulatory gastroenterology and cardiology services for possible testing by the Centers for Medicare and Medicaid Services' Center for Medicare and Medicaid Innovation.

Mar 17, 2015
Report

Specialty Payment Model Opportunities and Assessment: Oncology Model Design Report

This report shares research and analyses of claims data related to the design of a payment model for specialty oncology services for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare & Medicaid Services.

Mar 17, 2015
Journal Article

Comparison Between Clinical Registry and Medicare Claims Data on the Classification of Hospital Quality of Surgical Care

This paper aimed to estimate the effect of tobacco taxes on total mortality and cause-specific mortality in the 50 States plus the District of Columbia, USA, over the period 1970–2005 as well as the net effect on deaths averted in 2010.

Jan 28, 2015
Report

Home Health Care for California's Injured Workers: Options for Implementing a Fee Schedule

The California Department of Industrial Relations/Division of Worker's Compensation asked RAND to help develop a fee schedule for home health services provided to injured workers. The researchers made three sets of recommendations.

Jan 27, 2015
Journal Article

More Daring Ideas to Form Health Policy: Why Not?

When it comes to health policy, there are two basic approaches: (1) cautious and careful, or (2) disruptive and daring. The former is less threatening, but what might happen if decision makers were more driven by creativity and less concerned about regulations?

Jan 23, 2015
Journal Article

Challenges in Assessing the Process-Outcome Link in Practice

Expanded use of clinical process-of-care measures to assess the quality of health care in the context of public reporting and pay-for-performance applications led to a desire to demonstrate its value in terms of improved patient outcomes.

Jan 19, 2015
Report

Predictive Model Could Apply to Medicare Physician Fee Schedule

The Centers for Medicare and Medicaid Services uses a resource-based relative value (RBRV) scale to calculate payments for physicians. The values of the scale were validated with predictive modeling, and the result may be helpful in two key applications: flagging codes as potentially misvalued and determining why a code is valued differently than predicted.

Jan 16, 2015
Research Brief

RAND Modeling Offers Support for Transparent and Consistent CMS Physician Fee Schedules

The current process used by the Centers for Medicare & Medicaid Services for valuing physician work is based on physician survey responses. RAND researchers examined the feasibility of developing a model based instead on external data sources.

Jan 16, 2015
News Release

New Approach to Quality-Based Incentives Avoids Undesired Effects on Health Care Providers Who Care for Disadvantaged ...

Changing health care pay-for-performance programs to account for differences among providers in their patient characteristics can make the incentive schemes more equitable and avoid a redistribution of resources away from providers who care for socioeconomically disadvantaged patients.

Jan 14, 2015
Journal Article

New Approach to Quality-Based Incentives Avoids Undesired Effects on Health Care Providers Who Care for Disadvantaged Patients

Changing health care pay-for-performance programs to account for differences among providers in their patient characteristics can make the incentive schemes more equitable and avoid a redistribution of resources away from providers who care for socioeconomically disadvantaged patients.

Jan 9, 2015
Journal Article

Consumers Who Buy Subsidized Health Plans May Face Higher Costs in Competitive Markets

For people who buy subsidized coverage through marketplaces created under the ACA, those who live in areas with more plan offerings may have to pay a higher premium to receive the same deductible when compared to consumers in regions with fewer options.

Jan 9, 2015
Commentary

The Great Patient Experience Survey Myth

Patient experience with care is an essential element in any assessment of health care quality. Surveys give patients a voice and provide fair and relevant indicators that complement other metrics of health care quality to inform patients' choices and providers' decisions about how to improve care.

Dec 10, 2014
Report

Quantitative Evaluation of the Impact of the Healthy Communities Initiative in Cincinnati

In 2009, a Cincinnati group launched the Healthy Communities Initiative with the goals of improving health care and population health while reducing health care costs. In 2012, RAND Health Advisory Services assessed the Initiative's progress.

Oct 10, 2014
Commentary

The Winding Path to Effective Bundled Payment

It's not unusual for a demonstration to fall short of its original objectives. Learning from such cases is part of the innovation process. This is especially worthwhile for bundled payment, which has many potential benefits for patients, providers, and payers.

Aug 29, 2014
News Release

Effort to Adopt Bundled Payments Across California Falls Short of Goals

A pilot program intended to implement and test a cost-saving strategy for orthopedic procedures at hospitals in California failed to meet its goals, succumbing to recruitment challenges, regulatory uncertainty, administrative burden and concerns about financial risk.

Aug 4, 2014
Journal Article

Bundled Payments Fall Short in California

Despite widespread interest in bundled payments as a strategy to control health care costs, implementation efforts continue to disappoint. A pilot program in California failed to meet its goals, succumbing to recruitment challenges, regulatory uncertainty, administrative burden, and concerns about financial risk.

Aug 4, 2014
Report

Final Report: Evaluation of Tools and Metrics to Support Employer Selection of Health Plans

This report attempts to help employers understand the structural differences between health plans and the performance dimensions along which plans can differ, as well as to educate employers about available tools to evaluate plan options.

Apr 3, 2014
News Release

Promise of Value-Based Purchasing in Health Care Remains to Be Demonstrated

After a decade of experimentation with reforms that give health providers financial incentives to improve performance, relatively little is known about how to best execute such strategies or judge their success.

Mar 4, 2014

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