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Health Care Payment Approaches

Journal Article

Do Medicare Payment Policies Influence Hospitals' Timing of Patient Discharge?

The Medicare short-stay outlier payment policy created a strong financial incentive for long-term care hospitals to time patient discharges to maximize Medicare reimbursement. These results suggest that the new very-short-stay policy implemented in December 2012 could have a similar effect.

Jul 7, 2015
Report

The NIHR Invention for Innovation (i4i) programme: A review of progress and contributions to innovation in healthcare technologies

The NIHR Invention for Innovation (i4i) programme supports the development of innovative medical technologies. RAND Europe evaluated the programme to identify its outputs and impacts, and to examine the factors influencing performance.

Jun 11, 2015
Report

Improving Care for Chronic Conditions: Current Practices and Future Trends in Health Plan Programs

Documents the current range of health plans' chronic care management services, identifies best practices and industry trends, and examines factors in the plans' operating environment that limit their ability to optimize chronic care programs.

Jun 3, 2015
News Release

Medical Home Intervention with Shared Savings Shows Quality and Utilization Improvements

A medical home intervention that paid bonuses to physician practices based on financial savings showed significant improvements in quality and use of some medical services relative to comparison practices.

Jun 1, 2015
Content

Paying for Health Care

How health care providers are paid strongly influences their approach to clinical practice. The traditional fee-for-service model is still dominant in the United States, but there are several alternatives.

May 7, 2015
Journal Article

Hospital and Regional Variation in Medicare Payment for Inpatient Episodes of Care

Health care spending varies widely between geographic regions, but there is disagreement regarding the appropriate policy response.

Apr 22, 2015
Journal Article

Using Research to Transform the Health Care System

Using the knowledge base developed by health services research can stimulate innovative thinking about how to make health care systems safer, more efficient, more cost effective, and more patient centered.

Apr 22, 2015
Journal Article

Time to Reconsider Including Physicians in Bundled Payments?

Given new payment models and the changing relationship between physicians and hospitals, including physician costs in Medicare's Diagnosis-Related Groups (DRG) payments to hospitals could lead to better physician engagement in quality improvement efforts.

Apr 21, 2015
Journal Article

An Evaluation of Social Impact Bonds in Health and Social Care: Interim Report

This interim report describes the progress of the nine 'Trailblazer' projects that investigate the feasibility of setting up Social Impact Bond (SIB) projects in health and social care in England.

Apr 1, 2015
Blog

Five Years of the Affordable Care Act

The Affordable Care Act has officially been part of the U.S. health care landscape for five years. We reflect on the twists and turns that followed its passage and the RAND research that informed debates along the way, and look ahead to the future of the ACA.

Mar 23, 2015
News Release

Details and Context of New Payment Models Are Critical to Efforts of Physician Practices to Improve Care

Physician practices are engaging in new health care payment models intended to improve quality and reduce costs, but 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

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: 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
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
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

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