Health Care Reform

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The debate within the U.S. government about reforming the health care system centers on ways to control rising costs and assure high-quality, affordable care. RAND Health Care provides objective research and analysis on topics that can inform the health care reform debate, including financing; increasing access, insurance coverage, and quality; decreasing costs; and promoting wellness and prevention.

  • Person standing in a field looking toward mountains in the distance. Photo by Ivana Cajina/Unsplash

    Research Brief

    How to Transform Mental Health Care in the United States

    Jan 11, 2021

    With scientific advances, Medicaid expansion, and political consensus on the importance of improving mental health, the time is ripe for transforming the U.S. mental health system. This will mean structural reforms that address patients' challenges in finding, accessing, and receiving high-quality and timely care.

  • Health insurance form with model of COVID-19 virus and pen, photo by ajaykampani/Getty Images

    Commentary

    COVID-19: Preexisting Condition in a Post-ACA World?

    Nov 4, 2020

    The Affordable Care Act is far from perfect, but its protections are particularly relevant to the COVID-19 pandemic. If the ACA is struck down, then protections for preexisting conditions will go with it. Policymakers should consider the potential implications for millions of COVID-19 survivors.

Explore Health Care Reform

  • Imaging Mental Health in America, design by Giorgia Lupi

    Content

    Imaging Mental Health in America

    To kick off our artist residency program, RAND Art + Data, information designer Giorgia Lupi created a visualization inspired by RAND research on reforming the U.S. mental health system. The piece illustrates key numbers and forces animating the discussion about mental health care today.

    Jun 24, 2021

  • Blog

    Sexual Assault in the Military, School Security, Mental Health Care: RAND Weekly Recap

    This weekly recap focuses on the risk of sexual assault to sexual minorities in the U.S. military, making treatment more accessible to people struggling with opioid addiction, countering Russian propaganda, and more.

    Jun 4, 2021

  • A young woman having a counseling session with a psychologist using a video conferencing tool, photo by PeopleImages/Getty Images

    Commentary

    How COVID-19 Lessons Can Transform U.S. Mental Health Care

    It would be a powerful conclusion to the pandemic if Americans reimagined a health system that was resilient against future threats, including the resulting psychological trauma. Policymakers have the opportunity now to cut short the pandemic's long tail of mental illness by taking decisive action.

    Jun 2, 2021

  • Transform Mental Health

    Multimedia

    It Is Time to Transform U.S. Mental Health Care

    RAND health policy researcher Ryan McBain presents reasons why now is the right time to address problems in the U.S. mental health system.

    Mar 2, 2021

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    Research Brief

    10Plan, How Would It Affect Health Care Spending by Consumers and the Federal Government

    The 10Plan is a self-pay plan for individuals currently uninsured or covered by a private nongroup health insurance plan. The authors built a microsimulation model to estimate health care spending under both the status quo and the 10Plan.

    Feb 25, 2021

  • Journal Article

    Journal Article

    Survival Rates in Trauma Patients Following Health Care Reform in Massachusetts

    This article examines the effect of Massachusetts health care reform on survival rates of injured patients.

    Jan 28, 2021

  • A man paying for health care services at a reception desk, photo by kokouu/Getty Images

    Report

    The 10Plan: An Alternative Approach to Health Care Financing

    The 10Plan would require individuals to pay a copayment for each encounter but no premiums up front. They'd have Medicare rates, and could pay cash or borrow from the government at a low interest rate to pay for services. How would health care spending and federal costs change under the plan?

    Jan 25, 2021

  • Tool

    Tool

    Mental Health Systems Solutions Explorer

    This tool is designed by RAND researchers to help connect mental health systems, policy leaders, and decisionmakers with resources and evidence-based solutions that could help transform the complex mental health landscape in the United States.

    Jan 11, 2021

  • Highway headed toward the sun, photo by DieterMeyrl/Getty Images

    Report

    Transforming the U.S. Mental Health System

    The United States is at a time of promise for historic transformation in mental health care. This report describes the landscape of mental health in the United States, identifies opportunities for change, and makes evidence-based recommendations for a path forward.

    Jan 11, 2021

  • News Release

    News Release

    Transforming U.S. Mental Health System Is Possible; Broad Changes Will Be Needed to Improve Access and Quality

    Conditions are ripe for transforming the U.S. mental health care system, with scientific advances, the growth of Medicaid, and political consensus on the importance of improving mental health creating the possibility that goals once thought out of reach may be possible.

    Jan 11, 2021

  • Group of medical practitioners talking in a hospital hallway, photo by SolStock/Getty Images

    Journal Article

    The Importance of Understanding and Measuring Health System Structural, Functional, and Clinical Integration

    We explore if there are ways to characterize health systems-not already revealed by secondary data-that could provide new insights into differences in health system performance.

    Dec 10, 2020

  • Team of medical staff in discussion, photo by Dean Mitchell/Getty Images

    Journal Article

    Care Integration Within and Outside Health System Boundaries

    We developed manager and staff surveys to collect data on organizational, social, and clinical process integration, at four organizational levels: practice site, physician organization, health system, and outside health systems.

    Dec 10, 2020

  • Prescription pad, stethoscope, and gavel on top of the American flag

    Content

    U.S. Health Care Policy

    The U.S. health care policy landscape is poised for great change. Extensive RAND research offers insights about the likely impact of repealing or revising the ACA along key dimensions, including Medicaid, the individual mandate, effects on employers, tax subsidies, changing rating regulations, and essential health benefits.

    Dec 1, 2020

  • Close up of laptop, stethoscope, papers, and a person writing on a clipboard, photo by smolaw11/Getty Images

    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

  • Medical staff talking in a hospital corridor, photo by Wavebreakmedia/Getty Images

    Report

    Consolidation by Any Other Name: The Emergence of Clinically Integrated Networks

    In this report, the authors offer an initial assessment of clinically integrated networks (CINs), describe how health systems are using CINs strategically to compete in crowded health care markets, and identify why CINs require further study.

    Aug 3, 2020

  • Low angle shot of a group of doctors stacking hands in a hospital, photo by Hiraman/Getty Images

    Commentary

    Out of the Ashes: Forging the Post-Pandemic U.S. Health System

    With shifting insights, new problems, and exacerbation of old problems revealed by the pandemic, innovative solutions in the U.S. health system are being adopted where rapid change would normally have been rare. There is both an opportunity and a responsibility to assess how these changes are working and where they can improve health, reduce inequity, and save money.

    Jul 31, 2020

  • Blog

    COVID-19's Effects on U.S. Schools, Vaccine Uptake, Small Businesses: RAND Weekly Recap

    This weekly recap focuses on how COVID-19 has affected U.S. schools, potential barriers to vaccine uptake, what small businesses need to survive, and more.

    May 29, 2020

  • Clear piggy bank with coins and red medical case, photo by Altayb/Getty Images

    Commentary

    Options for Designing a Public Option

    State and federal policymakers are considering adding state-backed public options to the individual market in an effort to expand health coverage and improve affordability. We analyzed what would happen if public options became available in U.S. health insurance exchanges.

    May 28, 2020

  • A health insurance application on a tablet, photo by grinvalds/Getty Images

    Research Brief

    How Would a Public Option on Health Insurance Affect Costs and Coverage?

    Interest in a government-sponsored health insurance plan with publicly determined provider rates is growing. An analysis of four such public option plans finds that lower provider payment rates would lower premiums. But the effect on enrollees also depends on tax credits. And changes to the number of uninsured would be small.

    May 28, 2020

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