Health Care Reform


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.

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    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.

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    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

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    Carve-In Models for Specialty Behavioral Health Services: Lessons for California

    Many states separate, or "carve out," Medicaid financing of behavioral health services from that for other types of health care, but there has been a recent trend in some states toward "carve-ins": combining financing for behavioral health services with the larger pool of Medicaid-covered services. What lessons do other states' experiences offer for California?

    Feb 11, 2022

  • Journal Article

    Journal Article

    Early Development of Primary Care Networks in the NHS in England: A Qualitative Mixed-Methods Evaluation

    Primary care networks were introduced to improve care and help address sustainability issues in general practice. The purpose of this study was to collect early evidence on their implementation and development.

    Jan 5, 2022

  • Blog

    The Most Popular RAND Research of 2021

    As another extraordinary year draws to a close, we continue to believe that objective, nonpartisan research and analysis has a key role to play in navigating what continues to be a difficult time. Here are the 10 research projects that resonated most with readers in 2021.

    Dec 22, 2021

  • Blog

    RAND Commentary Highlights of 2021

    Vaccine rollouts, an attack on the U.S. Capitol, massive ransomware attacks, the withdrawal from Afghanistan, record numbers of job openings and people quitting, and more. RAND researchers weighed in on all these topics and more.

    Dec 21, 2021

  • Imaging Mental Health in America, design by Giorgia Lupi


    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

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    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


    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

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    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

  • 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

  • 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

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    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

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    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


    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

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    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


    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

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