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

  • doctor checking the throat of a young boy

    Research Brief

    The Math of State Medicaid Expansion

    RAND researchers have analyzed how opting out of Medicaid expansion would affect insurance coverage and spending and whether alternative policy options—such as partial Medicaid expansion—could cover as many people at lower costs to states.

    Jun 7, 2013

  • doctor speaking with senior patient

    Testimony

    Improving Care for Medicare Beneficiaries with Physician Payment Reform

    Physician payment policy is shifting from one that incentivizes the delivery of more services without regard to quality or outcomes to one that incentivizes the delivery of high quality, resource conscious health care. Thoughtful incentive design can ease the transition process for both physicians and the Medicare program.

    Jun 5, 2013

  • News Release

    News Release

    Expanding Medicaid Is Best Financial Option for States

    States that choose not to expand Medicaid under federal health care reform will leave millions of their residents without health insurance and increase spending on the cost of treating uninsured residents, at least in the short term.

    Jun 3, 2013

  • Nuns On The Bus rally and Texas Capitol visit about Medicaid

    Journal Article

    Expanding Medicaid Is Best Financial Option for States

    States that choose not to expand Medicaid under federal health care reform will leave millions of their residents without health insurance and increase spending on the cost of treating uninsured residents, at least in the short term.

    Jun 1, 2013

  • News Release

    News Release

    Strategies Could Curb Medicare Costs, but Also Drive Seniors Out of Insurance Program

    The rising cost of Medicare can be cut through strategies such as increasing premiums and raising the eligibility age, but those moves could drive many elderly Americans from the program, leaving them with limited access to health services.

    May 6, 2013

  • Doctor examining female senior patient with elbow pain

    Journal Article

    Strategies Could Curb Medicare Costs, but Also Drive Seniors Out of the Program

    The rising cost of Medicare can be cut through strategies such as increasing premiums and raising the eligibility age, but those moves could drive many elderly Americans from the program, leaving them with limited access to health services.

    May 1, 2013

  • Journal Article

    Journal Article

    The Oregon Experiment—effects of Medicaid on Clinical Outcomes

    Despite the imminent expansion of Medicaid coverage for low-income adults, the effects of expanding coverage are unclear. The 2008 Medicaid expansion in Oregon based on lottery drawings from a waiting list provided an opportunity to evaluate these effects.

    May 1, 2013

  • "My Medicaid Matters" rally on Capitol Hill

    Commentary

    Governors Missing the Point on Medicaid

    While a governor or legislator may disagree with Medicaid expansion for philosophical reasons, the claims that the expansion will be a burden on states' economies seem misguided given the full range of projected economic impacts on the states, writes Carter C. Price.

    Apr 29, 2013

  • pediatrician with patient and mother

    Testimony

    Efforts to Reform Physician Payment by Tying Payment to Performance

    Public and private sector purchasers are actively working to design value-based payment programs to achieve the goals of improved quality and more efficient use of health care resources. How these programs are designed is a complex undertaking and one that will determine the likelihood of their success.

    Feb 14, 2013

  • Arkansas flag

    Report

    The Economic Impact of the ACA on Arkansas

    For Arkansas, the Affordable Care Act will result in an increase in GDP of around $550 million and the creation of about 6,200 jobs. The new law will also increase health insurance coverage by 400,000 newly insured individuals.

    Jan 3, 2013

  • doctor exam

    Journal Article

    Medicare Payment Reform and Provider Entry and Exit

    An investigation of the impacts of Medicare payment reform on post-acute providers found that payment reforms reducing average and marginal payments reduced entries and increased exits from the market, which may affect market structure, access to care, quality and cost of care, and patient outcomes.

    Jan 1, 2013

  • Journal Article

    Journal Article

    Measuring Care Continuity: A Comparison of Claims-Based Methods

    Assessing care continuity is important in evaluating the impact of health care reform and changes to health care delivery.

    Jan 1, 2013

  • Journal Article

    Journal Article

    Do We Really Need More Physicians? Responses to Predicted Primary Care Physician Shortages

    Predicted primary care shortages have spurred action to increase the number of primary care physicians.

    Jan 1, 2013

  • ear exam on senior patient

    Journal Article

    How Well Do Medicare's Pay-for-Performance (P4P) Programs Match Desirable P4P Design Criteria?

    Alignment with best P4P practices varies across Medicare programs; the program for Medicare Advantage aligns most strongly. It is unclear which P4P design elements are critical for quality improvement. Unintended consequences of design features are poorly understood.

    Jan 1, 2013

  • Journal Article

    Journal Article

    Implications of New Insurance Coverage for Access to Care, Cost-Sharing, and Reimbursement

    Many physician practices will face a set of critical decisions in the coming years that may contribute to the ultimate success or failure of the ACA.

    Jan 1, 2013

  • hospital staff meeting

    Q&A

    ACOs: Making Organizations 'Accountable' for Care

    The Affordable Care Act focuses primarily on extending coverage to uninsured Americans, but it is also intended to help curb cost growth. M. Susan Ridgely explains one of the key tools for doing that—the “accountable care organization,” an alternative delivery model intended to lower costs while also improving quality of care.

    Dec 19, 2012

  • doctor with money in pocket

    Research Brief

    Providers Influence the Bulk of Health Care Spending in the U.S.

    Providers can dramatically improve American health care by focusing on “value” instead of “volume,” eliminating wasteful and inappropriate care, applying the best available evidence to their practices, and enhancing patient safety.

    Nov 15, 2012

  • Research Brief

    Research Brief

    Flattening the Trajectory of Health Care Spending: Insights from RAND Health Research

    RAND Health research supports four strategies to restrain health care spending growth and maintain quality: foster efficient and accountable providers, engage and empower consumers, promote population health, and facilitate high-value innovation.

    Nov 15, 2012

  • money and pills

    Commentary

    Health Care Costs Must Be Curbed, No Matter Who Wins

    Regardless of which candidate wins in November, and regardless of whether “Obamacare” is repealed, amended, or defended by the next Congress, the next president will have to contend with the spiraling cost of health care in the United States—a problem that is growing more acute with each passing year, writes Arthur Kellermann.

    Oct 17, 2012

  • Report

    Report

    Dissemination and Adoption of Comparative Effectiveness Research Findings When Findings Challenge Current Practices

    An analysis of factors that impede the translation of comparative effectiveness research (CER) into clinical practice and those that facilitate it, based on case studies of five recent CER studies.

    Oct 10, 2012

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