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Managed Health Care

Journal Article
Need for Eye Care Among Older Adults with Diabetes Mellitus in Fee-for-Service and Managed Medicare
Compare rates of need for eye care among Medicare beneficiaries with network-model Medicare+Choice (MC) and fee-for-service (FFS) health insurance.
Jan 1, 2005
Journal Article
Using Health-Related Quality of Life to Predict and Manage Pediatric Health Care
Increasing healthcare costs and the prevalence of managed care make population health management an imperative.
Jan 1, 2005
Research Brief
Inside the Black Box of Managed Care Decisions: Understanding Patient Disputes over Coverage Denials
This research provides some of the first empirical data on utilization review—the process in which initial coverage decisions are made—and patients' appeals of denials that result from utilization reviews.
Jan 1, 2004
Journal Article
Does Medicare Managed Care Provide Equal Treatment for Mental Illness Across Races?
While disparities in access to care are well documented, little is known about the quality of mental health care received by racial and ethnic minorities.
Jan 1, 2004
Journal Article
The Costs of Decedents in the Medicare Program: Implications for Payments to Medicare+choice Plans
To discuss and quantify the incentives that Medicare managed care plans have to avoid (through selective enrollment or disenrollment) people who are at risk for very high costs, focusing on Medicare beneficiaries in the last year of life - a group that accounts for more than one-quarter of Medicare's annual expenditures.
Jan 1, 2004
Journal Article
Effect of Primary Care Visits on the Demand for Specialty Care in Health Maintenance Organizations
Health maintenance organizations (HMOs) provide low cost access to primary care physicians (PCPs) in an effort to restrict expensive specialty use.
Jan 1, 2004
Journal Article
Impact of Managed Care on the Treatment, Costs, and Outcomes of Fee-for-Service Medicare Patients with Acute Myocardial Infarction
The level of managed care activity in the health care market affects the process of care for Medicare fee-for-service AMI patients.
Jan 1, 2004
Journal Article
HMO Backlash Caused Few People to Bolt from Health Plans
A backlash of public opinion against health maintenance organizations in the late 1990s did not result in large numbers of Americans switching to health insurance plans that offer greater consumer choice.
Jan 1, 2004
Journal Article
Effects of Primary Care Depression Treatment on Minority Patients' Clinical Status and Employment
The response of ethnic minorities to mental health care is largely unstudied.
Jan 1, 2004
Journal Article
The Volume-Quality Relationship of Mental Health Care: Does Practice Make Perfect?
The authors examined whether an analogous association exists between the volume of mental health delivery and the quality of mental health care.
Jan 1, 2004
Research Brief
Quality of Health Care Received by Older Adults
Experts have developed a system for measuring the quality of care delivered to the elderly and used the system to assess the quality of care given to a group of older adults who were members of a managed care plan.
Jan 1, 2004
Journal Article
The Quality of Medical Care Provided to Vulnerable Older Patients with Chronic Pain
Chronic pain management in older vulnerable patients is inadequate.
Jan 1, 2004
Journal Article
Primary Care Provider Perceptions of Barriers to and Facilitators of Colorectal Cancer Screening in a Managed Care Setting
CRC screening tests appear to be underused in the managed care setting examined in the current study.
Jan 1, 2004
Journal Article
Health Plan Effects on Patient Assessments of Medicaid Managed Care Among Racial/Ethnic Minorities
Health care organizations should engage in quality improvement activities to address the observed racial/ethnic disparities in assessments of care.
Jan 1, 2004
Journal Article
The Effect of HMOs on the Inpatient Utilization of Medicare Beneficiaries
To determine the effect of joining HMOs (health maintenance organizations) on the inpatient utilization of Medicare beneficiaries.
Jan 1, 2004
Journal Article
Patterns of Medical Resource and Psychotropic Medicine Use Among Adult Depressed Managed Behavioral Health Patients
Patients continue receiving mental health treatment in the medical sector.
Jan 1, 2004
Journal Article
The Effect of Mergers on Firms' Costs: Evidence from the HMO Industry
Mergers between HMOs that produce Medicare and other products are likely to create dis-economies of scope that increase costs.
Jan 1, 2004
Journal Article
Differential Use of the CAHPS 0-10 Global Rating Scale by Medicaid and Commercial Populations
This study is a secondary analysis of CAHPS 2.0 health plan survey data collected in 1999 and 2000.
Jan 1, 2004
Journal Article
Health-related Quality of Life as a Predictor of Pediatric Healthcare Costs: A Two-Year Prospective Cohort Analysis
The objective of this study was to test the primary hypothesis that parent proxy-report of pediatric health-related quality of life (HRQL) would prospectively predict pediatric healthcare costs over a two-year period.
Jan 1, 2004
Journal Article
The Effects of HMO Ownership on Hospital Costs and Revenues: Is There a Difference Between For-Profit and Nonprofit Plans?
Hospitals in high HMO areas experienced revenue and cost growth rates that were 21 and 18 percentage points below hospitals in low HMO areas.
Jan 1, 2004

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RAND Topic:
Managed Health Care

Research conducted by

RAND Health Care

Researcher Spotlight

Bradley D. Stein

Director, Opioid Policy, Tools, and Information Center (OPTIC)

Bradley Stein (he/him) is director of the NIH-funded RAND-USC Schaeffer Opioid Policy Center and a senior physician policy researcher at the RAND Corporation. A health services and policy researcher and practicing child and adolescent psychiatrist, Dr. Stein's research focuses on better…
Erin Audrey Taylor

Senior Policy Researcher

Erin Taylor (she/her) is a senior policy researcher at the RAND Corporation. Her research addresses a broad range of health care insurance, prescription drug, and care quality issues, including the impact of insurance benefit design on use of opioids and specialty drugs. Taylor is currently…

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