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Primary Care

Primary care providers are often the first point of contact for patients attempting to navigate a complex health care delivery system and seeking referrals to specialists. RAND has explored the increasing use of emergency departments as a primary care setting, the influence of primary care on health care spending, shared decisionmaking between patients and primary care providers, the emergence of retail health clinics, and more.

Report

Practice Expenses Associated with Comprehensive Primary Care Capabilities

To help the Centers for Medicare & Medicaid Services (CMS) reimburse primary care practices for investing in "comprehensive primary care" capabilities, the authors developed and piloted a method for estimating related practice expenses.

Nov 15, 2018
Report

Evaluation of the Global Payment Program: Midpoint Report

The Global Payment Program seeks to improve health care for California's uninsured by providing funds for both traditional and non-traditional services, settings, and providers. This is the report of the midpoint evaluation of the program.

Sep 7, 2018
Report

Recommendations for Improving Access to Primary Care

Access to primary care is critical for ensuring population health. Evidence-based priorities can help health care organizations improve access and access management.

Sep 5, 2018
Multimedia

Improving Access to Opioid Addiction Treatment

Treatment for opioid addiction and other substance use disorders often exists apart from primary care. It's also difficult to access and under-resourced. In response to these challenges, RAND's Katherine Watkins developed an innovative approach to addiction treatment through primary care settings.

Sep 1, 2018
Journal Article

Sustaining Alcohol and Opioid Use Disorder Treatment in Primary Care: A Mixed Methods Study

Access to external funding and staff support are two important factors for the sustainability of substance use disorder treatment provision within primary care clinics.

Aug 24, 2018
Journal Article

Journal Article

The Evaluation of Physicians' Communication Skills From Multiple Perspectives

A divergence between physician and patient expectations of communication practices may be common in primary care.

Aug 23, 2018
Journal Article

Journal Article

Impact of Medicaid Policy on the Oral Health of Publicly Insured Children

State policies that support non-dental primary care providers' application of fluoride varnish treatment were associated with improvements in oral health for young children with public insurance.

Aug 21, 2018
Journal Article

Journal Article

Rural And Nonrural Primary Care Physician Practices Increasingly Rely On Nurse Practitioners

Data from 2008-2016 show that both rural and non-rural primary care practices increasingly involve nurse practitioners (NPs) to deliver care.

Jul 6, 2018
Journal Article

Journal Article

Hospital-Based Quality Measures for Pediatric Mental Health Care

The study developed new pediatric mental health care quality measures and used them to identify sex and race disparities and substantial hospital variation.

Jul 3, 2018
Journal Article

Opening School-Based Health Clinics Can Lower Teacher Health Costs

Opening onsite health clinics to provide comprehensive primary care to teachers and their families can lower a school district's health care costs and decrease teacher absenteeism.

Jul 3, 2018
Journal Article

Journal Article

Patient Predictors of Substance Use Disorder Treatment Initiation in Primary Care

Primary care clinics are opportune settings for the delivery of substance use disorder treatment, but little is known about which patients initiate treatment in these settings.

Jun 28, 2018
Journal Article

Journal Article

Delivery and Impact of the NHS Health Check in the First 8 Years: A Systematic Review

Since 2009 all eligible persons in England have been entitled to an NHS Health Check. Uncertainty remains about who attends and the health-related impacts. This report reviews quantitative evidence on coverage, uptake and impact of NHS Health Checks.

Jun 27, 2018
Report

Patient-Centered Medical Home Implementation in Indian Health Service Direct Service Facilities

In 2008, the Indian Health Service launched a patient-centered medical home (PCMH) initiative to improve the quality of care in its clinics. RAND researchers identified barriers and strategies to assist clinics on the path to PCMH recognition.

May 25, 2018
Report

Report

Health Sector Reform in the Kurdistan Region — Iraq: Primary Care Management Information System, Physician Dual Practice Finance Reform, and Quality of Care Training (Kurdish-language version)

Since 2010, RAND has worked with the Kurdistan Regional Government to improve its health care system. This phase focused on a primary care management information system, physician dual practice reform, and patient safety training.

Apr 19, 2018
Journal Article

Journal Article

Care Experiences Among Medicare Beneficiaries With and Without a Personal Physician

Medicare patients without a personal physician reported worse patient experiences, and were 3 times more likely than those with a physician not to have seen any health care provider in the last 6 months.

Apr 12, 2018
Journal Article

Journal Article

"It Encourages Them to Complain": A Qualitative Study of the Unintended Consequences of Assessing Patient-Reported Pain

This article describes potential unintended consequences of implementing routine pain screening in primary care.

Apr 11, 2018
Journal Article

Journal Article

Impact of a Mental Health Based Primary Care Program on Emergency Department Visits and Inpatient Stays

Introducing primary care services into mental health clinics may increase utilization of inpatient services, perhaps due to newly identified unmet medical need.

Apr 10, 2018
Journal Article

Effects of Motivational Interviewing Fidelity on Substance Use Treatment Engagement in Primary Care

Motivational interviewing is used extensively to improve health and substance use-related outcomes, but therapists may need more training in strategic use of the approach.

Apr 3, 2018
Journal Article

Journal Article

Integrating Behavioral Health and Primary Care Services for People with Serious Mental Illness: A Qualitative Systems Analysis of Integration in New York

Effective integration of behavioral and physical health care does not advance along a single continuum from minimally to fully integrated care but along several, parallel pathways.

Mar 22, 2018
Journal Article

Journal Article

Impact of Issuing Longer- Versus Shorter- Duration Prescriptions: A Systematic Review

UK recommendations to provide shorter prescriptions are not substantiated by the current evidence base.

Mar 14, 2018

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RAND Topic:
Primary Care

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RAND Health Care