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Health Care Quality

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The gap between the care patients should get and what they actually receive likely contributes to thousands of preventable deaths each year, and health care systems worldwide continue to face the challenge of delivering quality care at an affordable cost. RAND has conducted research designed to measure and improve health care quality and to provide reliable decision support data to patients, providers, and purchasers.

Commentary
Doubling NIH Funding for Women's Health Would Yield Substantial Return on Investment
The scientific evidence base generally is biased toward the male body as a result of a long history of generous funding for diseases that predominantly affect men and underfunding for those that predominantly affect women. But the cost of the science pales in comparison to the price we continue to pay for what we don't know about caring for women.
Jul 8, 2022
Research Brief
Standards for Delivering High-Quality Care to Veterans with Invisible Wounds
Depression, PTSD, traumatic brain injury, and substance use disorders interfere with veterans' employment, family life, community engagement, and well-being. There are effective treatments but also barriers to accessing them. A set of standards can help identify providers who serve veterans and deliver high-quality care.
May 9, 2022

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Testimony
Health Care Consolidation
Health care consolidation reduces competition and contributes to increased health care spending. It also has not yielded improvements in quality or health outcomes for patients. What is the current state of consolidation among U.S. health care providers, insurers, pharmacy benefit managers, and private equity firms?
May 17, 2023
Journal Article
The Impact of Nurse Practitioner-Led Primary Care on Quality and Cost for Medicaid-Enrolled Patients in States With Pay Parity
This retrospective cohort study evaluated the quality and cost implications of receiving primary care from nurse practitioners (NPs) compared to physicians in 14 states that reimburse NPs at the Medicaid fee-for-service physician rate (pay parity).
May 16, 2023
Research Brief
How Does Telehealth Affect Health Care Quality, Access, Equity, and Costs?
Early in the COVID-19 pandemic, health care providers pivoted to telehealth out of necessity. As policymakers look beyond the pandemic, concerns about telehealth's effects on health care spending and quality persist.
May 11, 2023
Journal Article
Treatment Goals for Rheumatoid Arthritis: Patient Engagement and Goal Collection
We worked with a steering committee and surveyed patients with rheumatoid arthritis to test a new method for engaging patients in healthcare valuation using patient goals.
May 4, 2023
Journal Article
Changes in In-Person, Audio-Only, and Video Visits in California's Federally Qualified Health Centers, 2019-2022
The decline in audio-only visits from the early pandemic peak appears to coincide with the return of in-person visits rather than growth in video visits.
Apr 25, 2023
News Release
Audio-Only Telehealth Remains Common At Many Safety Net Clinics
In August 2022, more than two years into the COVID-19 pandemic, audio-only telehealth visits still accounted for 1 in 5 primary care visits and 2 in 5 mental health care visits at safety net clinics in California.
Apr 11, 2023
Journal Article
Are the Experiences of Those New to Medicare Good from the Start?
The results of this study provide some assurance that Medicare's onboarding process is effective, and that the care experiences of new enrollees with health care services are broadly similar to those with longer experience in the Medicare program.
Mar 29, 2023
Report
Behavioral Health Care Following the Onset of the Pandemic
In what ways did the onset of the COVID-19 pandemic change how behavioral health care was delivered to service members with PTSD, depression, or substance use disorder?
Mar 20, 2023
Journal Article
Follow-Up Shadow Coaching Improves Primary Care Provider-Patient Interactions and Maintains Improvements When Conducted Regularly: A Spline Model Analysis
Re-coaching improved patient experience more than initial coaching, suggesting the reactivation of knowledge from initial coaching. However, re-coaching gains also eroded. Coaching should occur every 6–12 months to maintain behaviors and scores.
Mar 9, 2023
Report
A Needs Assessment of Women Veterans in Western Pennsylvania: Final Report to Adagio Health
To identify opportunities to expand and enhance Adagio Health's efforts to support women veterans' health and wellness, the authors quantitatively and qualitatively assessed the needs of women veterans in the Adagio Health service area.
Mar 8, 2023
Research Brief
Opportunities to Improve Support for Western Pennsylvania’s Women Veterans
Despite their growing numbers, women who have served in the U.S. military continue to encounter challenges accessing the services and support they need. What national and local programs, services, and supports for veterans are available to meet those needs?
Mar 8, 2023
News Release
Care Experiences Are Worse in For-Profit Hospices Than in Not-for-Profit Hospices
Family caregivers of patients treated by more than 3,100 U.S. hospices reported worse care experiences on average from for-profit hospices across all of the domains assessed, including help for pain and getting timely care.
Feb 27, 2023
Commentary
RAND Experts on Veteran Mental Health Respond to the White House Mental Health Research Priorities
The White House identified eight research priorities to better manage America's current mental health crisis. RAND researchers highlight why each area is critical for veteran mental health and how RAND is contributing to address them.
Feb 20, 2023
Journal Article
State Approaches to Tackling the Opioid Crisis Through the Health Care System
In this paper, policy experts discuss three broad strategies states are taking, through a variety of policy levers, to enhance the quality of and access to treatment for opioid use disorder.
Feb 8, 2023
Journal Article
Income-related Disparities in Medicare Advantage Behavioral Health Care Quality
Low income is associated with lower performance on behavioral health measures, but associations differ across racial groups. Improving care integration and addressing barriers to care may improve equity across income levels.
Jan 24, 2023
Commentary
Gender Biases in Health Care: Listen to Women About Their Own Health
More and more information, evidence, and personal stories are emerging suggesting women are not being listened to or believed by health care professionals about their symptoms of physical illness. There is ongoing work in the United Kingdom to improve and integrate women's health services, which creates hope for improvements.
Jan 19, 2023
Journal Article
The Hospital Care Experiences of Older Patients Compared to Younger Patients
Patients ages 75+ reported less-positive experiences than patients ages 55-74, especially for measures of communication. These differences may be specific to inpatient care.
Dec 23, 2022
Journal Article
Reasons Primary Care Practices Chose Patient Experience Surveys During Patient-Centered Medical Home Transformation
In 2008–2017, 15–18% of U.S. primary care practices sought or maintained patient-centered medical home recognition. We interviewed a sample of 105 of these practices to determine why patient experience surveys were chosen.
Dec 7, 2022
Journal Article
Shadow Coaching Improves Patient Experience With Care, But Gains Erode Later
We examined whether shadow coaching improves patient experience across 44 primary care practices in a large urban Federally Qualified Health Center.
Dec 7, 2022
Journal Article
Summary of the 2020 AHRQ Research Meeting on 'Advancing Methods of Implementing and Evaluating Patient Experience Improvement Using Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Surveys'
The Agency for Healthcare Research and Quality held a research meeting on using Consumer Assessment of Healthcare Providers and Systems (CAHPS®) data for quality improvement (QI) and evaluating such efforts. This article summarizes the meeting.
Dec 7, 2022

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RAND Topic:
Health Care Quality

Research conducted by

Researcher Spotlight

Sangeeta C. Ahluwalia

Associate Research Department Director, Behavioral and Policy Sciences Department

Sangeeta Ahluwalia (she/her/hers) is associate research department director for the Behavioral and Policy Sciences Department and a senior policy researcher at the RAND Corporation. She is also an adjunct associate professor of health policy at the UCLA Fielding School of Public Health.…
Heather Gomez-Bendaña

Assistant Policy Researcher, RAND, and Ph.D. Candidate, Pardee RAND Graduate School

Heather Gomez-Bendaña (she/her/ella) is an assistant policy researcher at RAND and a Ph.D candidate at the Pardee RAND Graduate School. Her research interests include social determinants of health, special needs population, people with disabilities, health care access, health disparities, health…

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