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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.

Research Brief
How to Transform Mental Health Care in the United States
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.
Jan 11, 2021
Commentary
COVID-19: Preexisting Condition in a Post-ACA World?
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.
Nov 4, 2020

Explore Health Care Reform

Journal Article
CalAIM and Specialty Behavioral Health Care: Lessons from Other States on Value-Based Payment
This report examines the experience of state Medicaid agencies with implementation of value-based payment models for behavioral health care and the implications of that experience for future payment reform in California.
May 5, 2023
Report
Reforming Military Health Care Costs: Issues for Future Research
The authors of this report describe emerging topics related to military health care costs and policy to provide policymakers and researchers with future research to pursue.
Mar 13, 2023
Report
Carve-In Models for Specialty Behavioral Health Services: Lessons for California
Many states separate, or
Feb 11, 2022
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 rand.org 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
Content
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
Commentary
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
Multimedia
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
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
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
Report
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
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
Report
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
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
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
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
Content
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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