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The U.S. health insurance model frequently costs more and provides less care than systems in other Western nations. RAND's health insurance research began in 1971 with the 15-year Health Insurance Experiment, the only community-based experimental study of how cost-sharing arrangements affect people’s use of health services, their quality of care, and their health status. Subsequent research has continued to inform the U.S. policy debate.

Commentary
Can the Health Insurance System Handle Massive Medicaid Reductions?
For many who have or will soon lose Medicaid as monthly redeterminations restart, and for millions more who could lose insurance due to other factors like job loss, three recent policy developments might increase the chances that they find new health care coverage.
May 12, 2023
Report
Private Health Plans Paid Hospitals 224 Percent of What Medicare Would Pay
During 2020, prices paid to hospitals by employers and private insurers for both inpatient and outpatient services averaged 224 percent of what Medicare would have paid for the same services. Prices among states varied widely.
May 17, 2022

Explore Health Insurance

Journal Article
Prevalence of Buprenorphine Providers Requiring Cash Payment From Insured Women Seeking Opioid Use Disorder Treatment
Researchers used an audit (simulated patient) study methodology to examine appointment-granting behavior by buprenorphine prescribers in ten different U.S. states.
Jun 14, 2023
Commentary
Your Health Insurance May Not Be As Good As Your State Requires—and It's Perfectly Legal
Massachusetts has a law to ensure ease of access to birth control pills, saying there should be no copays and women can fill a 12-month prescription at once. Infertility care has similar protections. But many health plans don't have to comply with state laws because they are “self-insured.”
Jun 9, 2023
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
Testimony
Health Care Price Transparency: Opportunities to Improve Affordability and Data Effectiveness
Significant progress has been made to increase the transparency of health care prices at the federal and state levels, but much more needs to be done to leverage price transparency data. Enabling broader use of these data can help address price variation and health care spending.
May 16, 2023
Blog
RAND Turns 75: A Look Through the Decades At World-Changing Research
From anticipating the Space Age in the 1940s to studying gun policy and COVID-19 responses in the 2020s, RAND is celebrating 75 years of research that has made a difference.
May 8, 2023
Tool
RAND HRS Longitudinal File 2020 (V1) Documentation: Includes 1992-2020 (Early Release)
This tool is a cleaned, easy-to-use, and streamlined data product containing information from the Health and Retirement Study, a longitudinal household survey that facilitates research into different aspects of population aging in the United States.
Apr 13, 2023
Journal Article
Prior Authorization Restrictions on Medications for Opioid Use Disorder: Trends in State Laws from 2005 to 2019
Researchers conducted a review of U.S. regulations and statutes between 2005 and 2019 related to medications for opioid use disorder to identify the frequency and types of prior authorization prohibitions in state laws.
Feb 9, 2023
Journal Article
An Exploratory Analysis of Differential Prescribing of High-Risk Opioids by Insurance Type Among Patients Seen by the Same Clinician
The objective of this paper is to explore how high-risk opioid analgesic prescribing varies by payer type among patients seeing the same prescriber and identify clinician characteristics associated with variable prescribing.
Feb 8, 2023
Journal Article
Trends in US Ambulatory Care Patterns During the COVID-19 Pandemic, 2019–2021
In this study, there was an increase in the return to expected rates of use of ambulatory care services between March 2020 and February 2021. This increase was lower for patients with Medicaid or Medicaid-Medicare dual eligibility.
Feb 3, 2023
Journal Article
Part D Senior Savings Model: Model Reach and Scope
This report describes the reach and scope of Medicare's Part D Senior Savings model, which has lower, fixed cost sharing for a specified set of model drugs.
Nov 9, 2022
Commentary
Medicare Drug Price Negotiation: Key Decisions to Reach a 'Fair Price'
Government negotiation of Medicare drug prices—even for a small set of older, single-source drugs—is a remarkable policy development. But how exactly will the government do it?
Nov 7, 2022
Journal Article
Association Between Hospital-Physician Vertical Integration and Medication Adherence Rates
Increases in vertical integration were not associated with changes in medication adherence rates. However, adherence rates after vertical integration declined for non-Whites, patients over 80 years old, and patients with greater comorbidities.
Oct 28, 2022
Journal Article
The Impact of the Affordable Care Act Insurance Expansions on Opioid-Related Emergency Department Visits
We leverage ACA coverage expansions to study the impact of health insurance on opioid-related emergency department visits while accounting for potentially confounding changes in relevant state-level policies.
Oct 27, 2022
Journal Article
Evaluation of Phase II of the Medicare Advantage Value-Based Insurance Design Model Test: First Two Years of Implementation (2020–2021), and Appendixes
This report presents the RAND Corporation team's findings from its evaluation of Phase II of the Medicare Advantage Value-Based Insurance Design model test, for the years 2020 and 2021.
Oct 19, 2022
Blog
Microchips, Ukraine, Outer Space: RAND Weekly Recap
This weekly recap focuses on how safeguarding Taiwan is the answer to America's microchip problem, a moment of clarity in Ukraine, new rules in space, and more.
Oct 7, 2022
Journal Article
Laws for Expanding Access to Medications for Opioid Use Disorder: A Legal Analysis of 16 States & Washington D.C.
This study reports on the results of a qualitative analysis that identified and categorized state medications for opioid use disorder related statutes and regulations in a stratified random sample of 16 states and Washington D.C.
Oct 7, 2022
Report
Health Care Consolidation: What Does the Evidence Say?
Hospital horizontal consolidation is associated with higher prices paid to providers. And there is some evidence of the same for vertical consolidation of hospitals and physician practices. What effect might the No Surprises Act—created to protect consumers from surprise medical bills—have on consolidation trends?
Sep 30, 2022
Journal Article
Survey of Hospital Chargemaster Transparency
We compared hospital chargemaster data within a local hospital market where patients would reasonably try to shop or compare services.
Sep 15, 2022
Journal Article
Effects of Medicaid Automatic Enrollment on Disparities in Insurance Coverage and Caregiver Burden for Children with Special Health Care Needs
We analyze how Medicaid automatic enrollment policies for children with special health care needs who are enrolled in Supplemental Security Income reduce disparities in health insurance coverage and caregiving burden.
Aug 23, 2022

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RAND Topic:
Health Insurance

Research conducted by

Researcher Spotlight

Michael Dworsky

Senior Economist

Michael (Misha) Dworsky is a senior economist at the RAND Corporation. His research interests are in health economics, labor economics, public finance, and the economics of insurance. His work at RAND focuses on workers’ compensation, health insurance, disability, and health care utilization.…
Christopher M. Whaley

Economist

Christopher M. Whaley is a health economist at the RAND Corporation and professor at the RAND Pardee Graduate School. His research focuses on health care price transparency and market structure and has been published in clinical, health policy, and economics journals. Whaley's research has also…

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