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RAND Health

Overview
Works: 513 works in 805 publications in 4 languages and 45,092 library holdings
Roles: Publisher
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Most widely held works about RAND Health
 
Most widely held works by RAND Health
Evaluation of the Arkansas tobacco settlement program : progress through 2011 by John Engberg( Book )

5 editions published in 2012 in English and held by 173 WorldCat member libraries worldwide

The Tobacco Settlement Proceeds Act, a referendum passed by Arkansans in the November 2000 election, invests Arkansas' share of the tobacco Master Settlement Agreement funds in seven health-related programs. RAND was contracted to perform a comprehensive evaluation of the progress of the seven programs in fulfilling their missions, as well as the effects of the programs on smoking and other health-related outcomes. This report discusses the Arkansas Tobacco Settlement Commission's activities and its responses to recommendations by RAND in the earlier evaluation reports and documents continued activity and progress by the seven funded programs for 2011. This report is the fifth and final biennial report from RAND. It evaluates the progress of each of the funded programs, including assessing progress in achieving programmatic goals and tracking the programs' activities and indicators. It also updates trends in outcome measures developed to monitor the effects of the funded programs on smoking and other health-related outcomes. Finally, it provides both program-specific and statewide recommendations for future program activities and funding, including ongoing strategic planning, developing evaluation measures, collaboration with other programs, and sustaining funding and growth
Trends in special medicare payments and service utilization for rural areas in the 1990s( Book )

2 editions published in 2002 in English and held by 159 WorldCat member libraries worldwide

This report analyzes special payments that Medicare has been making to rural providers. These special payments are intended to support the rural health care infrastructure to help ensure access to care for Medicare beneficiaries. The research provides a comprehensive overview of these payments, including documentation of the supply of providers, trends in payments, and Medicare costs per beneficiary. Four types of special payments were examined: (1) payments to sole community hospitals, Medicare-dependent hospitals, and rural referral centers; (2) reimbursements to rural health clinics and federally qualified health centers; (3) bonus payments to physicians in rural health professional shortage areas; and (4) capitation payments in rural counties
The future of health care in the Kurdistan Region, Iraq : toward an effective, high-quality system with an emphasis on primary care by Melinda Moore( Book )

6 editions published in 2014 in 3 languages and held by 84 WorldCat member libraries worldwide

At the request of the Kurdistan Regional Government (KRG), RAND researchers undertook a yearlong analysis of the health care system in the Kurdistan Region of Iraq, with a focus on primary care. RAND staff reviewed available literature on the Kurdistan Region and information relevant to primary care; interviewed a wide range of policy leaders, health practitioners, patients, and government officials to gather information and understand their priorities; collected and studied all available data related to health resources, services, and conditions; and projected future supply and demand for health services in the Kurdistan Region; and laid out the health financing challenges and questions. In this volume, the authors describe the strengths of the health care system in the Kurdistan Region as well as the challenges it faces. The authors suggest that a primary care-oriented health care system could help the KRG address many of these challenges. The authors discuss how such a system might be implemented and financed, and they make recommendations for better utilizing resources to improve the quality, access, effectiveness, and efficiency of primary care
The role of faith-based organizations in HIV prevention and care in Central America by Kathryn Pitkin Derose( Book )

6 editions published in 2010 in Spanish and held by 82 WorldCat member libraries worldwide

Faith-based organizations (FBOs) have historically played an important role in delivering health and social services in developing countries; however, little research has been done on their role in HIV prevention and care, particularly in Latin America. This study describes FBO involvement in HIV/AIDS in three Central American countries hard hit by this epidemic: Belize, Guatemala, and Honduras. Summarizing the results of key informant and stakeholder interviews with health and FBO leaders and site visits to FBO-sponsored HIV/AIDS clinics, hospices, programs, and other activities, the authors describe the range of FBO activities and assess the advantages of FBO involvement in addressing HIV/AIDS, such as churches' diverse presence and extensive reach, and the challenges to such involvement, such as the unwillingness of some FBOs to discuss condom use and their lack of experience in evaluating the impact of programs. The authors conclude with a discussion of possible ways that FBOs can address the HIV epidemic, both independently and in collaboration with other organizations, such as government ministries of health
Measuring success in health care value-based purchasing programs : summary and recommendations by Cheryl Damberg( Book )

4 editions published in 2014 in English and held by 81 WorldCat member libraries worldwide

Value-based purchasing (VBP) refers to a broad set of performance-based payment strategies that link financial incentives to health care providers' performance on a set of defined measures in an effort to achieve better value. The U.S. Department of Health and Human Services (HHS) is advancing the implementation of VBP across an array of health care settings in the Medicare program in response to requirements in the 2010 Patient Protection and Affordable Care Act, and policymakers are grappling with many decisions about how best to design and implement VBP programs so that they are successful in achieving stated goals. This report summarizes the current state of knowledge about VBP programs, focusing on pay-for-performance programs, accountable care organizations, and bundled payment programs. The authors discuss VBP program goals and what constitutes success; the evidence on the impact of these programs; factors that characterize high- and low-performing providers in VBP programs; the measures, incentive structures, and benchmarks used by VBP programs; evidence on spillover effects and unintended consequences; and gaps in the knowledge base. The report concludes with a set of recommendations for the design, implementation, and monitoring and evaluation of VBP programs and a discussion of HHS's efforts in this regard
Effects of health care payment models on physician practice in the United States by Mark W Friedberg( Book )

3 editions published in 2015 in English and held by 74 WorldCat member libraries worldwide

The project reported here, sponsored by the American Medical Association (AMA), aimed to describe the effects that alternative health care payment models (i.e., models other than fee-for- service payment) have on physicians and physician practices in the United States. These payment models included capitation, episode-based and bundled payment, shared savings, pay for performance (PFP), and retainer-based practice. Accountable care organizations and medical homes, which are two recently expanding practice and organizational models that are based on one or more of these alternative payment models, were also included. Project findings are intended to help guide efforts by the AMA and other stakeholders to make improvements to current and future alternative payment programs and help physician practices succeed in these new payment models--i.e., to help practices simultaneously improve patient care, preserve or enhance physician professional satisfaction, satisfy multiple external stakeholders, and maintain economic viability as businesses. The report provides both findings and recommendations
Factors affecting physician professional satisfaction and their implications for patient care, health systems, and health policy by Mark W Friedberg( Book )

6 editions published in 2013 in English and held by 74 WorldCat member libraries worldwide

One of the American Medical Association's core strategic objectives is to advance health care delivery and payment models that enable high-quality, affordable care and restore and preserve physician satisfaction. Such changes could yield a more sustainable and effective health care system with highly motivated physicians. To that end, the AMA asked RAND Health to characterize the factors that lead to physician satisfaction. RAND sought to identify high-priority determinants of professional satisfaction that can be targeted within a variety of practice types, especially as smaller and independent practices are purchased by or become affiliated with hospitals and larger delivery systems. Researchers gathered data from 30 physician practices in six states, using a combination of surveys and semistructured interviews. This report presents the results of the subsequent analysis, addressing such areas as physicians' perceptions of the quality of care, use of electronic health records, autonomy, practice leadership, and work quantity and pace. Among other things, the researchers found that physicians who perceived themselves or their practices as providing high-quality care reported better professional satisfaction. Physicians, especially those in primary care, were frustrated when demands for greater quantity of care limited the time they could spend with each patient, detracting from the quality of care in some cases. Electronic health records were a source of both promise and frustration, with major concerns about interoperability between systems and with the amount of physician time involved in data entry
Improving the deployment of Army health care professionals : an evaluation of PROFIS by Melony E Sorbero( Book )

2 editions published in 2013 in English and held by 69 WorldCat member libraries worldwide

The Army Medical Department's Professional Filler System was developed in 1980 to support continuous overseas contingency operations while simultaneously balancing the Army's requirement to maintain a healthy force, deploy a medical force to support military operations, and manage/meet access-to-care demands for all military health system beneficiaries. PROFIS allows health care providers to practice in a military treatment facility when not deployed, which contributes to the maintenance of their medical and technical skills. The PROFIS Deployment System, developed in 2005, is an internal management system that is used to battle roster deploying units with the correct PROFIS personnel so that the U.S. Army Medical Command can plan proactively for deployments. Recently, there have been concerns over how PROFIS affects the medical readiness and availability of providers for training with the unit preparing to deploy. This report describes the functionality of the Army's PROFIS in the current operating environment and assesses potential modifications or improvements to the system. Using a literature review, interviews, a survey, and administrative data, this research sought to identify and understand the effect of PROFIS, and deployments more broadly, on providers and other military personnel. The study also assessed modifications and alternatives to the current PROFIS that might address the identified issues
Health care spending and efficiency in the U.S. Department of Veterans Affairs by David I Auerbach( Book )

2 editions published in 2013 in English and held by 50 WorldCat member libraries worldwide

In its 2013 budget request, the Obama administration sought $140 billion for the U.S. Department of Veterans Affairs (VA), 54 percent of which would provide mandatory benefits, such as direct compensation and pensions, and 40 percent of which is discretionary spending, earmarked for medical benefits under the Veterans Health Administration (VHA). Unlike Medicare, which provides financing for care when its beneficiaries use providers throughout the U.S. health care system, the VHA is a government-run, parallel system that is primarily intended for care provision of veterans. The VHA hires its own doctors and has its own hospital network infrastructure. Although the VHA provides quality services to veterans, it does not preclude veterans from utilizing other forms of care outside of the VHA network--in fact, the majority of veterans' care is received external to the VHA because of location and other system limitations. Veterans typically use other private and public health insurance coverage (for example, Medicare, Medicaid) for external care, and many use both systems in a given year (dual use). Overlapping system use creates the potential for duplicative, uncoordinated, and inefficient use. The authors find some suggestive evidence of such inefficient use, particularly in the area of inpatient care. Coordination management and quality of care received by veterans across both VHA and private sector systems can be optimized (for example, in the area of mental illness, which benefits from an integrated approach across multiple providers and sectors), capitalizing on the best that each system has to offer, without increasing costs
Maintaining military medical skills during peacetime : outlining and assessing a new approach by Christine Eibner( Book )

2 editions published in 2008 in English and held by 11 WorldCat member libraries worldwide

Military medical personnel are tasked with fulfilling both the benefits mission and the readiness mission of the U.S. Department of Defense (DoD). However, the medical skills required during deployment are likely to differ significantly from those required during peacetime. This study explored an arrangement in which some personnel are stationed in nonmilitary settings where the case mix might more closely resemble that expected under deployment
Understanding the public health implications of prisoner reentry in California : phase I report by Lois M Davis( Book )

4 editions published between 2009 and 2011 in English and held by 3 WorldCat member libraries worldwide

Socioeconomic and health characteristics of California state prisoners -- Distribution and concentration of parolees in California -- Conceptual framework and methods for defining the health care safety net for parolees -- Counties' capacity to meet the health care needs of the reentry population
Final report on assessment instruments for prospective payment system by Joan Buchanan( Book )

3 editions published in 2004 in English and held by 1 WorldCat member library worldwide

These appendices accompany a report that evaluates alternative assessment tools for use in a prospective payment system (PPS) for inpatient rehabilitation facilities. They include samples of study forms and instructions; descriptions of measures; recruitment and participation letters; characteristics of participating facilities; sample study newsletters; and sampling protocols. The PPS was designed for use with the Functional Independence Measure. Policymakers hoped to substitute a new, more comprehensive, multipurpose assessment instrument, the Minimum Data Set-Post-Acute Care (MDS-PAC). This study compares the potential effects of this substitution. The MDS-PAC is a comprehensive data collection tool, with over 300 items, including sociodemographic information, pre-admission history, advance directives, cognitive and communication patterns, mood and behavior patterns, functional status, bladder/bowel management, diagnoses, medical complexities, pain status, oral/nutritional status, procedures/services, functional prognosis, and resources for discharge. To use the MDS-PAC in the new payment system, researchers needed a way to create a FIM-like motor score and a FIM-like cognitive score. A proposed translation was refined and evaluated. The goal of the report was to determine whether the planned substitution of the MDS-PAC for the FIM in the proposed inpatient rehabilitation hospital prospective payment system would adversely affect system performance, patients, or hospitals
Patient privacy, consent, and identity management in health information exchange : issues for the military health system by Susan D Hosek( )

4 editions published in 2013 in English and held by 0 WorldCat member libraries worldwide

The Military Health System (MHS) and the Veterans Health Administration (VHA) have been among the nation's leaders in health information technology (IT), including the development of health IT systems and electronic health records that summarize patients' care from multiple providers. Health IT interoperability within MHS and across MHS partners, including VHA, is one of ten goals in the current MHS Strategic Plan. As a step toward achieving improved interoperability, the MHS is seeking to develop a research roadmap to better coordinate health IT research efforts, address IT capability gaps, and reduce programmatic risk for its enterprise projects. This report contributes to that effort by identifying gaps in research, policy, and practice involving patient privacy, consent, and identity management that need to be addressed to bring about improved quality and efficiency of care through health information exchange. Major challenges include (1) designing a meaningful patient consent procedure, (2) recording patients' consent preferences and designing procedures to implement restrictions on disclosures of protected health information, and (3) advancing knowledge regarding the best technical approaches to performing patient identity matches and how best to monitor results over time. Using a sociotechnical framework, this report suggests steps for overcoming these challenges and topics for future research
Medicines as a service : a new commercial model for big pharma in the postblockbuster world by Soeren Mattke( )

4 editions published in 2012 in English and held by 0 WorldCat member libraries worldwide

The pharmaceutical industry can reconfigure its considerable resources to develop innovative and meaningful business models that are based on services related to prescription drugs for chronic conditions. We argue that such innovation beyond the pill is consistent with the core capabilities of large pharmaceutical companies and has the potential to achieve profit levels similar to those of its traditional models. Our argument is based on the fact that, although effective medicines for most chronic conditions exist, access and adherence to medicines are far from what would be needed to achieve full treatment efficacy. Therefore, value can be created by getting and keeping more patients on their drugs, and innovative business models would allow pharmaceutical companies to capture that value
The Collegiate Learning Assessment : setting standards for performance at a college or university by Chaitra M Hardison( )

1 edition published in 2009 in English and held by 0 WorldCat member libraries worldwide

"This report describes the application of a technique for setting standards on the Collegiate Learning Assessment (CLA), a measure of critical thinking value-added at higher education institutions. The goal of the report is to illustrate how institutions can set their own standards on the CLA using a method that is appropriate for the unique characteristics of the CLA."--Provided by publisher
Assessing alternative modifications to the Affordable Care Act impact on individual market premiums and insurance coverage by Christine Eibner( )

2 editions published in 2014 in English and held by 0 WorldCat member libraries worldwide

This report summarizes analysis in which the COMPARE microsimulation model was used to estimate how several potential changes to the ACA, including eliminating the individual mandate, eliminating the law's tax-credit subsidies, and combined scenarios that change these and other provisions of the act, might affect 2015 individual market premiums and overall insurance coverage. Underlying these estimates is our COMPARE-based analysis of how premiums and insurance coverage outcomes depend on young adults' propensity to enroll in insurance coverage
Evaluating the Impact of Prevention and Early Intervention Activities on the Mental Health of California's Population by Katherine Watkins( )

1 edition published in 2012 in English and held by 0 WorldCat member libraries worldwide

In 2004, California voters passed the Mental Health Services Act, which was intended to transform California's community mental health system from a crisis-driven system to one that included a focus on prevention and wellness. The vision was that prevention and early intervention (PEI) services comprised the first step in a continuum of services designed to identify early symptoms and prevent mental illness from becoming severe and disabling. Twenty percent of the act's funding was dedicated to PEI services. The act identified seven negative outcomes that PEI programs were intended to reduce: suicide, mental health-related incarcerations, school failure, unemployment, prolonged suffering, homelessness, and removal of children from the home. The Mental Health Services Oversight and Accountability Commission (MHSOAC) coordinated with the California Mental Health Services Authority (CalMHSA), an independent administrative and fiscal intergovernmental agency, to seek development of a statewide framework for evaluating and monitoring the short- and long-term impact of PEI funding on the population. CalMHSA selected the RAND Corporation to develop a framework for the statewide evaluation. This report describes the approach, the data sources, and the frameworks developed: an overall approach framework and outcome-specific frameworks
The evolving role of emergency departments in the United States by Kristy Gonzalez Morganti( )

1 edition published in 2013 in English and held by 0 WorldCat member libraries worldwide

The research described in this report was performed to develop a more complete picture of how hospital emergency departments (EDs) contribute to the U.S. health care system, which is currently evolving in response to economic, clinical, and political pressures. Using a mix of quantitative and qualitative methods, it explores the evolving role that EDs and the personnel who staff them play in evaluating and managing complex and high-acuity patients, serving as the key decisionmaker for roughly half of all inpatient hospital admissions, and serving as "the safety net of the safety net" for patients who cannot get care elsewhere. The report also examines the role that EDs may soon play in either contributing to or helping to control the rising costs of health care
Invisible wounds of war : psychological and cognitive injuries, their consequences, and services to assist recovery by Terri L Tanielian( )

1 edition published in 2008 in English and held by 0 WorldCat member libraries worldwide

Since October 2001, approximately 1.64 million U.S. troops have been deployed for Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) in Afghanistan and Iraq. Early evidence suggests that the psychological toll of these deployments -- many involving prolonged exposure to combat-related stress over multiple rotations -- may be disproportionately high compared with the physical injuries of combat. In the face of mounting public concern over post-deployment health care issues confronting OEF/OIF veterans, several task forces, independent review groups, and a Presidential Commission have been convened to examine the care of the war wounded and make recommendations. Concerns have been most recently centered on two combat-related injuries in particular: post-traumatic stress disorder and traumatic brain injury. With the increasing incidence of suicide and suicide attempts among returning veterans, concern about depression is also on the rise. The study discussed in this monograph focuses on post-traumatic stress disorder, major depression, and traumatic brain injury, not only because of current high-level policy interest but also because, unlike the physical wounds of war, these conditions are often invisible to the eye, remaining invisible to other servicemembers, family members, and society in general. All three conditions affect mood, thoughts, and behavior; yet these wounds often go unrecognized and unacknowledged. The effect of traumatic brain injury is still poorly understood, leaving a large gap in knowledge related to how extensive the problem is or how to address it. RAND conducted a comprehensive study of the post-deployment health-related needs associated with these three conditions among OEF/OIF veterans, the health care system in place to meet those needs, gaps in the care system, and the costs associated with these conditions and with providing quality health care to all those in need. This monograph presents the results of our study, which should be of interest to mental health treatment providers; health policymakers, particularly those charged with caring for our nation's veterans; and U.S. service men and women, their families, and the concerned public. All the research products from this study are available at http://veterans.rand.org. Data collection for this study began in April 2007and concluded in January 2008. Specific activities included a critical reviewof the extant literature on the prevalence of post-traumatic stress disorder, major depression, and traumatic brain injury and their short- and long-term consequences; a population-based survey of service members and veterans who served in Afghanistan or Iraq to assess health status and symptoms, as well asutilization of and barriers to care; a review of existing programs to treat service members and veterans with the three conditions; focus groups withmilitary service members and their spouses; and the development of a microsimulation model to forecast the economic costs of these conditions overtime. Among our recommendations is that effective treatments documented in the scientific literature -- evidence-based care -- are available for PTSD and major depression. Delivery of such care to all veterans with PTSD or majordepression would pay for itself within two years, or even save money, by improving productivity and reducing medical and mortality costs. Such care may also be a cost-effective way to retain a ready and healthy military force for the future. However, to ensure that this care is delivered requires system-level changes across the Department of Defense, the Department of Veterans Affairs, and the U.S. health care system
 
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Trends in special medicare payments and service utilization for rural areas in the 1990s
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The role of faith-based organizations in HIV prevention and care in Central AmericaMaintaining military medical skills during peacetime : outlining and assessing a new approachUnderstanding the public health implications of prisoner reentry in California : phase I report