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  • 2010-2014  (14)
  • 2005-2009
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  • RAND Health  (14)
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  • 2010-2014  (14)
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  • 1
    Online Resource
    Online Resource
    Patient privacy, consent, and identity management in health information exchange : issues for the military health system (2013)
    Santa Monica, CA : RAND
    Details
    ISBN: 9780833077974 , 0833077996 , 0833077902 , 0833077988 , 083307797X , 9780833077981 , 9780833077905 , 9780833077998
    Language: English
    Pages: 1 Online-Ressource (xxiii, 78 pages)
    Parallel Title: Print version Hosek, Susan D Patient privacy, consent, and identity management in health information exchange
    DDC: 610.285
    Keywords: Medical records Access control ; Medicine, Military Information services ; Medical informatics ; Information storage and retrieval systems Medical care ; Medical records ; Medicine, Military ; Medical informatics ; Information storage and retrieval systems ; Medical Records ; Confidentiality ; Informed Consent ; Medical Informatics ; Military Medicine ; Military Personnel ; MEDICAL ; Allied Health Services ; Medical Technology ; HEALTH & FITNESS ; Holism ; HEALTH & FITNESS ; Reference ; MEDICAL ; Alternative Medicine ; MEDICAL ; Atlases ; MEDICAL ; Essays ; MEDICAL ; Family & General Practice ; MEDICAL ; Holistic Medicine ; MEDICAL ; Osteopathy ; Armed Forces ; Medical care ; Information storage and retrieval systems ; Medical care ; Medical informatics ; Medical records ; Access control ; Medicine, Military ; Information services ; Medicine ; Health & Biological Sciences ; Medical & Biomedical Informatics ; United States ; United States Armed Forces ; Medical care ; United States ; United States ; Uniteed States ; Electronic books
    Abstract: 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
    Abstract: 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
    Note: "RAND Arroyo Center and RAND Health , Includes bibliographical references
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  • 2
    Online Resource
    Online Resource
    The evolving role of emergency departments in the United States (2013)
    Santa Monica, CA : RAND
    Details
    ISBN: 9780833080820 , 0833080822 , 9780833080806 , 0833080792 , 0833080806 , 9780833080790
    Language: English
    Pages: 1 Online-Ressource (xi, 63 pages)
    Edition: Santa Monica, CA RAND Electronic reproduction; Available via World Wide Web
    Parallel Title: Online version Morganti, Kristy Gonzalez Evolving role of emergency departments in the United States
    Parallel Title: Print version Evolving role of emergency departments in the United States
    DDC: 362.18
    Keywords: Emergency medical services ; Hospitals Emergency services ; Emergency medicine ; Emergency medical services ; Hospitals ; Emergency medicine ; Emergency Service, Hospital trends ; Emergency Service, Hospital economics ; Electronic books ; Public Health ; Emergency medicine ; POLITICAL SCIENCE ; Public Policy ; Social Security ; Emergency medical services ; Hospitals ; Emergency services ; United States ; Health & Biological Sciences ; Hospitals & Medical Centers ; POLITICAL SCIENCE ; Public Policy ; Social Services & Welfare ; United States ; Electronic book
    Abstract: 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
    Abstract: 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
    Note: "RAND Health , Includes bibliographical references (pages 57-63) , Electronic reproduction; Available via World Wide Web
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  • 3
    Online Resource
    Online Resource
    CMS Innovation Center Health Care Innovation Awards : evaluation plan (2013)
    Santa Monica, CA : RAND
    Details
    ISBN: 9780833083043 , 083308304X
    Language: English
    Pages: 1 Online-Ressource (133 pages)
    Keywords: Centers for Medicare & Medicaid Services (U.S.) ; Centers for Medicare & Medicaid Services (U.S.) ; Medicare ; Medicaid ; Health services administration Awards ; Medical care Awards ; Medicare ; Medicaid ; Health services administration ; Medical care ; Program Evaluation methods ; Benchmarking ; Organizational Innovation ; Cost Savings methods ; Quality of Health Care ; MEDICAL ; Evidence-Based Medicine ; Centers for Medicare & Medicaid Services (U.S.) ; Medicare ; United States ; Medicaid ; Electronic books
    Abstract: The Center for Medicare and Medicaid Innovation within the Centers for Medicare & Medicaid Services (CMS) has funded 108 Health Care Innovation Awards, funded through the Affordable Care Act, for applicants who proposed compelling new models of service delivery or payment improvements that promise to deliver better health, better health care, and lower costs through improved quality of care for Medicare, Medicaid, and Children⁰́₉s Health Insurance Program enrollees. CMS is also interested in learning how new models would affect subpopulations of beneficiaries (e.g., those eligible for Medicare and Medicaid and complex patients) who have unique characteristics or health care needs that could be related to poor outcomes. In addition, the initiative seeks to identify new models of workforce development and deployment, as well as models that can be rapidly deployed and have the promise of sustainability. This report describes a strategy for evaluating the results. The goal for the evaluation design process is to create standardized approaches for answering key questions that can be customized to similar groups of awardees and that allow for rapid and comparable assessment across awardees. The evaluation plan envisions that data collection and analysis will be carried out on three levels: at the level of the individual awardee, at the level of the awardee grouping, and as a summary evaluation that includes all awardees. Key dimensions for the evaluation framework include implementation effectiveness, program effectiveness, workforce issues, impact on priority populations, and context. The ultimate goal is to identify strategies that can be employed widely to lower cost while improving care
    Abstract: The Center for Medicare and Medicaid Innovation within the Centers for Medicare & Medicaid Services (CMS) has funded 108 Health Care Innovation Awards, funded through the Affordable Care Act, for applicants who proposed compelling new models of service delivery or payment improvements that promise to deliver better health, better health care, and lower costs through improved quality of care for Medicare, Medicaid, and Children⁰́₉s Health Insurance Program enrollees. CMS is also interested in learning how new models would affect subpopulations of beneficiaries (e.g., those eligible for Medicare and Medicaid and complex patients) who have unique characteristics or health care needs that could be related to poor outcomes. In addition, the initiative seeks to identify new models of workforce development and deployment, as well as models that can be rapidly deployed and have the promise of sustainability. This report describes a strategy for evaluating the results. The goal for the evaluation design process is to create standardized approaches for answering key questions that can be customized to similar groups of awardees and that allow for rapid and comparable assessment across awardees. The evaluation plan envisions that data collection and analysis will be carried out on three levels: at the level of the individual awardee, at the level of the awardee grouping, and as a summary evaluation that includes all awardees. Key dimensions for the evaluation framework include implementation effectiveness, program effectiveness, workforce issues, impact on priority populations, and context. The ultimate goal is to identify strategies that can be employed widely to lower cost while improving care
    Note: "This research was conducted by RAND Health"--Preface , "RAND Corporation , Includes bibliographical references , Title from title screen (viewed August 9, 2013)
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  • 4
    Online Resource
    Online Resource
    Delaying the employer mandate : small change in the short term, big cost in the long run (2013)
    Santa Monica, CA : RAND
    Details
    ISBN: 9780833083074 , 0833083074
    Language: English
    Pages: 1 Online-Ressource (4 pages)
    DDC: 344.73022
    Keywords: United States ; United States ; Health care reform ; Health care reform ; Health Care Reform ; Insurance Coverage ; Insurance, Health economics ; Health care reform ; Patient Protection and Affordable Care Act (United States) ; United States ; Electronic books
    Abstract: In July 2013, the Obama administration announced a one-year delay in enforcement of the Affordable Care Act⁰́₉s (ACA) penalty on large employers that do not offer affordable health insurance coverage. To help policymakers understand the implications of this decision, RAND analysts employed the COMPARE microsimulation model to gauge the impact of the one-year delay of the so-called employer mandate. They found that the delay will not have a large impact on insurance coverage: Because relatively few firms and employees are affected, only 300,000 fewer people, or 0.2% of the population, will have access to insurance from their employer, and nearly all of these will get insurance from another source. However, a one-year delay in implementation of the mandate will result in $11 billion dollars less in federal inflows from employer penalties for that year. A full repeal of the employer mandate would cause revenue to fall by $149 billion over the next ten years (10% of the ACA⁰́₉s spending offsets), providing substantially less money to pay for other components of the law. The bottom line: the on-year delay in the employer mandate will have relatively few consequences, primarily resulting in a relatively small one-year drop in revenue; however, a complete elimination of the mandate would have a large cumulative net cost, potentially removing a nontrivial revenue source that in turn funds the coverage provisions in the ACA
    Note: "RAND Corporation , Includes bibliographical references , Title from title screen (viewed August 9, 2013)
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  • 5
    Online Resource
    Online Resource
    Exploring the addition of physician identifiers to the California hospital discharge data set (2013)
    Santa Monica, CA : RAND
    Details
    ISBN: 9780833082770 , 0833082779
    Language: English
    Pages: 1 Online-Ressource (61 pages)
    DDC: 362.1109794021
    Keywords: Medical care Handbooks, manuals, etc Data processing ; Hospitals Admission and discharge ; Data processing ; Medical care ; Hospitals ; Data Collection ; Patient Discharge ; Practice Patterns, Physicians' ; Hospitalization ; Medical care ; Data processing ; Handbooks and manuals ; California ; Hospitals ; Admission and discharge ; Data processing ; California ; Electronic books
    Abstract: To advance consideration of whether California should collect and release physician-identified data, RAND conducted a study to explore issues associated with requiring the inclusion of physician identifiers in the California hospital discharge data set and the potential use of physician-identified data by the state and/or release to others. RAND researchers conducted interviews with a broad set of California stakeholders, reviewed the legal and regulatory authority of the Office of Statewide Health Planning and Development to collect and release physician identifiers, and interviewed representatives from other states to understand any issues encountered by the states in their collection and use of physician-identified data. The authors found that physician-identified data could be useful to a variety of stakeholders. Of the 48 states that have hospital discharge reporting programs, all but California collect physician identifiers and do so without substantial burden to hospitals. States vary in their release policies, but those who do release the data have not reported problems. California stakeholders expressed concerns related to who would have access to the data, how the data would be analyzed, and how consumers would interpret the information, which should be carefully considered in efforts to advance the collection of physician identifiers in the California hospital discharge data
    Abstract: To advance consideration of whether California should collect and release physician-identified data, RAND conducted a study to explore issues associated with requiring the inclusion of physician identifiers in the California hospital discharge data set and the potential use of physician-identified data by the state and/or release to others. RAND researchers conducted interviews with a broad set of California stakeholders, reviewed the legal and regulatory authority of the Office of Statewide Health Planning and Development to collect and release physician identifiers, and interviewed representatives from other states to understand any issues encountered by the states in their collection and use of physician-identified data. The authors found that physician-identified data could be useful to a variety of stakeholders. Of the 48 states that have hospital discharge reporting programs, all but California collect physician identifiers and do so without substantial burden to hospitals. States vary in their release policies, but those who do release the data have not reported problems. California stakeholders expressed concerns related to who would have access to the data, how the data would be analyzed, and how consumers would interpret the information, which should be carefully considered in efforts to advance the collection of physician identifiers in the California hospital discharge data
    Note: "RAND Health , Includes bibliographical references , Title from title screen (viewed on January 25, 2013)
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  • 6
    Online Resource
    Online Resource
    A two-step procedure to estimate participation and premiums in multistate health plans (2013)
    Santa Monica, CA : RAND
    Details
    ISBN: 9780833082893 , 0833082892
    Language: English
    Pages: 1 Online-Ressource (55 pages)
    DDC: 368.38/200973
    Keywords: United States ; United States ; Health insurance ; Health insurance ; United States ; Patient Protection and Affordable Care Act (United States) ; Health insurance ; Electronic books
    Abstract: Multistate plans (MSPs) provide an attractive alternative among the health insurance plans established by the Affordable Care Act (ACA) because they will have to be offered in multiple states. In this study, the authors⁰́₉ first objective was to identify and characterize population groups that would likely be interested in enrolling in MSPs (Phase 1 of the study). The second objective was to develop a methodology to project participation and to estimate premiums for these plans (Phase 2). For this second phase, the authors developed a two-step procedure to estimate the demand for MSPs. In the first step, they used the COMPARE microsimulation model and its utility maximization algorithms to project enrollment, irrespective of whether exchange participants choose an MSP or another exchange plan. The second step consists of calculating MSP premiums by means of a tool written in the R language that separates MSP participants from enrollees in other exchange plans using criteria selectable by the user. In this report, the authors present results from Phase 1 and from the first step of Phase 2 and explain the methodology and challenges associated with the second step. National-level microsimulation results suggest that three target population groups expected to prefer MSPs are also more likely to join the exchanges than the general population by over two percentage points. States with a higher uninsurance rate and lower participation in the nongroup market under current law, such as Texas, are projected to have a larger percentage enrollment in the individual market exchanges after enactment of the ACA. Thus, these states may also have a higher percentage of MSP participants than other states. The main policy recommendation is for the Office of Personnel Management to make use of the findings of this report and to exercise the MSP premium calculator tool to aid in the implementation of the Multistate Plan Program
    Abstract: Multistate plans (MSPs) provide an attractive alternative among the health insurance plans established by the Affordable Care Act (ACA) because they will have to be offered in multiple states. In this study, the authors⁰́₉ first objective was to identify and characterize population groups that would likely be interested in enrolling in MSPs (Phase 1 of the study). The second objective was to develop a methodology to project participation and to estimate premiums for these plans (Phase 2). For this second phase, the authors developed a two-step procedure to estimate the demand for MSPs. In the first step, they used the COMPARE microsimulation model and its utility maximization algorithms to project enrollment, irrespective of whether exchange participants choose an MSP or another exchange plan. The second step consists of calculating MSP premiums by means of a tool written in the R language that separates MSP participants from enrollees in other exchange plans using criteria selectable by the user. In this report, the authors present results from Phase 1 and from the first step of Phase 2 and explain the methodology and challenges associated with the second step. National-level microsimulation results suggest that three target population groups expected to prefer MSPs are also more likely to join the exchanges than the general population by over two percentage points. States with a higher uninsurance rate and lower participation in the nongroup market under current law, such as Texas, are projected to have a larger percentage enrollment in the individual market exchanges after enactment of the ACA. Thus, these states may also have a higher percentage of MSP participants than other states. The main policy recommendation is for the Office of Personnel Management to make use of the findings of this report and to exercise the MSP premium calculator tool to aid in the implementation of the Multistate Plan Program
    Note: "RAND Health , Includes bibliographical references , Title from title screen (viewed March 20, 2013)
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  • 7
    Online Resource
    Online Resource
    Factors affecting physician professional satisfaction and their implications for patient care, health systems, and health policy (2013)
    Santa Monica, CA : Rand Corp
    Details
    ISBN: 9780833082213 , 0833082213 , 9780833082206 , 0833083627 , 0833082205 , 9780833083623
    Language: English
    Pages: 1 Online-Ressource (150 pages)
    Series Statement: Research report
    Parallel Title: Print version Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care, Health Systems, and Health Policy
    Keywords: Physicians Attitudes ; Physicians Job satisfaction ; Medical care Quality control ; Medicine Practice ; Physicians ; Physicians ; Medical care ; Medicine ; Job Satisfaction ; Quality of Health Care ; Professional Practice ; Electronic Health Records utilization ; Physicians psychology ; Electronic books ; Physicians ; Job satisfaction ; Medicine ; Practice ; Medical Professional Practice ; Medical care ; Quality control ; MEDICAL ; Evidence-Based Medicine ; Physicians ; Attitudes ; United States ; Health & Biological Sciences ; Medicine ; United States ; Electronic books
    Abstract: 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
    Abstract: 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
    Note: "RR-439-AMA , "Produced within RAND Health, a division of the RAND Corporation , Includes bibliographical references
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  • 8
    Online Resource
    Online Resource
    Evaluation of the Council to Improve Foodborne Outbreak Response (CIFOR) Guidelines for foodborne disease outbreak response and associated toolkit (2013)
    Santa Monica, CA : RAND Health
    Details
    ISBN: 9780833083685 , 0833083686
    Language: English
    Pages: 1 Online-Ressource (1 PDF file (xiv, 58 pages)))
    Series Statement: Research report RR-307-CSTE
    DDC: 615.954
    Keywords: Council to Improve Foodborne Outbreak Response (U.S.) ; Foodborne diseases Prevention ; Foodborne diseases ; Disease Outbreaks prevention & control ; Guidelines as Topic ; Foodborne Diseases epidemiology ; Foodborne Diseases prevention & control ; United States ; Foodborne diseases ; Prevention ; Electronic books ; Evaluation Studies
    Abstract: Foodborne disease is a significant public health problem. Estimates from the U.S. Centers for Disease Control and Prevention (CDC) indicate that, in 2011, approximately one in six individuals in the United States was affected by a foodborne disease, resulting in 127,839 hospitalizations and roughly 3,000 deaths (Centers for Disease Control and Prevention, 2011; Scallan et al., 2011). With reducing the burden of foodborne disease among its primary goals, CIFOR developed the Guidelines for Foodborne Outbreak Response (2009) and a companion Toolkit (2011) to facilitate improvements in foodborne disease outbreak detection and response at the state and local levels. The objective of this study is to assess the distribution and use of the CIFOR Guidelines and Toolkit to determine whether and to what extent they are reaching their intended users and achieving their intended goals. Findings from this evaluation provide important information about how the dissemination, content, and structure of the Guidelines and Toolkit can be changed to facilitate their use and further improve foodborne outbreak response
    Abstract: Foodborne disease is a significant public health problem. Estimates from the U.S. Centers for Disease Control and Prevention (CDC) indicate that, in 2011, approximately one in six individuals in the United States was affected by a foodborne disease, resulting in 127,839 hospitalizations and roughly 3,000 deaths (Centers for Disease Control and Prevention, 2011; Scallan et al., 2011). With reducing the burden of foodborne disease among its primary goals, CIFOR developed the Guidelines for Foodborne Outbreak Response (2009) and a companion Toolkit (2011) to facilitate improvements in foodborne disease outbreak detection and response at the state and local levels. The objective of this study is to assess the distribution and use of the CIFOR Guidelines and Toolkit to determine whether and to what extent they are reaching their intended users and achieving their intended goals. Findings from this evaluation provide important information about how the dissemination, content, and structure of the Guidelines and Toolkit can be changed to facilitate their use and further improve foodborne outbreak response
    Note: "Sponsored by the Council of State and Territorial Epidemiologists , Includes bibliographical references , Title from PDF title page
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  • 9
    Online Resource
    Online Resource
    Oral health in the District of Columbia : parental and provider perspectives (2013)
    Santa Monica, CA : RAND Health
    Details
    ISBN: 9780833082817 , 0833082817
    Language: English
    Pages: 1 Online-Ressource (1 PDF file (xi, 31 pages)))
    Series Statement: Research report RR-179-CNMC
    DDC: 617.645
    Keywords: Mouth Care and hygiene ; Medicaid ; Children Dental care ; Mouth ; Medicaid ; Children ; Child ; Dental Health Services ; Oral Health ; Health Services Accessibility ; Medicaid ; Washington (D.C.) ; Children ; Dental care ; Mouth ; Care and hygiene ; District of Columbia ; Electronic books
    Abstract: Research suggests that there are significant barriers to oral health care for many children in Washington, D.C. This report assesses the perspectives of Washington, D.C., stakeholders, including parents and providers, about the oral health of children, particularly those insured by Medicaid. The authors present qualitative data from focus groups with parents and providers, from an oral health forum with primary care medical and oral health clinicians and representatives from the D.C. government, and from a provider survey. The opinions captured here provide a snapshot of the challenges to improving access to oral care for D.C. children and suggest recommendations for doing so
    Abstract: Research suggests that there are significant barriers to oral health care for many children in Washington, D.C. This report assesses the perspectives of Washington, D.C., stakeholders, including parents and providers, about the oral health of children, particularly those insured by Medicaid. The authors present qualitative data from focus groups with parents and providers, from an oral health forum with primary care medical and oral health clinicians and representatives from the D.C. government, and from a provider survey. The opinions captured here provide a snapshot of the challenges to improving access to oral care for D.C. children and suggest recommendations for doing so
    Note: Includes bibliographical references , Title from PDF title page
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  • 10
    Online Resource
    Online Resource
    The budgetary effects of Medicaid expansion on Pennsylvania : an expansion on previous work (2013)
    Santa Monica, CA : RAND
    Details
    ISBN: 9780833082947 , 0833082949
    Language: English
    Pages: 1 Online-Ressource (1 online resource)
    Parallel Title: Print version Price, Carter C Budgetary effects of Medicaid expansion on Pennsylvania
    DDC: 362.10425809798
    Keywords: United States ; United States ; Medicaid ; Medicaid ; Pennsylvania ; Patient Protection and Affordable Care Act (United States) ; Medicaid ; Electronic books
    Abstract: The Affordable Care Act is a substantial reform of the U.S. health care insurance system. In the spring of 2013, the RAND Corporation conducted an analysis assessing the budget effects of the expansion of Medicaid on the Commonwealth of Pennsylvania. The analysis was in part based on a specific set of assumptions 1) regarding the application of Pennsylvania⁰́₉s tax code and 2) about expenditures and revenue sources that could have a material impact on the budgetary outcomes. This addendum examines the sensitivity of those findings to alternative assumptions about the state budgetary effects
    Abstract: The Affordable Care Act is a substantial reform of the U.S. health care insurance system. In the spring of 2013, the RAND Corporation conducted an analysis assessing the budget effects of the expansion of Medicaid on the Commonwealth of Pennsylvania. The analysis was in part based on a specific set of assumptions 1) regarding the application of Pennsylvania⁰́₉s tax code and 2) about expenditures and revenue sources that could have a material impact on the budgetary outcomes. This addendum examines the sensitivity of those findings to alternative assumptions about the state budgetary effects
    Note: "The research described in this report was conducted within RAND Health"--Preface , "RAND Corporation , Includes bibliographical references
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  • 11
    Online Resource
    Online Resource
    Improving the deployment of Army health care professionals : an evaluation of PROFIS (2013)
    Santa Monica, CA : RAND Corporation
    Details
    ISBN: 9780833081124 , 0833081128 , 9780833078049 , 0833078046
    Language: English
    Pages: 1 Online-Ressource (xxii, 99 pages)
    Series Statement: Report TR-1227-A
    Series Statement: RAND Corporation technical report series TR1227
    DDC: 355.3/450973
    Keywords: United States Operational readiness ; United States Medical personnel ; United States Personnel management ; United States ; United States ; United States ; Military planning ; Military planning ; Persons ; Named Groups ; Disciplines and Occupations ; Military Personnel ; Military Medicine ; Occupational Groups ; Medicine ; Health Occupations ; Military planning ; Military & Naval Science ; Law, Politics & Government ; Military Administration ; United States ; United States ; Armed Forces ; Medical personnel ; Armed Forces ; Operational readiness ; Armed Forces ; Personnel management ; Electronic books
    Abstract: 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
    Abstract: 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
    Note: "The research described in this report was sponsored by the Army Office of the Surgeon General , Includes bibliographical references (pages 97-99)
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  • 12
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    The economic impact of the Affordable Care Act on Arkansas (2013)
    Santa Monica, CA : RAND
    Details
    ISBN: 9780833083760 , 0833083767
    Language: English
    Pages: 1 Online-Ressource (20 pages)
    DDC: 362.109747
    Keywords: United States Administration ; United States ; Health care reform Finance ; Health care reform ; Universal Coverage organization & administration ; Patient Protection and Affordable Care Act organization & administration ; Health Care Reform economics ; Insurance, Health economics ; Universal Health Insurance organization & administration ; Management ; Arkansas ; Patient Protection and Affordable Care Act (United States) ; Health care reform ; Finance ; Arkansas ; Electronic books
    Abstract: The Affordable Care Act (ACA) will increase coverage through the expansion of Medicaid and the creation of a Health Insurance Exchange with subsidies. RAND researchers analyzed the ACA⁰́₉s economic impact on the state of Arkansas and found that by 2016, about 400,000 people will be newly insured, net federal payments to the state will amount to $430 million annually, and the total gross domestic product will see a net increase of $550 million
    Note: "RAND Health , Includes bibliographical references , Title from title screen (viewed January 4, 2013)
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  • 13
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    Workplace wellness programs study : final report (2013)
    Santa Monica, CA : Rand Corporation
    Details
    ISBN: 9780833080738 , 0833081217 , 0833080733 , 9780833081216
    Language: English
    Pages: 1 Online-Ressource (xxxi, 137 pages)
    Series Statement: Research report
    Parallel Title: Print version Mattke, Soeren Workplace wellness programs study
    Keywords: Employee health promotion ; Occupational health services ; Health behavior ; Health promotion ; Industrial hygiene ; Employee health promotion ; Occupational health services ; Health behavior ; Health promotion ; Industrial hygiene ; Workplace ; Health Promotion ; Occupational Health Services ; Health Behavior ; Medicine ; Health & Biological Sciences ; Industrial Medicine ; United States ; Occupational health services ; MEDICAL ; Preventive Medicine ; Employee health promotion ; Health behavior ; Health promotion ; Industrial hygiene ; United States ; Electronic books
    Abstract: The report investigates the characteristics of workplace wellness programs, their prevalence, their impact on employee health and medical cost, facilitators of their success, and the role of incentives in such programs. The authors employ four data collection and analysis streams: a review of the scientific and trade literature, a national survey of employers, a longitudinal analysis of medical claims and wellness program data from a sample of employers, and five case studies of existing wellness programs in a diverse set of employers to gauge the effectiveness of wellness programs and employees' and employers' experiences
    Abstract: The report investigates the characteristics of workplace wellness programs, their prevalence, their impact on employee health and medical cost, facilitators of their success, and the role of incentives in such programs. The authors employ four data collection and analysis streams: a review of the scientific and trade literature, a national survey of employers, a longitudinal analysis of medical claims and wellness program data from a sample of employers, and five case studies of existing wellness programs in a diverse set of employers to gauge the effectiveness of wellness programs and employees' and employers' experiences
    Note: "RAND Health , "RR-254-DOL"--Page 4 of cover , Includes bibliographical references
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  • 14
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    Health care spending and efficiency in the U.S. Department of Veterans Affairs (2013)
    Santa Monica, CA : RAND
    Details
    ISBN: 9780833080295 , 0833083406 , 0833080296 , 9780833083401
    Language: English
    Pages: 1 Online-Ressource (14 pages)
    Keywords: United States Appropriations and expenditures ; Evaluation ; United States ; Veterans Medical care ; Management ; Veterans ; Expenditures, Public ; United States ; Veterans ; Medical care ; Management ; United States ; HISTORY ; Military ; General ; Electronic books
    Abstract: 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
    Note: "RAND Corporation , "The research was conducted within RAND Health"--Back cover , Caption title , Includes bibliographical references (pages 13-14)
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