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Lessons from the Rand Health Insurance Experiment

By: Joseph P. Newhouse,Rand Corporation. Insurance Experiment Group

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Free for All?

Lessons from the Rand Health Insurance Experiment

By: Joseph P. Newhouse,Rand Corporation. Insurance Experiment Group

In the most important health insurance study ever conducted researchers at the RAND Corporation devised all experiment to address two key questions in health care financing: how much more medical care will people use if it is provided free of charge, and what are the consequences for their health? For three- or five-year periods the experiment measured both use and health outcomes in populations carefully selected to be representative of both urban and rural regions throughout the United States. Participants were enrolled in a range of insurance plans requiring different levels of copayment for medical care, from zero to 95 percent. The researchers found that in plans that reimbursed a higher proportion of the bill, patients used substantially more services - indeed, those who paid nothing used 40 percent more services than those required to pay a high deductible - but the effect on the health of the average person was negligible. In addition, participants who were assigned at random to a well-established health maintenance organization used hospitals substantially less than those in the fee-for-service system, again with no measurable effect on the health of the average person. This book collects in one place for the first time results previously dispersed through many journals over many years. Drawing comprehensive, coherent conclusions from an immense amount of data, it is destined to be a classic work serving as an invaluable reference for all those concerned with health care policy - health service researchers, policymakers in both the public and the private sectors, and students.

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Page Count

516

Publisher

Harvard University Press

Published Date

ISBN 10

0674318463

ISBN 13

9780674318465

Medicare's Quality Improvement Organization Program

Maximizing Potential

By: Institute of Medicine,Board on Health Care Services,Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs

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Medicare's Quality Improvement Organization Program

Maximizing Potential

By: Institute of Medicine,Board on Health Care Services,Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs

Medicare's Quality Improvement Organization Program is the second book in the new Pathways to Quality Health Care series. Focusing on performance improvement, it considers the history, role, and effectiveness of the Quality Improvement Organization (QIO) program and its potential to promote quality improvement within a changing health care delivery environment that includes standardized performance measures and new data collection and reporting requirements. This book carefully examines the QIOs that serve every state as well as the national program that guides and supports them. In addition, it highlights the important roles that a national program with private organizations in each state can play in promoting higher quality care. Medicare's Quality Improvement Organization Program looks closely at the technical assistance role of the QIO program and the need to encourage and support providers to improve their performance. By providing an in-depth assessment of the federal experience with quality improvement and recommendations for program improvement, this book helps point the way for those who strive to create higher quality and better value in health care. Intended for multiple audiences, Medicare's Quality Improvement Organization Program is essential reading for members of Congress, the federal executive branch, the QIOs, health care providers and clinicians, and stakeholder groups.

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Page Count

542

Publisher

National Academies Press

Published Date

ISBN 10

0309133696

ISBN 13

9780309133692