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Bing Center for Health Economics

Improving health and the efficiency of health care service delivery are among today's most vexing public policy problems. RAND economists have a long and distinguished history of applying innovative research methods to such problems. With the help of a generous donation from former RAND trustee Peter Bing, RAND created the Bing Center for Health Economics to continue and strengthen this tradition of innovative, high-profile research in health economics and health services research.

Announcements

Victor R. Fuchs Research Award Recipients Named — 2009

The RAND Corporation has presented the second Victor R. Fuchs Research Award to a team from Yale and Queen's University for publishing the best research paper with the potential to spawn new research in an underdeveloped area of health economics or health policy. The $10,000 prize has been awarded to Jason M. Fletcher of Yale University and Steven F. Lehrer of Queen's University.

Featured Research

Regulating Drug Prices — January 12, 2009

The effects of regulating drug prices in the United States in terms of the trade-off between benefiting the current generation (with lower prices) and benefiting future generations (with greater pharmaceutical innovation).

Subsidizing in vitro fertilization could have long-term economic benefits — September 30, 2008

Subsidizing in vitro fertilization might represent a net return to the government given the taxes that the child would pay over his/her lifetime.

Featured Projects

Analyzing trends in health and health care utilization among the insured population in China

The team is studying the recent development of social health insurance in selected regions in China, and aims to study the effect of policy change on individual health care expenditure, prescription drug use, and physician behavior change through itemized claim data. The group's main area of interest is diabetes care, hypertension and renal dialysis.

Impact of benefit generosity on health plan selection

This project examined the impact of benefit changes on choice of health plans and whether this impact varies by health status. Analysts examined comprehensive claims data from a major U.S. employer that introduced changes in its health plan and drug coverage offerings for non-Medicare eligible retirees between 2001 and 2002. The study team observed the same individuals across the two years, and examine the switching behavior of beneficiaries in response to the new benefits. They results showed that beneficiaries with better health status are more likely to switch to less generous plans. We separated the impact that medical generosity and the drug generosity had on plan selection. We found that although the medical generosity plays a more important role, its impact on selection does not vary significantly with health status. On the other hand, the impact of drug generosity on plan selection varies significantly with the number of prior chronic conditions. In particular, sicker individuals are more sensitive to drug benefit design.

Do hospital patients value inefficiency?

Researchers commonly assess the extent to which hospitals could operate at lower cost, that is, more "efficiently." One study of American hospitals concluded that inefficiency accounts for almost fourteen percent of total industry costs. However, hospital outputs may also include health services or amenities (such as private rooms, good food, or attentive nurses due to low staff/patient ratios) that would be labeled "inefficient" by conventional measures but that nonetheless are valued by patients. This study is assessing whether a patientís choice of hospital reveals additional information about a hospital's output and, if so, how this information can improve assessment of hospital performance.

Recent Research

A Comparison of the Health Systems in China and India — August 8, 2008

Although they have achieved substantial advances in life expectancy and disease prevention since the middle of the 20th century, the Chinese and Indian health systems provide little protection against financial risk, and patient satisfaction is a lower priority than it should be.

Prospective payment system for inpatient rehabilitation may reduce costs — July 9, 2008

A new prospective payment system for inpatient rehabilitation facilities significantly decreased costs and length of stay without impacting mortality or rates of return to the community.

Does How Much and How You Page Matter? Evidence from the Inpatient Rehabilitation Facility Prospective Payment System and Costs of Care — June 2008

The implementation of a new prospective payment system for inpatient rehabilitation facilities had little or no impact on mortality or the rate of return to community residence.

More Recent Research »

Related Publications

Information is worth a lot — February 20, 2009

More than 70 percent of all Medigap purchasers buy their policies through agents because the plan choices are very complex. But agent-sold policies cost an average of $140 more than policies sold directly to individuals.

Regulating Drug Prices — January 12, 2009

The effects of regulating drug prices in the United States in terms of the trade-off between benefiting the current generation (with lower prices) and benefiting future generations (with greater pharmaceutical innovation).

Organizational costs for quality improvement in depression care are significant — October 27, 2008

Organizational costs for improving the quality of depression care are significant and should be planned for when implementing an evidence-based depression-care program.

Prescription drug cost sharing related to reductions in pharmacy use

Increased prescription drug cost sharing results in lower rates of drug treatment, lower adherence rates among existing users, and more frequent discontinuation of therapy, as well as increased use of non-drug-related medical services in cases involving some chronic conditions.

Health Insurance Subsidies Won't Significantly Cut Number of Uninsured

Government subsidies that cut health insurance premium prices in half for people without insurance would reduce the number of uninsured Americans by just 3 percent.

Prescription Drug Cost Sharing and Access

Increased cost sharing is highly correlated with reductions in pharmacy use, worse adherence among existing users, and more frequent discontinuation of therapy.

Who decides risk-benefit balance?

This paper urges the health policy community to develop a more consistent way of thinking about when risk-benefit decisions should remain at the individual level, when they should be resolved by regulators, and when a hybrid approach involving individual and regulatory decisions is advisable.

Commercial pay-for-performance incentives linked to quality improvement initiatives

A telephone survey of physician groups in Massachusetts indicates an association between pay-for-performance incentives and the use of quality improvement initiatives.
More Related Publications »
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