Rand health quarterly最新文献

Quality and Patient Safety Review Processes in Military Treatment Facilities and Operational Clinical Services. 军事治疗设施和临床服务的质量和病人安全审查过程。

Rand health quarterly Pub Date : 2026-09-29 eCollection Date: 2026-09-01 DOI: 10.7249/rhq-13-04-07

Jason Michel Etchegaray, Peggy G Chen, Joachim O Hero, Samantha Matthews, Stacey Yi, Kimberly A Hepner

{"title":"Quality and Patient Safety Review Processes in Military Treatment Facilities and Operational Clinical Services.","authors":"Jason Michel Etchegaray, Peggy G Chen, Joachim O Hero, Samantha Matthews, Stacey Yi, Kimberly A Hepner","doi":"10.7249/rhq-13-04-07","DOIUrl":"https://doi.org/10.7249/rhq-13-04-07","url":null,"abstract":"RAND researchers assessed the quality and patient safety review processes for care delivered in military treatment facilities (MTFs) and via operational clinical services (OCSs). MTFs are fixed or permanent medical facilities. OCSs are often provided in austere or operational environments that can be temporary, mobile, or permanent. OCS settings vary widely in their infrastructure and capabilities depending on the operational needs, resources, and location. The authors conducted an assessment of seven quality and patient safety review processes: credentialing and privileging; quality assurance (QA), standard of care (SOC), and incident review; health care provider accountability; clinical quality metrics transparency; eliminating variation in clinical quality metrics; applying clinical quality management (CQM) to operational settings; and CQM organizational roles and responsibilities. They developed and deployed an internal assessment in which representatives from five U.S Department of Defense (DoD) organizations (the Assistant Secretary of Defense for Health Affairs; the Director of the Defense Health Agency [DHA]; and the Surgeons General of the Army, Navy, and Air Force) reported the ways in which they ensure that service members receive high-quality, safe care. The authors also conducted qualitative interviews with 216 personnel across 19 MTFs and OCS settings who had a role in either overseeing CQM processes or providing care. Findings were used to identify potential opportunities for improvement. Recommendations included updating lists of active OCS settings, clarifying quality and patient safety requirements, and addressing institutional knowledge loss.","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"13 4","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Health Care Access and Quality for New York Veterans Provided by the U.S. Department of Veterans Affairs and Community Care: Volume I, Understanding the Impact of Proposed Policy Changes. 美国退伍军人事务和社区护理部为纽约退伍军人提供的医疗保健机会和质量：第一卷，了解拟议政策变化的影响。

Rand health quarterly Pub Date : 2026-09-29 eCollection Date: 2026-09-01 DOI: 10.7249/rhq-13-04-06

Claire E O'Hanlon, Catria Gadwah-Meaden, Ensheng Dong, Jonathan H Cantor, Heather M Salazar, Carrie M Farmer

{"title":"Health Care Access and Quality for New York Veterans Provided by the U.S. Department of Veterans Affairs and Community Care: Volume I, Understanding the Impact of Proposed Policy Changes.","authors":"Claire E O'Hanlon, Catria Gadwah-Meaden, Ensheng Dong, Jonathan H Cantor, Heather M Salazar, Carrie M Farmer","doi":"10.7249/rhq-13-04-06","DOIUrl":"https://doi.org/10.7249/rhq-13-04-06","url":null,"abstract":"The U.S. Department of Veterans Affairs (VA) has approximately 9 million enrolled veterans annually, including over 300,000 in New York. While VA traditionally delivers care through its own facilities, the VA Community Care program allows eligible veterans to receive VA-funded care from private-sector providers. Proposed policy changes seek to expand eligibility for Community Care by relaxing or removing current standards related to drive time, wait time, and service availability. This study examines how such changes could affect access to and the quality of care for veterans in New York. The companion study (Volume II) provides supplementary methods and data that are helpful, but not critical, for understanding the analyses. Overall, expanding Community Care eligibility may modestly improve geographic access but has uncertain effects on timeliness and mixed implications for care quality for veterans in New York. Further data and modeling are needed to assess the full impact of these proposed policy changes.","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"13 4","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Qualified Medical Evaluators and the Medical-Legal Process in California Workers' Compensation. 合格的医疗评估人员和加州工人赔偿的医疗法律程序。

Rand health quarterly Pub Date : 2026-09-29 eCollection Date: 2026-09-01 DOI: 10.7249/rhq-13-04-03

Sara E Heins, Amy Mahler, Travis Hubble, Shona Olalere Oluwatola, Danya Birnbaum, Cheryl K Montemayor, Jennifer Gildner, Michael Dworsky

引用次数: 0

The Effect of the Massachusetts Health Care Cost Growth Benchmark on Hospital Revenues and Other Spending Outcomes: Associations with Hospital Revenue, Hospital Prices, and Insurance Premiums. 马萨诸塞州医疗保健成本增长基准对医院收入和其他支出结果的影响：与医院收入、医院价格和保险费的关联。

Rand health quarterly Pub Date : 2026-09-29 eCollection Date: 2026-09-01 DOI: 10.7249/rhq-13-04-02

Elizabeth Chase, Christine Eibner, Rose Kerber, Jodi L Liu

{"title":"The Effect of the Massachusetts Health Care Cost Growth Benchmark on Hospital Revenues and Other Spending Outcomes: Associations with Hospital Revenue, Hospital Prices, and Insurance Premiums.","authors":"Elizabeth Chase, Christine Eibner, Rose Kerber, Jodi L Liu","doi":"10.7249/rhq-13-04-02","DOIUrl":"https://doi.org/10.7249/rhq-13-04-02","url":null,"abstract":"In this study, the authors evaluate the effects of Massachusetts's health care cost growth benchmark-established in 2012 to constrain health care spending-on hospital revenues, health care prices, and health insurance premiums. The cost growth benchmark, enforced by the Massachusetts Health Policy Commission, sets annual spending growth targets and includes accountability measures for providers and payers. Although the cost growth benchmark was exceeded in most years since 2013, the policy may have slowed spending growth compared with what would have occurred otherwise. The study uses four statistical approaches to estimate the benchmark's effects, comparing Massachusetts hospitals and counties with various groups of hospitals and counties in other states and employing pre- and post-policy data. Results were mixed and method-dependent: Some approaches suggested that the cost growth benchmark reduced inpatient and outpatient hospital revenue and prices, while the authors found no significant effects in other approaches. There was no evidence that the benchmark affected health insurance premiums. The analysis was limited by confounding factors, especially the near-simultaneous implementation of the Affordable Care Act, and by differences among Massachusetts and comparison states. The authors caution that findings are exploratory and not causal. Overall, the evidence that the Massachusetts health care cost growth benchmark reduced hospital revenue and prices was weak and inconsistent. The authors suggest that stronger enforcement or complementary policies may be needed to more effectively control health care spending growth.","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"13 4","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

U.S. Veterans and Psychedelics: Prevalence of Use and Policy Preferences. 美国退伍军人和致幻剂：使用的普遍性和政策偏好。

Rand health quarterly Pub Date : 2026-09-29 eCollection Date: 2026-09-01 DOI: 10.7249/rhq-13-04-08

Michelle Priest, Terry L Schell, Ben Senator, Beau Kilmer

引用次数: 0

Annual Trends Among the Unsheltered in Three Los Angeles Neighborhoods: The Los Angeles Longitudinal Enumeration and Demographic Survey (LA LEADS) 2025 Annual Report. 洛杉矶三个社区无庇护者的年度趋势：洛杉矶纵向枚举和人口调查（LA LEADS） 2025年年度报告。

Rand health quarterly Pub Date : 2026-09-29 eCollection Date: 2026-09-01 DOI: 10.7249/rhq-13-04-05

Louis Abramson, Sarah B Hunter, Rick Garvey, Cyril Cherian, Jason M Ward

引用次数: 0

Letter from the Editor. 编辑来信。

Rand health quarterly Pub Date : 2026-09-29 eCollection Date: 2026-09-01

引用次数: 0

State-Level Impacts of Key Medicaid Provisions in the One Big Beautiful Bill Act. 《一个美丽的大法案》中关键医疗补助条款的州级影响。

Rand health quarterly Pub Date : 2026-09-29 eCollection Date: 2026-09-01 DOI: 10.7249/rhq-13-04-04

Preethi Rao, Lawrence Baker, Federico Girosi, Elaine Li, Rose Kerber, Christine Eibner

{"title":"State-Level Impacts of Key Medicaid Provisions in the One Big Beautiful Bill Act.","authors":"Preethi Rao, Lawrence Baker, Federico Girosi, Elaine Li, Rose Kerber, Christine Eibner","doi":"10.7249/rhq-13-04-04","DOIUrl":"https://doi.org/10.7249/rhq-13-04-04","url":null,"abstract":"On July 4, 2025, President Donald Trump signed into law the One Big Beautiful Bill Act (Public Law 119-21), a massive budget reconciliation package with implications for many sectors of the U.S. economy. The law contains a series of policy changes that aim to reduce federal spending and improve program integrity in Medicaid, the nation's joint state-funded and federally funded health program for people with low incomes and disabilities. Broadly, these Medicaid changes impose work requirements on non-disabled adults, increase the frequency and stringency of eligibility determinations and redeterminations, limit spending on immigrants, and tighten provisions that have historically enabled states to increase their federal funding. The authors of this study combined publicly available data, published literature, state and federal agency reports, and other sources of information and developed customized approaches to build state-level estimates through 2034 of Medicaid fund impact and enrollment changes associated with several key provisions of the law.","PeriodicalId":74637,"journal":{"name":"Rand health quarterly","volume":"13 4","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Developing Patient-Reported Outcome Measures of Timely Experience of Diagnosis (PROMOTE-Dx) for Cancer: Survey and Quality Measure Development Report. 开发癌症及时诊断经验（PROMOTE-Dx）的患者报告结果测量：调查和质量测量开发报告。

Rand health quarterly Pub Date : 2026-09-29 eCollection Date: 2026-09-01 DOI: 10.7249/rhq-13-04-01

Rebecca Anhang Price, Carl T Berdahl, Melissa A Bradley, Elizabeth Marsolais, Joshua M Pevnick, Danielle Schlang, Anagha Alka Tolpadi, Feifei Ye, Claire E O'Hanlon

引用次数: 0

The Science of Gun Policy: A Critical Synthesis of Research Evidence on the Effects of Gun Policies in the United States, Fifth Edition. 《枪支政策科学：美国枪支政策影响研究证据的关键综合》，第五版。

Rand health quarterly Pub Date : 2026-06-26 eCollection Date: 2026-06-01

Rosanna Smart, Andrew R Morral, James P Murphy, Rupa Jose, Amanda Charbonneau, Terry L Schell

引用次数: 0