| Rand Health Insurance Experiment |
Article Index for Rand |
Website Links For Rand |
Information AboutRand Health Insurance Experiment |
| CATEGORIES ABOUT RAND HEALTH INSURANCE EXPERIMENT | |
| healthcare | |
| insurance | |
| rand corporation | |
|
The RAND Health Insurance Experiment (RAND HIE) was a comprehensive study of Health Care cost, utilization and outcome in the United States. It is the only randomized study of health insurance, and the only study which can give definitive evidence as to the causal effects of different health insurance plans. Most health economics studies are observational, and can only give associational evidence. Although the fieldwork of the study was conducted between 1974 and 1982, the results are still highly relevant, since RAND HIE is the only study which can make causal statements. CONCLUSIONS Newhouse, in summarizing the RAND study, reported that visits to doctors and hospitals decline with higher cost sharing "although for low income families such cutbacks reduced their use of beneficial as well as unnecessary services and was estimated to have increased rates of death from preventable illness."Newhouse JP, Consumer-directed health plans and the RAND health insurance experiment, Health Affairs 2004;23:107-13 (Cited in BMJ 334:238) In the general study group, there was no measurable difference in health states between the groups, but for subgroups such as the chronically ill, chronic illnesses such as diabetes and high blood pressure were not as well controlled among the high cost-sharing group than among the low cost-sharing groups. In a 2007 update, RAND researchers published a review of the literature on cost sharing published between 1985 and 2006. They concluded:
HISTORY In using funding from the then- United States Department Of Health, Education, And Welfare . The company insured 5809 people, Random ly assigned to insurance plans that either had no cost-sharing, 25, 50 or 95% copayment rates with a maximum annual payment of $1000. It also randomly assigned 1,149 persons to a staff model HMO, the Group Health Co-operative of Puget Sound. That group faced no cost sharing and was compared with those in the fee-for-service system with no cost sharing as well as an additional 733 members of the Co-operative who were already enrolled in it. The study opened the way for increased cost-sharing for medical care in the 1980s and 1990s. NOTES REFERENCES Online
Hard Copy
|
|
|