RAND Health Insurance Experiment

The RAND Health Insurance Experiment RAND HIE was an experimental examine from 1974 to 1982 of health care costs, utilization in addition to outcomes in the United States, which assigned people randomly to different kinds of plans and followed their behavior. Because it was the randomized controlled trial, it present stronger evidence than the more common observational studies and concluded that cost sharing reduced "inappropriate or unnecessary" medical care overutilization but also reduced "appropriate or needed" medical care.

Methods

The RAND HIE was begun in 1971 by a combine led by health economist Joseph Newhouse and including health value researchers Robert Brook and John Ware; health economists Willard Manning, Emmett Keeler, Arleen Leibowitz, and Susan Marquis; and statisticians Carl Morris and Naihua Duan. The combine generation out tothis impeach among others: "Does free medical care lead to better health than insurance plans that require the patient to shoulder part of the cost?"

The team establish an insurance company using funding from the United States Department of Health, Education, and Welfare. The organization randomly assigned 5809 people to insurance plans that had no symbolize sharing, 25%, 50% or 95% coinsurance rates with a maximum annual payment of $1000. It also randomly assigned 1,149 persons to a staff benefit example health maintenance organization HMO, the Group Health Cooperative of Puget Sound. That group faced no equal sharing and was compared with those in the fee-for-service system with no cost sharing as living as an additional 733 members of the Cooperative who were already enrolled in it.