Health Care Financing and Payment

RTI researchers study policy issues in health care financing and reimbursement, including the design and evaluation of health care insurance, payment, and financing systems. Paying particular attention to the role of financial incentives in health care, we analyze costs, financial outcomes, quality, and efficiency. Our researchers design, implement, and evaluate payment methods as well as analyze the choices and decisions of individuals and the behavior of health care professionals and institutions in the health care marketplace.

Focus Areas

  • Provider and health plan reimbursement and payment systems
  • Financial incentives, including pay for performance
  • Health care costs and utilization
  • Health care markets and competition
  • Benefits and characteristics of alternative health insurance models

Capabilities

  • Development, implementation, and evaluation of payment and delivery models for government health programs
  • Rate-setting and simulation analysis
  • Descriptive and policy analysis of large medical claims and prescription drug data sets
  • Risk adjustment methodologies

Clients

  • Centers for Disease Control and Prevention
  • Centers for Medicare & Medicaid Services
  • Department of Defense TRICARE Management Authority
  • Department of Health and Human Services' Assistant Secretary for Planning and Evaluation
  • Institute of Medicine
  • Medicaid and CHIP Payment and Access Commission
  • Medicare Payment Advisory Commission
  • National Cancer Institute
  • Rhode Island Quality Institute
  • States of Maryland, Massachusetts, New Hampshire, and West Virginia
  • U.S. News & World Report
Affordable Care Act risk transfers calculated using RTI International-developed methodology

For the first time, the U.S. federal government has calculated risk transfers among insurers participating in the sta... Read more »


Experts

people-photo Gregory C. Pope
Director, Health Care Financing and Payment Program
people-photo Henry Bachofer
Senior Research Public Health Analyst
people-photo Melvin J. Ingber
Principal Scientist
people-photo John Kautter
Principal Scientist
people-photo Jerry Cromwell
Senior Fellow, Health Economics
people-photo Leslie Greenwald
Principal Scientist
people-photo Sujha Subramanian
Fellow, Cancer Economics and Policy; Senior Health Economist