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Issues at the Forefront of National Health Care Reform
The issue of reforming our nation’s health care system will dominate much of the policy debate in 2009 and beyond. This system, which accounts for 16 percent of our economy, produces hundreds of life-saving marvels every day, yet fails to provide affordable health care for all Americans. While consuming more resources per capita than any other health care system in the world, our system yields outcomes that are often worse than those of other countries and well below our own expectations and what seems possible. These tensions have led to broad-based public interest in finding ways to improve the quality, efficiency, affordability, equity, and financing of health care. Mathematica researchers are proud to have contributed to the base of research and data that will help guide the policy debate. Some of the most important contributions are summarized below.
How Do We Promote Access for All Americans?
 Ensuring that people can get the care they require is a central concern in health care reform. The debate centers on health insurance coverage and whether everyone who wants it can obtain it at a reasonable price. Studies of access also look at how to address issues related to physical accessibility and how to provide services to underserved communities. We have examined the following topics in this area: |
- How do we measure who is uninsured?
- What strategies work to expand coverage?
- Are there ways to make health insurance more affordable for more Americans?
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What Can Be Done to Enhance Efficiency and Promote Value?
A key issue in health reform is controlling the continued rapid rise in health care costs. Lowering costs can go a long way in making it more feasible to extend insurance coverage to more Americans. But we must also find ways to promote efficiency and increase the value delivered by the system. This includes finding ways to measure the quality of care so that steps can be taken to reward high-quality providers. It also includes the introduction of disease management and other interventions that seek to make care delivery more efficient. Some of our most relevant research in this area has addressed the following questions:
- What factors affect costs of health care?
- What methods work for measuring and reporting the quality of health care?
- How effective are disease management and care management initiatives?
- What new Medicare developments can foster health care reform?
- Do consumer education, shared decisionmaking, engagement, and other broad-based strategies help reform organization of care?
- What provider payment and financial incentives are most effective?
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How Can the Health Care System Be Made More Equitable?
Our health care system has led to disparities in care use and outcomes for different segments of society. We have sought accurate ways to measure disparities and looked at distribution of costs among individuals, employers, providers, and government. Our studies have examined the following:
- What are the nature and magnitude of disparities in access and outcomes?
- How can public policy address disparities in access and outcomes?
- How do we assess the needs of special populations and design appropriate programs?
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How Can We Make the Transition to a Higher-Performing System?
After a consensus emerges on what to do about health care, the next question will be how to move from our current system to the new one effectively. Our research has looked at health care transitions in several states at the forefront of health care reform, examined efforts by innovative demonstration programs to sustain themselves, and investigated the potential of informatics to improve the system. We have studied: