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103D CONGRESS

2D SESSION H. R. 4463

To provide for studies in order to establish a basis for evaluating the impact

of health care reform.

IN THE HOUSE OF REPRESENTATIVES

MAY 19, 1994

Mr. STUDDS introduced the following bill; which was referred jointly to the

Committees on Energy and Commerce and Ways and Means

A BILL

To provide for studies in order to establish a basis for

evaluating the impact of health care reform.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Health Care Reform

5 Assessment Act of 1994’’.

6 SEC. 2. IDENTIFYING STRATEGIES FOR ASSESSING IMPACT

7 OF HEALTH CARE REFORM.

8 (a) IN GENERAL.—Within 90 days after the date of

9 the enactment of this Act, the Secretary of Health and

10 Human Services shall seek to enter into an agreement
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1 with the Institute of Medicine of the National Academy

2 of Sciences (or another nonprofit, nongovernmental orga3 nization or consortium of institutions) to study and report

4 on the impact of health care reform legislation at the na5 tional, regional, and State levels.

6 (b) PURPOSE.—The purpose of the study under this

7 section is to develop a detailed framework, using a pro8 spective, longitudinal study design, to assess the impact

9 of health care reforms on national goals, such as the goals

10 of assuring security of coverage, promoting simplicity of

11 administration, achieving health care savings, encouraging

12 individual responsibility, improving quality of care, pro13 moting choice, and improving health status.

14 (c) REPORT.—The Secretary shall require the organi15 zation conducting the study under this section to submit

16 to the Secretary and the Congress a report within 18

17 months after the date of the enactment of this Act. The

18 report shall include recommendations regarding each of

19 the following:

20 (1) What are appropriate indicators of national

21 progress towards meeting the national goals referred

22 to in subsection (b).

23 (2) What are appropriate study designs that

24 would assess the impact of health care reform on

25 these indicators and that could take into account
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1 different approaches to health care reform that may

2 be used in different States and regions (or by dif3 ferent Federal agencies), as well as by foreign coun4 tries.

5 (3) What are data elements and public and pri6 vate sources of information for measuring such indi7 cators. With respect to such elements:

8 (A) What special requirements or authori9 ties are needed to permit access to confidential

10 data (and to assure continued confidentiality of

11 such data) needed to measure such indicators.

12 (B) What methods for obtaining these data

13 elements that are not currently in use would be

14 useful.

15 (C) What are the approaches to establish16 ing a core set of primary data as part of a na17 tional health care reform collection effort that

18 could overlap with the evaluation of health care

19 reform.

20 (D) What should be the relationship be21 tween Federal, State, and local agencies to

22 gather, report, and share information on health

23 care reform and its assessment.
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1 (4) What are the nature, scope, and frequency

2 of reports that would best serve the Secretary and

3 the Congress for evaluating health reform efforts.

4 (5) What are the overall cost estimates associ5 ated with obtaining and evaluating this information

6 on the impact of health care reform.

7 (6) What are the ways that health care reform

8 assessment findings could be used by various groups,

9 such as patients, providers, insurers, employers, tax10 payers, and various government agencies.

11 (d) AUTHORIZATION OF APPROPRIATIONS.—There is

12 authorized to be appropriated $1,000,000 to carry out the

13 study under this section.

14 SEC. 3. DEVELOPING BASELINE FOR EVALUATING HEALTH

15 CARE REFORM.

16 (a) IN GENERAL.—Not later than 1 year after the

17 date of the enactment of this Act, the Secretary of Health

18 and Human Services shall seek to enter into an agreement

19 with the Institute of Medicine of the National Academy

20 of Sciences (or another nonprofit, nongovernmental orga21 nization or consortium of institutions) to develop and re22 port on baseline information to measure access to, and

23 quality and cost of, health care and the individual and

24 public health status of permanent residents of the United

25 States.
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1 (b) PURPOSE.—The purpose of the study under this

2 section is to establish a benchmark for assessing the short3 term and long-term impact of health care reform efforts

4 at the national, regional, and State level.

5 (c) RELATION TO OTHER STUDY.—

6 (1) DESIGN.—The baseline information to be

7 collected under this section shall be based, to the ex8 tent reasonable, on the study designs, data sources,

9 and indicators likely to be included in recommenda10 tions made under section 2(c).

11 (2) COORDINATION.—The Secretary shall seek,

12 to the extent reasonable, to enter into an agreement

13 under this section with the same organization that

14 is conducting the study under section 2, in order to

15 facilitate the maximum cooperation and coordination

16 in the performance of both studies.

17 (d) REPORT.—

18 (1) IN GENERAL.—The Secretary shall require

19 the organization conducting the study under this

20 section to submit to the Secretary and the Congress

21 a report within 30 months after the date of the en22 actment of this Act. The report shall include infor23 mation and assessments regarding the following (as

24 of the date of the enactment of this Act or prior to

25 implementation of health care reform):
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1 (A) The levels of access to health care

2 services.

3 (B) The levels of quality of care of those

4 services.

5 (C) The cost of the care provided, based on

6 measures such as cost of services, the cost of

7 treating various conditions, and the average and

8 marginal cost of maintaining and improving

9 health.

10 (D) The health status of the public, as a

11 whole and by population subgroups.

12 (2) BASIS.—The information described in para13 graph (1) shall be reported in a manner that permits

14 separate evaluation of—

15 (A) health care services in the public and

16 private sectors, and

17 (B) different types of services, including

18 institutional services, ambulatory services, acute

19 services, long-term care services, mental health

20 services, and population-based services in the

21 public and private sectors.

22 (e) AUTHORIZATION OF APPROPRIATIONS.—There is

23 authorized to be appropriated $3,000,000 to carry out the

24 study under this section.

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