I
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.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Health Care Reform
Assessment Act of 1994’’.
SEC. 2. IDENTIFYING STRATEGIES FOR ASSESSING IMPACT
OF HEALTH CARE REFORM.
(a) IN GENERAL.—Within 90 days after the date of
the enactment of this Act, the Secretary of Health and
Human Services shall seek to enter into an agreement
with the Institute of Medicine of the National Academy
of Sciences (or another nonprofit, nongovernmental orga-
nization or consortium of institutions) to study and report
on the impact of health care reform legislation at the na-
tional, regional, and State levels.
(b) PURPOSE.—The purpose of the study under this
section is to develop a detailed framework, using a pro-
spective, longitudinal study design, to assess the impact
of health care reforms on national goals, such as the goals
of assuring security of coverage, promoting simplicity of
administration, achieving health care savings, encouraging
individual responsibility, improving quality of care, pro-
moting choice, and improving health status.
(c) REPORT.—The Secretary shall require the organi-
zation conducting the study under this section to submit
to the Secretary and the Congress a report within 18
months after the date of the enactment of this Act. The
report shall include recommendations regarding each of
the following:
(1) What are appropriate indicators of national
progress towards meeting the national goals referred
to in subsection (b).
(2) What are appropriate study designs that
would assess the impact of health care reform on
these indicators and that could take into account
different approaches to health care reform that may
be used in different States and regions (or by dif-
ferent Federal agencies), as well as by foreign coun-
tries.
(3) What are data elements and public and pri-
vate sources of information for measuring such indi-
cators. With respect to such elements:
(A) What special requirements or authori-
ties are needed to permit access to confidential
data (and to assure continued confidentiality of
such data) needed to measure such indicators.
(B) What methods for obtaining these data
elements that are not currently in use would be
useful.
(C) What are the approaches to establish-
ing a core set of primary data as part of a na-
tional health care reform collection effort that
could overlap with the evaluation of health care
reform.
(D) What should be the relationship be-
tween Federal, State, and local agencies to
gather, report, and share information on health
care reform and its assessment.
(4) What are the nature, scope, and frequency
of reports that would best serve the Secretary and
the Congress for evaluating health reform efforts.
(5) What are the overall cost estimates associ-
ated with obtaining and evaluating this information
on the impact of health care reform.
(6) What are the ways that health care reform
assessment findings could be used by various groups,
such as patients, providers, insurers, employers, tax-
payers, and various government agencies.
(d) AUTHORIZATION OF APPROPRIATIONS.—There is
authorized to be appropriated $1,000,000 to carry out the
study under this section.
SEC. 3. DEVELOPING BASELINE FOR EVALUATING HEALTH
CARE REFORM.
(a) IN GENERAL.—Not later than 1 year after the
date of the enactment of this Act, the Secretary of Health
and Human Services shall seek to enter into an agreement
with the Institute of Medicine of the National Academy
of Sciences (or another nonprofit, nongovernmental orga-
nization or consortium of institutions) to develop and re-
port on baseline information to measure access to, and
quality and cost of, health care and the individual and
public health status of permanent residents of the United
States.
(b) PURPOSE.—The purpose of the study under this
section is to establish a benchmark for assessing the short-
term and long-term impact of health care reform efforts
at the national, regional, and State level.
(c) RELATION TO OTHER STUDY.—
(1) DESIGN.—The baseline information to be
collected under this section shall be based, to the ex-
tent reasonable, on the study designs, data sources,
and indicators likely to be included in recommenda-
tions made under section 2(c).
(2) COORDINATION.—The Secretary shall seek,
to the extent reasonable, to enter into an agreement
under this section with the same organization that
is conducting the study under section 2, in order to
facilitate the maximum cooperation and coordination
in the performance of both studies.
(d) REPORT.—
(1) IN GENERAL.—The Secretary shall require
the organization conducting the study under this
section to submit to the Secretary and the Congress
a report within 30 months after the date of the en-
actment of this Act. The report shall include infor-
mation and assessments regarding the following (as
of the date of the enactment of this Act or prior to
implementation of health care reform):
(A) The levels of access to health care
services.
(B) The levels of quality of care of those
services.
(C) The cost of the care provided, based on
measures such as cost of services, the cost of
treating various conditions, and the average and
marginal cost of maintaining and improving
health.
(D) The health status of the public, as a
whole and by population subgroups.
(2) BASIS.—The information described in para-
graph (1) shall be reported in a manner that permits
separate evaluation of—
(A) health care services in the public and
private sectors, and
(B) different types of services, including
institutional services, ambulatory services, acute
services, long-term care services, mental health
services, and population-based services in the
public and private sectors.
(e) AUTHORIZATION OF APPROPRIATIONS.—There is
authorized to be appropriated $3,000,000 to carry out the
study under this section.
Æ