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Issue Brief Series
New series highlights issues central to health care reform:
- How insurance coverage improves health outcomes
- Preventive health services
- Evidence-based care
- Disease management
- Financial incentives for providers and consumers
- Medical homes
Implementing National Health Care Reform
How best to reform our nation’s health care system will continue to dominate much of the policy debate for many years. This system, which accounts for 16 percent of our economy and produces hundreds of life-saving marvels every day, has failed to provide affordable health care for all Americans. While consuming more resources per capita than any other health care system in the world, our health care 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 knowledge base that helped guide this policy debate and to be contributing to the research that will guide the implementation of the Patient Protection and Affordable Care Act (PPACA) (HR 4872). 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. Health insurance coverage and making sure that everyone who wants it can obtain it at a reasonable price are central to the PPACA. 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?
Read more.
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 toward 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 innovative ways of delivering health care, including disease management, care coordination, medical homes, and accountable care organizations?
- What new Medicare developments can foster health care reform?
- Do consumer education, shared decision making, engagement, and other broad-based strategies help reform organization of care?
- What provider payment and financial incentives are most effective?
Read more.
How Can the Health Care System Be Made More Equitable?
Our health care system has led to disparities in health care use and outcomes for different segments of our society. Mathematica researchers have contributed innovative ways to measure disparities, as well as new ways to reduce disparities. 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?
Key to the implementation of the PPACA is 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 the following: