Health Services Research as a Source of Legislative Analysis and Input: The Role of the California Health Benefits Review Program

Oliver, Thomas R.; Singer, Rachel

doi:10.1111/j.1475-6773.2006.00523.x

Cited by 10 publications

(14 citation statements)

References 27 publications

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“… * Those states listed here as having MBR laws are different from those listed in Oliver and Singer (2006). Bellows and colleagues examine the characteristics of state laws that have established MBR programs in the U.S. Oliver and Singer (2006) summarize information gathered by CHBRP through key informants interview with officials in each state.…”

Section: Resultsmentioning

confidence: 99%

State‐Mandated Benefit Review Laws

Bellows

Halpin

McMenamin

2006

Health Services Research

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Objective. To determine which states have laws that require the review of mandated health insurance benefits and describe the various approaches states take in reviewing mandated benefits, as stated in the mandated benefit review (MBR) laws. Data Sources. We queried online databases of the individual state statutes and reviewed the state statutes and state legislative agendas for all 50 states and Washington, DC to identify those states with active MBR laws as of September 2004. Study Design. We reviewed the identified MBR laws to catalog their various components. The components chosen for this analysis include: general review strategy, designated reviewers, time frame for conducting reviews, criteria used in the review, requirements to use actuaries, sources of funding, and state data collection systems. Two of the authors independently created analysis categories and coded the MBR laws to document details on the major components of the laws. Principal Findings. We identified 26 state MBR laws active as of September 2004. A majority of the MBR laws specified a prospective review approach and only one law used an exclusively retrospective review approach. A substantial amount of variation was found with regards to the designated reviewers, time frames for conducting reviews, and criteria used in the review. Few states specified the use of actuaries, sources of funding, and state data collection systems. Conclusions. The number of states that have enacted MBR laws has increased substantially in recent years, however, different states have structured the review of mandated benefits differently, according to the values and perceived needs of the state legislatures. It is important that states increasingly consider a broader scope of review criteria so state decision makers can position themselves to mandate only those benefits that add real value to the state's health care system.

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Section: Resultsmentioning

confidence: 99%

State‐Mandated Benefit Review Laws

Bellows

Halpin

McMenamin

2006

Health Services Research

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“…Most state legislators and staff members have little formal training in health policy or health services research. In California, the ability of legislators and some staff to develop expertise in health care on the job is constrained by term limits of six years in the assembly and eight years in the senate, which result in the frequent turnover of committee chairs and staff ( Jewell and Bero 2008; Oliver and Singer 2006). Consequently, one of CHBRP's most important roles is teaching legislators and their staff the complexities of the literature on some of the topics addressed in the benefit mandate bills.…”

Section: Lessons Learned From Reviewing the Medical Effectiveness Of mentioning

confidence: 99%

“…We believe that CHBRP's design has contributed to its largely positive reception. Earlier studies have found that policymakers value information that is relevant, timely, credible, and accessible (Colby et al 2008; Jewell and Bero 2008; Oliver and Singer 2006). All the CHBRP reports are relevant to California legislators because all address bills under consideration.…”

Section: Implications For Policymakersmentioning

confidence: 99%

“…Here we focus on the lessons we have learned over the past six years from conducting medical effectiveness reviews for CHBRP. Our article builds on a series of papers published in 2006 that discuss the establishment of the program, the development of its analytic methods, and the first and second years of its operation (Halpin et al 2006; Kominski et al 2006; Luft et al 2006; McMenamin, Halpin, and Ganiats 2006; Oliver and Singer 2006; Philip 2006 ) . Over the ensuing years, the number of reports issued by CHBRP has grown from twenty‐two to fifty‐nine.…”

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confidence: 99%

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Translating Medical Effectiveness Research into Policy: Lessons from the California Health Benefits Review Program

et al. 2009

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Methods: This article is based on the authors' experience reviewing benefit mandate bills for CHBRP and findings from evaluations of the program. General observations are illustrated with examples from CHBRP's reports. Information about efforts to incorporate evidence into health policymaking in other states and nations was obtained through a review of published literature.Findings: CHBRP produces reports that California legislators, legislative staff, and other major stakeholders value and use routinely in deliberations about benefit mandate bills. Where available, the program relies on previously published meta-analyses and systematic reviews to streamline the review of the medical literature. Faculty and staff responsible for the medical effectiveness sections of CHBRP's reports have learned four major lessons over the course of the program's six-year history: the need to (1) recognize the limitations of the medical literature, (2) anticipate the need to inform legislators about the complexity of evidence, (3) have realistic expectations regarding the impact of medical effectiveness reviews, and (4) understand the consequences of the reactive nature of mandated benefit reviews.

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“…Second, it has direct decision‐making authority; its findings are binding on state agencies. By comparison, the California Health Benefits Review Program (CHBRP) reviews costs and benefits but the legislature decides whether to accept, reject, or modify the CHBRP responses to its inquiries (Oliver and Singer ; California Health Benefits Review Program ,b). The USPSTF assesses preventive health services—screenings, counseling, and preventive medications (USPSTF ).…”

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confidence: 99%