Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #111709

Sara B. McMenamin, PhD, MPH¹, Helen A. Halpin, PhD¹, and Theodore Ganiats, MD². (1) Center for Health and Public Policy Studies, University of California, Berkeley, 140 Warren Hall #7360, Berkeley, CA 94720-7360, 510-643-1675, saram@uclink4.berkeley.edu, (2) UCSD, School of Medicine, 9500 Gilman Drive, MC 0628, La Jolla, CA 92093-0628

Historically, very little attention has been given to questions of how proposed health care reforms might affect the health of the population at the state or national level. The passage of Assembly Bill 1996 (AB 1996) in California authorized the University of California to create the California Health Benefits Review Program (CHBRP) to provide comprehensive and timely analyses of proposed health benefit mandates introduced in the state legislature including an analysis of the medical, financial, and public health impacts of the proposed mandates. This paper presents the methodology and assumptions CHBRP utilized to conduct the public health impact analysis. This analysis includes the presentation of baseline data on related health outcomes, data on the impact of the mandate on the health of the community as measured by changes in health outcomes, data on gender and racial disparities in health outcomes, an examination of the reduction of premature death and a discussion of the economic loss associated with disease. Challenges to conducting a public health impact analysis include the lack of state-level baseline data on important health outcomes and information on differences in health services utilization by race and ethnicity. Additionally, while using estimates of medical efficacy from the scientific literature to estimate health outcomes in a population is likely to overstate the effects of a mandate, the limitations in available data are likely to underestimate the scope of reported public health impacts. The approach California has developed for assessing the public health impacts of benefit mandate legislation, while challenging, represents a leap forward towards a more comprehensive assessment of proposed state health benefit mandates and represents the first attempt to translate health insurance benefits policy into population health outcomes. Analysis of public health impacts of proposed state health benefit mandates, combined with analyses of evidence of medical efficacy and costs, enables state legislators to consider the "value" of health care services in public policy making. Value represents the improvement in health status realized for an investment of health care dollars. Such analyses have the potential to lead to the design of more cost-effective health insurance policy.

Learning Objectives: At the conclusion of the session, a participant in this session will be able to

(
• describe the types of data elements required to conduct a public health impact analysis, (
• articulate the assumptions and procedures for conducting a public health impact analysis, and (
• discuss the potential for evidence-based research to influence the state policy-making process.

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation