[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4463 Introduced in House (IH)]

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 Representatives 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 organization 
or consortium of institutions) to study and report on the impact of 
health care reform legislation at the national, regional, and State 
levels.
    (b) Purpose.--The purpose of the study under this section is to 
develop a detailed framework, using a prospective, 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, 
promoting choice, and improving health status.
    (c) Report.--The Secretary shall require the organization 
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 
        different Federal agencies), as well as by foreign countries.
            (3) What are data elements and public and private sources 
        of information for measuring such indicators. With respect to 
        such elements:
                    (A) What special requirements or authorities 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 establishing a core 
                set of primary data as part of a national health care 
                reform collection effort that could overlap with the 
                evaluation of health care reform.
                    (D) What should be the relationship between 
                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 associated 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, taxpayers, 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 
organization or consortium of institutions) to develop and report 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 extent reasonable, on the 
        study designs, data sources, and indicators likely to be 
        included in recommendations 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 enactment of this Act. The report shall 
        include information 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 paragraph (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.

                                 <all>