Health Care Reform: Implications of Geographic Boundaries for Proposed
Alliances (Testimony, 02/24/94, GAO/T-HEHS-94-108).

A common feature of many health reform bills is the creation of public
or private health alliances that would seek to broaden coverage, pool
risks, give consumers a choice of health care plans, and disseminate
information on the costs and quality of plans.  All the bills leave the
establishment of alliance boundaries to the states.  This testimony
discusses (1) the provisions of major health reform bills concerning the
configuration of alliance boundaries; (2) experiences of two states that
have established entities similar to alliances; (3) features and
procedures for creating a Metropolitan Statistical Area; and (4) issues
relating to the potential effects of alliance boundaries on existing
health markets, access to health care, and distribution of health care
costs within a state.  Concerns about the boundary provisions of the
health reform proposals include the potential for gerrymandering,
changing the provision and receipt of health care, segmenting high-risk
groups, and isolating underserved areas.

--------------------------- Indexing Terms -----------------------------

 REPORTNUM:  T-HEHS-94-108
     TITLE:  Health Care Reform: Implications of Geographic Boundaries 
             for Proposed Alliances
      DATE:  02/24/94
   SUBJECT:  Health insurance cost control
             Health care services
             Insurance premiums
             Health maintenance organizations
             Statistical data
             State-administered programs
             Proposed legislation
             Health care cost control
             Demographic data
IDENTIFIER:  Health Security Act
             Managed Competition Act of 1993
             Health Equity and Access Reform Today Act of 1993
             Medicaid Program
             Florida
             Washington
             California
             CalPERS Health Benefits Program (CA)
             National Health Care Reform Initiative
             Clinton Health Care Plan
             
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