The RAND Corporation has launched an online tool that provides policymakers and interested parties with a resource to help understand and evaluate the effects of healthcare reform.
The tool, called COMPARE (Comprehensive Assessment of Reform Efforts), synthesizes what is known about the current healthcare system, provides information on proposals to modify the system and delivers insight about how potential policy changes are likely to affect healthcare delivery and costs in the United States.
RAND officials say the centerpiece of COMPARE is a policy options dashboard that offers both a snapshot and an in-depth look at the implications that various policy changes could have on a range of outcomes like costs to government, quality of care and access to care, as well as the ease with which changes could be implemented.
The dashboard also depicts gaps in knowledge about the consequences of changes in the nation's healthcare system.
Results on the dashboard are informed by a review of prior experience with the policy options and a microsimulation modeling tool that allows policymakers to estimate the impact of specific policy changes on coverage, spending, consumer financial risk and health.
"COMPARE is a global positioning system for healthcare policy," said Elizabeth McGlynn, associate director of RAND Health and co-director of COMPARE. "It is a tool that tells us where we are and, more importantly, where the new proposals will take us in the immensely complex matter of healthcare reform."
"There is no magic solution to our nation's healthcare challenges, and every proposal likely to emerge will contain inevitable trade-offs between cost and quality of care and access to it. COMPARE will help make realistic assessments, based on objective standards and facts, and therefore encourage a full understanding of the immensely complicated benefits and risks of the policy choices ahead," she said.
According to RAND officials, the dashboard has already pointed out the following:
- An individual mandate is the most cost-effective strategy for decreasing the number of uninsured.
- For most options, how the policy is designed has a significant impact on its effectiveness and whether there will be unintended consequences. For individual mandates, the level of subsidies that would be available, the development of a national insurance exchange and the penalties for noncompliance all determine likely reductions in the uninsured and the associated costs to the government and others.
- There is a link between having health insurance and life expectancy. The model estimates that life expectancy would increase by six months on average among newly insured persons who maintain coverage until age 65.
- There is no evidence that many proposals for saving money - prevention, disease management, pay-for-performance, malpractice reform - will actually reduce spending on healthcare in the next decade.
- Payment reform options are likely to produce the greatest opportunity for reducing healthcare spending, but most of the proposed changes have not been tested on a wide scale.
"All the parties in the coming healthcare debate will have their own opinions on how best to address the challenges we face," said Jeffrey Wasserman, co-director of COMPARE and a senior policy researcher at RAND. "We created COMPARE to contribute credible, objective and easy-to-understand facts and analysis so that those opinions can be based on real information. We don't expect that everyone will like everything COMPARE reports, but we hope everyone will recognize the contribution COMPARE makes to the healthcare debate."
