We focus on a number of topic areas identified by state health policy leaders as important to population health.
Keep up with news and updates from the Milbank Memorial Fund. Get the latest from thought leaders, including Christopher F. Koller, president of the Fund.
We publish The Milbank Quarterly, as well as reports, issues briefs, and case studies on topics important to population health.
The Center for Evidence-based Policy at Oregon Health & Science University is a national leader in evidence-based decision making and policy design.
The Milbank Memorial Fund is an endowed operating foundation that publishes The Milbank Quarterly, commissions projects, and convenes state health policy decision makers on issues they identify as important to population health.
December 2009 (Volume 87)
December 2009 | Janet M. Coffman, Mi-Kyung Hong, Wade M. Aubry, Harold S. Luft, Edward H. Yelin
Context: Legislatures and executive branch agencies in the United States and other nations are increasingly using reviews of the medical literature to inform health policy decisions. To clarify these efforts to give policymakers evidence of medical effectiveness, this article discusses the California Health Benefits Review Program (CHBRP). This program, based at the University of California, analyzes the medical effectiveness of health insurance benefit mandate bills for the California legislature, as well as their impact on cost and public health.
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.
Conclusions: CHBRP has demonstrated that it is possible to produce useful reviews of the medical literature within the tight time constraints of the legislative process. The program’s reports have provided state legislators with independent analyses that allow them to move beyond sifting through conflicting information from proponents and opponents to consider difficult policy choices and their implications.
Author(s): Janet M. Coffman; Mi-Kyung Hong; Wade M. Aubry; Harold S. Luft; Edward Yelin
Keywords: evidence-based medicine; health insurance; insurance benefits; mandated benefits
Read on Wiley Online Library
Read on JSTOR
Volume 87, Issue 4 (pages 863–902)
Published in 2009
Research and Advice Giving: A Functional View of Evidence-Informed Policy Advice In a Canadian Ministry of Health
Aging in America in the Twenty-first Century: Demographic Forecasts From the MacArthur Foundation Research Network on an Aging Society
Get the Latest from the Milbank Memorial Fund