Cost and Coverage: The Impact of Implementing Various State Health Care Reform Proposals Nationally. Methodology


The Office of the Assistant Secretary for Planning and Evaluation (ASPE) contracted with The Lewin Group to model and analyze the cost and coverage impacts of implementing various state health care reform proposals nationally.  The Lewin Group used their proprietary Health Benefits Simulation Model (HBSM) for the analysis.  All modeling done for the various analyses were performed assuming full implementation of the reform(s) in the year 2010.

The HBSM model is a micro-simulation model of the U.S. health care system.  The model is a fully integrated platform for simulating policies ranging from narrowly defined Medicaid and SCHIP coverage expansions to broad-based reforms such as changes in the tax treatment of health benefits.  HBSM was created to provide comparisons of the impact of alternative health reform models on coverage and expenditures for employers, governments and households.  The model facilitates comparisons of alternative health reform initiatives by using uniform data and assumptions.  For example, take-up rates for Medicaid, SCHIP and various subsidy proposals are simulated using uniform take-up equations and modules.  Uniform methods are also used to simulate changes in health services utilization attributed to changes in coverage status and cost-sharing parameters.  This uniform approach assures that it can develop estimates of program impacts for very different policies using consistent assumptions and reporting formats.

A more detailed description of the model is available in The Lewin Group’s full report to ASPE, “The Cost and Coverage Impacts of Selected Health Reform Options Available to States.”  For a copy of the report, please contact Carrie Shelton or Thomas Musco, in ASPE’s Office of Health Policy, at (202) 690-6870.

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