Document Detail

Translating medical effectiveness research into policy: lessons from the California Health Benefits Review Program.
MedLine Citation:
PMID:  20021589     Owner:  NLM     Status:  MEDLINE    
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.
Janet M Coffman; Mi-Kyung Hong; Wade M Aubry; Harold S Luft; Edward Yelin
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Milbank quarterly     Volume:  87     ISSN:  1468-0009     ISO Abbreviation:  Milbank Q     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-21     Completed Date:  2010-01-25     Revised Date:  2013-05-31    
Medline Journal Info:
Nlm Unique ID:  8607003     Medline TA:  Milbank Q     Country:  United States    
Other Details:
Languages:  eng     Pagination:  863-902     Citation Subset:  IM    
Department of Family and Community Medicine, University of California, San Francisco, USA.
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MeSH Terms
Evidence-Based Medicine*
Government Regulation
Health Policy / economics*
Insurance Benefits / economics,  legislation & jurisprudence*
Insurance Claim Review / economics*,  legislation & jurisprudence
Policy Making
Translational Medical Research*
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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