New Book, Administrative Solutions in Health Reform, Offers Recommendations

Management analysis of approaches for improving access to health care

From 2006 to 2009, the National Academy of Social Insurance and the National Academy of Public Administration convened an expert study panel to examine the likely administrative issues involved in reforming the health care system, and published reports on their findings and recommendations.

Key Results: Project staff reported the following results in published documents and a report to the Robert Wood Johnson Foundation (RWJF):

  • The expert study panel identified and described seven core administrative activities and functions that need to be performed regardless of the health system in place:
    • Planning and coordinating implementation.
    • Subsidizing health insurance premiums and cost sharing.
    • Administering health insurance mandates.
    • Regulating health insurance.
    • Restructuring health insurance markets.
    • Designing administrative organizations.
    • Simplifying administration and controlling costs.
  • Experts commissioned by the study panel wrote 10 research papers examining issues related to the seven core administrative activities and functions. Shorter versions of these papers were published in a book.
  • The National Academy of Social Insurance and the National Academy of Public Administration published Administrative Solutions in Health Reform: Report of the Study Panel on Administrative Issues in Expanding Access to Health Care, a summary of the project's findings (July 2009).
  • Project staff widely disseminated study findings to congressional and executive branch staff.

 

Key Findings and Recommendations: Project staff reported the following key findings and recommendations in Administrative Solutions in Health Reform: Report of the Study Panel on Administrative Issues in Expanding Access to Health Care (July 2009):

  • To the extent feasible, health reform should build on existing governmental capacities, arrangements and institutions.
  • The president should promptly designate an agency and a person to direct the implementation of health reform.
  • Administrative issues and their connections with each other should receive careful attention as legislation is developed and implemented.
  • The agency with primary responsibility for implementing health reform should have political stature and operational flexibility.
  • Health reform legislation should include a carefully constructed schedule for phasing in its many varied elements.
  • The administrative challenges posed by expanding health care can be met.

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