WASHINGTON, July 20 /PRNewswire-USNewswire/ --Administrative issues should receive careful attention when health reform legislation is being drafted, according to a new report released by an expert panel of the National Academy of Public Administration and National Academy of Social Insurance.



"Sound administration needs to be built into the design of health reform," said William A. Morrill, co-chair of the panel and a senior fellow at Caliber Associates, and ICF International Company. "It shouldn't be an afterthought." Robert A. Berenson, Institute Fellow at the Urban Institute, also served as co-chair. "Whatever form the legislation takes," Berenson said, "the challenging issues of implementation will require continued attention. Government's ability to administer the plan will be critical to its success."



In its report, the panel examines administrative functions that are central to a variety of health reform proposals, defines the choices, summarizes what is known about them, and makes specific recommendations. Regardless of the reform proposal at hand, the report provides legislators and policymakers with ways to:

-- Keep eligibility rules simple to encourage participation and facilitate administration, -- Make any health insurance mandates easily enforceable, -- Ensure fairness and capacity in a restructured health insurance market, -- Choose an appropriate organizational design to administer new health care programs, and -- Put mechanisms in place to support health care cost control.



The members of the study panel represent a wide variety of perspectives and include academics, researchers, consultants, and executives of health care companies, foundations, and associations (list attached). Several panel members have had hands-on experience in the administration of Medicare, Medicaid, or private health insurance programs or in the delivery of health care services. The panel's recommendations fall into seven categories: planning and coordinating implementation of health reform, subsidizing health insurance premiums and cost sharing, administering health insurance mandates, regulating health insurance, restructuring health insurance markets, designing administrative organizations, and simplifying administration and controlling costs.



The panel's recommendations and their rationale are described in detail in its final report, Administrative Solutions in Health Reform. As part of its work, the panel also commissioned noted experts to prepare background papers on the subjects of its inquiry. These papers have been available since January on NASI's website. Edited versions of the papers were published in May in a companion volume, Expanding Access to Health Care: A Management Approach, available from M.E. Sharpe, Inc.




Financial support for this project was provided by the Robert Wood Johnson Foundation, the nation's largest philanthropy devoted exclusively to improving the health and healthcare of all Americans. The National Academy of Social Insurance, founded in 1986, promotes informed policy making on social insurance and related programs, including Social Security, Medicare, Medicaid, and employer-sponsored health insurance. Established in 1967 and chartered by Congress in 1987, the National Academy of Public Administration is a non-profit, independent organization of top public management and organizational leaders who tackle the nation's most critical and complex public management challenges.



Study Panel on Administrative Issues in Expanding Access to Health Care



Robert A. Berenson,+ Co-Chair

Urban Institute



William A. Morrill,* Co-Chair

Caliber Associates



Kenneth S. Apfel*+

University of Maryland



Beth C. Fuchs+

Health Policy Alternatives, Inc.



Thomas R. Hefty

Blue Cross Blue Shield United of Wisconsin (retired)



Feather O. Houstoun*

William Penn Foundation



Robert E. Hurley

Virginia Commonwealth University (emeritus)



Jack Lewin

American College of Cardiology



Catherine G. McLaughlin+

University of Michigan



Sallyanne Payton*

University of Michigan School of Law



Michael C. Rogers*

MedStar Health



Raymond C. Scheppach*

National Governors Association



Mark D. Smith+

California HealthCare Foundation





* Fellow, National Academy of Public Administration



+ Member, National Academy of Social Insurance





SOURCE National Academy of Social Insurance