Legislators, policy wonks, and Team Obama need a serious set of online decision-support tools (DSTs) to understand, compare, and evaluate the myriad and conflicting proposals to reform health care. In mid-January, the RAND Corporation entered the fray, busily promoting to the media and legislative staff what it calls a global positioning system to comprehend the effects and unintended consequences of competing reform proposals. Called COMPARE (Comprehensive Assessment of Reform Efforts), this online toolkit (www.RANDCOMPARE.org ) allows health care stakeholders to kick the tires of various policy options before implementation.
Explore this issue:May 2009
RANDCOMPARE is essentially an enhanced business dashboard-a DST to communicate complex information quickly by using maps, charts, and other graphics to show multiple results together (see Effective Health Care Dashboards). For example, it compares how policy options such as individual mandates, employer mandates, purchasing pools, or refundable tax credits would affect aggregate spending, consumer financial risk, the patient’s experience, systemic waste, health coverage, capacity, and operational feasibility.
Elizabeth McGlynn, PhD, Associate Director of RAND Health and COMPARE’s Co-Director, said the tool will help make realistic assessments, based on objective standards and facts, and therefore encourage a full understanding of the immensely complicated benefits and risks of the policy choices ahead. She noted that policy options selected for the dashboard and their underlying assumptions were based on RAND’s 26-member advisory committee, who looked at 25 years of health policy proposals and reviewed relevant literature. When asked about two glaring omissions, innovative health plans stripped of onerous mandates and allowing the selling of plans across state lines, she said, We didn’t include them because we made a decision to launch and will eventually add other policy options over time.