CHBRPCalifornia Health Benefits Review Program
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For example, CHBRP acknowledges that while "observational studies are less rigorous than are RCTs" they should be evaluated whether they are the only source of information on relevant outcomes, such as subsets of patients (CHBRP, 2013b, 2014).
By contrast, CHBRP employs an actuary and cost model to help evaluate the costs of benefits it reviews.
In an effort to be responsive to the provisions of AB 1996 and to establish and maintain clear analytic standards, CHBRP has established a faculty/professional analyst-based model that marries academic standards with the tight time pressures inherent in real-time legislative decision making.
A brief description of CHBRP's infrastructure may be useful for context-setting.
The CHBRP analyses are intended to offer the legislature unbiased, evidence-based information to assist in making its decisions.
In the legislation that created the CHBRP, California legislators identified two major types of financial effects they were interested in understanding regarding proposed mandates: (1) the present baseline coverage for the benefit and baseline per unit costs, utilization, and total per-member, per-month (PMPM) health care expenditures, and (2) projected changes in coverage, per-unit costs, utilization, and PMPM expenditures following the implementation of the mandate.
Although policy makers refer loosely to mandates, broadly speaking, the kinds of mandates CHBRP examines usually are benefit mandates that require health insurers to cover specific services, in contrast to insurance mandates that require employers to provide insurance coverage to uninsured employees.
The section of the CHBRP report on baseline health outcomes also presents data on health outcomes associated with the disease such as morbidity and mortality.
In addition, the CHBRP model adjusts for differences in member demographics, regional physician and hospital practice patterns, and managed care effects specific to the California health care system.
After CHBRP sent its report on AB 2185 to the legislature in April 2004, the bill was amended six times, twice in the State Assembly and four times in the State Senate.