Inaugural event a part of IHA’s 2023 Stakeholders Series
IHA held its first-ever Health Policy Update webinar on June 20. The event was part of IHA’s 2023 Stakeholders’ Series, our outreach program that includes more than 400 industry stakeholders. Over the three webinar sessions, speakers shared legislative and policy updates, perspectives on the Office of Health Care Affordability, and an update on initiatives to improve provider directory accuracy.
Here are highlights from the sessions:
Legislative and policy updates
Athena Chapman of Chapman Consulting shared several important updates during a legislative and regulatory update. First, despite a budget shortfall in California, no substantial reductions in healthcare spending are planned. The deadline to finalize the budget is June 27.
A proposal to renew the managed care organization (MCO) tax would continue to help fund the Medi-Cal program by pulling down additional federal dollars through a tax on health plans. The proposal calls for the MCO tax to be retroactive to April 1, 2023, and would generate about $3.7 billion in additional general fund revenue. The proposal also increases provider rates to 87.5% of Medicare for safety net providers, including primary care, maternity care, and non-specialty mental healthcare in 2024, and to additional providers in 2025.
Chapman also highlighted Assembly Bill 1690, a universal healthcare coverage bill that would guarantee accessible, affordable, equitable, and high-quality healthcare to every Californian. The two-year bill will advance in the 2024 legislative session. She also shared that new Department of Managed Health Care health equity metrics are moving forward. Health plan compliance with the new metrics begins in 2023, and DMHC will release the first Health Equity and Quality Compliance annual report in 2025.
Office of Health Care Affordability panel discussion
During a panel discussion, leaders from the Office of Health Care Affordability, a health plan, a consumer advocacy group, and IHA shared perspectives about work to transform health care to ensure Californians receive accessible, affordable, equitable, and high-quality care.
Office of Health Care Affordability Deputy Director Vishaal Pegany highlighted the office’s three primary responsibilities: managing spending targets, monitoring system performance, and assessing market consolidation. In 2024, the office will announce proposed spending targets. 2025 will be a reporting year, with 2026 being the first enforceable year.
Andrew Kiefer, vice president of government affairs at Blue Shield of California, lauded OHCA’s approach of aligning incentives and creating transparency to improve patient outcomes and lower costs. Kiefer also noted OHCA’s plan to standardize how health plans pay providers is vital to gaining meaningful adoption of value-based payment models.
Health Access Consultant Beth Capell highlighted the progress California has made in increasing the number of people with health insurance to 94.5%. She likened that transformation to the changes that need to occur over the next decade to improve affordability and outcomes for patients.
The panel discussion concluded with IHA’s Vice President of Strategic Design and Initiatives, Dolores Yanagihara, who shared IHA programs and initiatives that align with the work of OHCA. Yanagihara described IHA’s Align. Measure. Perform. (AMP) Program, which has measured healthcare performance for the past decade. She also shared IHA’s work in understanding how increased primary care investment can improve health outcomes and patient experience and lower the total cost of care.
Provider directory update
Symphony General Manager Jacqui Darcy discussed federal and state legislative activity related to provider directories. Assembly Bill 236 would require health plans to audit and delete inaccurate listings from their directories annually. The proposed bill ties existing requirements to accuracy benchmarks and penalties.
At the federal level, Darcy provided an update on a U.S. Senate Finance Committee hearing on reducing barriers to mental healthcare through improved provider directory accuracy. IHA President and CEO Jeff Rideout, MD, MA, FACP, testified at the hearing on behalf of IHA. Dr. Rideout highlighted the work of Symphony and the need for an industry solution with a single utility to reduce administrative burden and improve accuracy.
If you missed the webinar or would like to replay one of the sessions, find the recording and slides here.