OHCA, established in 2022, will profoundly shape health care in California. Its legislated goals are to slow health care spending growth, promote high-value system performance, and assess market consolidation. CHA is actively engaged in the implementation process, advocating to improve affordability for patients while ensuring hospitals are able to make much-needed investments to improve access, quality, and equity.
Latest News
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CHA Argues OHCA’s Proposed Hospital Sector ‘Strains Credibility,’ Encourages Hospitals to Weigh In
CHA News -
OHCA Faces Tough Questions from Lawmakers, Hospitals
CHA News -
State Legislative Landscape Starts to Come Into Focus
CEO Message, CHA News -
OHCA’s Rush Will Be Detrimental to Patient Care
CEO Message, CHA News
Advocacy
In addition to in-person advocacy at OHCA meetings, CHA has submitted the following comment letters.
“The California Hospital Association, on behalf of more than 400 hospitals and health systems, urges the board to reconsider its approach — before patient care is irreparably damaged.”
CHA Letter to OHCA Board – February 2025
At 3% for five years despite high inflation, an aging population, and widespread provider financial distress, the proposed target would prove unattainable, unsustainable, and unsupportive of health care entities’ efforts to
CHA comments on proposed statewide health spending target – March 2024
improve the value of health care, not just lower its costs.
Additional Letters
- February 21, 2025: CHA Comments on the February 2025 Health Care Affordability Board Meeting
- January 24, 2025: CHA Comments on the January 2025 Health Care Affordability Board Meeting
- December 12, 2024: CHA Comments on the December 2024 Health Care Affordability Board Meeting
- October 9, 2024: CHA Comments on the October 2024 Health Care Affordability Board Meeting
- August 23, 2024: CHA Comments on the August 2024 Health Care Affordability Board Meeting
- June 21, 2024: CHA Comments on May 2024 Health Care Affordability Board Meeting
- May 20, 2024: CHA Comments on April 2024 Health Care Affordability Board Meeting
- April 19, 2024: CHA Comments on March 2024 Health Care Affordability Board and Advisory Committee Meetings
- February 22, 2024: CHA Comments on the January 2024 Health Care Affordability Board and Advisory Committee Meetings
- January 18, 2024: CHA Urges Serious Scrutiny of the Proposed Spending Target and Significant Changes to Avoid Negative Consequences
- December 13, 2023: CHA Comments on the October 24, 2023 Health Care Affordability Board Meeting and November 30, 2023 Health Care Advisory Committee Meeting
- November 15, 2024: CHA Comments Ahead of the November 2024 Health Care Affordability Board Meeting
- October 18, 2023: CHA Comments on the September 2023 OHCA Board and Advisory Committee Meetings
- September 12, 2023: CHA Comments on the August 2023 Health Care Affordability Board Meeting | Cost and market impact review draft regulations, patient attribution methodology, spending target considerations
- August 14, 2023: CHA Comments on the June 2023 Health Care Affordability Board and Advisory Committee Meetings | Principles for the cost and market impact review process, clinical risk adjustment, data-driven decision making for the spending targets, and data transparency
- June 12, 2023: CHA Comments on the May 23, 2023, Health Care Affordability Board Meeting | Addresses advisory committee appointments, concerns around payer-reported data, spending target adjustments, risk adjustment
- March 6, 2025: CHA Comments on Proposed Health Care Sector Definition: Hospital Sector
- June 20, 2024: CHA Comments on Cost and Market Impact Review Proposal
- May 24, 2024: CHA Comments on Proposed Health Care Workforce Stability Standards
- March 8, 2024: CHA Comments on Proposed Statewide Health Care Spending Target Recommendations to the Board
- February 26, 2024: Proposed Emergency Regulatory Action – Health Care Spending Targets; Total Health Care Expenditures (THCE) Data Collection
- December 11, 2023: CHA Comments on Proposed Emergency Regulatory Action – Promotion of Competitive Health Care Markets; Health Care Affordability: Cost and Market Impact Reviews
- December 1, 2023: CHA Comments on the Oct. 20, 2023 Version of the Total Health Care Expenditures Data Collection Draft Regulations
- October 17, 2023: CHA Comments on the Revised Draft “Material Change Transactions and Pre-Transaction Review” Regulations
- August 31, 2023: CHA Comments on the Draft “Material Change Transactions and Pre-Transaction Review” Regulations | Regulatory letter on version one of the cost and market impact review draft regulations
Resources
Senate Bill 184, part of the 2022-23 state budget package, established the Office of Health Care Affordability within the Department of Health Care Access and Information (HCAI). The office’s objectives and responsibilities are to:
Jurisdiction. The office’s authority extends to payers, such as health plans and public health care coverage programs; providers, including hospitals and physician groups; and fully-integrated delivery systems.
Governance. OHCA is housed within the Department of Health Care Access and Information and is overseen by an eight-member board with input from an advisory committee.
See OHCA’s website for links to public meetings, laws and regulations, and additional information.
Implementation of the office will occur gradually over the next several years:
The office’s work coincides with a period of unparalleled financial distress for hospitals. Rising costs, — including expenses for workforce and other needs, along with state-mandated capital improvement projects — mean that hundreds of California’s hospitals are operating with negative margins, losing money every day to care for patients.
Education
Education Briefs
OHCA Updates on Implementation – This series provides background and updates on implementing several tasks including increasing transparency of health care spending.
On-Demand Recordings
Executive Update: Office of Health Care Affordability Focuses Its Attention on Hospitals – February 19, 2025 – 59 min
Office of Health Care Affordability (OHCA) – A Deep Dive on Spending Targets – February 12, 2024 – 59 min
Office of Health Care Affordability Cost & Market Impact Review Process – January 8, 2024 – 72 min
Office of Health Care Affordability (OHCA) 101: What You Need to Know and What Is to Come – Dec. 18, 2023 – 46 min
Hospital Finance Week: Spotlight: California’s New Office of Health Care Affordability – Aug. 24, 2022 – 90 min