Office of Health Care Affordability

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 engaging 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.

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In addition to in-person advocacy at OHCA meetings, CHA has submitted the following comment letters on draft regulations to the board and advisory committee.

“We share [OHCA’s] commitment to improving the affordability of health care for all Californians. We are here to partner with OHCA to promote affordability while addressing longstanding deficiencies in access, quality, and equity.”

CHA letter to OHCA Board Chair Dr. Mark Ghaly – October 18, 2023

Read the full letter

“We ask for a number of meaningful changes to ensure the regulations […] prevent avoidable and widespread negative impacts on California’s health care providers and their patients.”

CHA regulatory to letter to OHCA – October 17, 2023

Read the full letter

Previous Letters

Topics: Cost and market impact review draft regulations, patient attribution methodology, spending target considerations

Topics: Regulatory letter on version 1 of the cost and market impact review draft regulations

Topics: Principles for the cost and market impact review process, clinical risk adjustment, data-driven decision making for the spending targets, and data transparency

Addresses Advisory Committee appointments, concerns around payer-reported data, spending target adjustments, risk adjustment


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.


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