What’s happening: At its most recent meeting, the Office of Health Care Affordability (OHCA) board elected Kim Johnson, secretary of the California Health and Human Services Agency, as its new chair — and considered potential adoption of hospital sector targets, a provisional approach to measuring hospital spending, and a proposal for tracking quality and equity.
What else to know: Ahead of the meeting, CHA wrote to the board on these topics, urging further learning and progress toward implementation before adopting sector targets; supporting a comprehensive yet streamlined approach to measuring quality, equity, and access; and asking that the behavioral health investment goal consider the full continuum of behavioral health services.
Following Johnson’s appointment as board chair, replacing former chair Mark Ghaly, MD, MPH, the OHCA board dove into several informational topics at its Nov. 20 meeting.
The board discussed allowing OHCA to set different spending growth targets for different segments of the health care industry — and the presentation focused squarely on establishing sector targets for one or more hospital field segments, such as hospitals deemed as high-cost. The board did not decide on a clear direction, and the conversation is expected to continue at the Dec. 16 board meeting.
The board also reviewed OHCA’s proposed provisional approach to measuring hospitals’ spending, which OHCA intends to use to measure hospital performance against the spending targets. The proposed approach would primarily rely on the annual financial disclosure reports that hospitals currently file with OHCA’s parent department, the Department of Health Care Access and Information, as the data source. Spending would be measured as inpatient and outpatient net patient revenue, which would be adjusted by volume and the case-mix index (accounting for service mix and patient acuity), and then assessed for year-over-year growth. The approach came under heavy scrutiny from board members, who questioned whether it would appropriately capture outpatient spending. They showed interest in identifying other data sources, such as payer-reported data on hospital spending and different ways of capturing outpatient spending.
Also at the meeting, OHCA presented its proposed approach for measuring quality and equity, which would rely upon data measures already developed and scheduled for collection by state agencies and other organizations. For hospitals, OHCA proposes to look at the measures used by the Hospital Equity Measures Reporting Program, recently developed pursuant to Assembly Bill 1204.
Finally, the board discussed several pending changes to health care spending data collected from payers. Due to time constraints, the board deferred discussion of the behavioral health investment benchmark to the Dec. 16 meeting.
Contact Ben Johnson, group vice president, financial policy, at bjohnson@calhospital.org with any questions or feedback.
