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CEO Message: Protecting Patients by Fighting Back on Rate Setting

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Earlier this week, we asked California’s hospital leaders to raise their voices to urge congressional leaders not to set a benchmark rate as a way of addressing surprise billing.

The need to push back arose late last week after committees in both the Senate and the House of Representatives announced they had reached an agreement on legislation to tackle the high-profile issue of consumers receiving surprise medical bills. The package — which could be voted on as soon as next week — includes both a benchmark rate and an independent dispute resolution process for claims over a certain amount.

Fortunately, on Wednesday, the House Ways and Means Committee offered another bipartisan alternative. As Congress grapples with this important issue, it’s more important that they thoughtfully consider all of the complexities than rush to a hastily crafted legislative solution.

Thank you to all who have already reached out to your representatives, helping to continue the drumbeat we began last year to make clear to lawmakers that hospitals support eliminating surprise billing, but that fixed “benchmark” rates are not the right solution and threaten critical resources for patients.

Protecting patients is what hospitals do, so for you as leaders, it’s simple: People seeking necessary medical care should be protected from unexpected bills, and no patient should ever pay more for emergency care just because their insurance company chooses not to contract with a hospital. Giving patients the peace of mind to heal includes removing them from payment negotiations between insurers and providers, and creating safeguards from the gaps in insurance that result in surprise bills.

We need to keep reminding policymakers that, while benchmark rates offer financial protections for insurers, they offer none at all for consumers.

As leaders, you also know that caring for patients includes protecting their access to care. It is incumbent on all of us to make sure Congress understands that creating a benchmark payment rate threatens access – both by reducing available resources and by giving health plans less incentive to enlist facilities and physicians in their networks.

What lawmakers need to do – and they need our help – is to prevent patients who have received needed health care services from getting surprise bills for that care. Once that assurance is in place, payments made from the insurer to the provider become irrelevant to patients.

As we learn more about details of the different federal proposals, we will share them with you. This issue, of vital importance to patients and hospitals alike, requires our vigilance now and in the near future.

We cannot afford to miss a beat.

— Carmela

Operational News

This post has been archived and contains information that may be out of date.

Confused by email distribution lists, or unsure what list to use when sending a message?

Many of us are.

Navigating these lists is a bit like being lost in the country and getting driving directions from a local. He can’t tell you the name of the road to turn on, but it’s just beyond a big tree.

In other words, after a while, you get it, but explaining it to someone else is a different story.


This post has been archived and contains information that may be out of date.

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New State Initiative Trains Providers to Screen Patients for Childhood Trauma

This post has been archived and contains information that may be out of date.

California Surgeon General Dr. Nadine Burke Harris and Dr. Karen Mark, medical director for the Department of Health Care Services (DHCS), have unveiled a new initiative to help health care providers screen patients for adverse childhood experiences (ACEs) that increase the likelihood of health conditions caused by toxic stress.

CHA DataSuite Releases Third Quarter 2019 Value-Based Purchasing Impact Analysis

This post has been archived and contains information that may be out of date.

CHA DataSuite has issued hospital-specific analyses showing the estimated impact of the federal fiscal year (FFY) 2021 Medicare inpatient hospital Value-Based Purchasing (VBP) Program, based on publicly available data and program rules established by the Centers for Medicare & Medicaid Services (CMS). 

CEO Message: Care and Feeding

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Amid the grand legislative battles that play out at the Capitol, along with other street fights like those over public ballot initiatives, it’s important to take a moment to call attention to the quiet, steady, and often unheralded work that goes on to help hospitals.

A fair amount of this work is related to regulatory bodies, like the California Department of Public Health, an agency hospitals have expressed frustration over due to what has felt like inconsistent interpretation and application of state rules.

That’s why we’re grateful for two occasions last month that we hope will herald a different working relationship between hospitals and the department. On Nov. 19 in Sacramento and on Nov. 21 in Pasadena, we facilitated two programs where hospital leaders had the opportunity to connect directly with regulators — to share concerns and collaborate on ideas that could improve effectiveness and efficiency.

This was the first time such meetings were held.

In all, nearly 400 hospital representatives attended, along with nearly 100 regulators from CDPH and its district offices.

A few key takeaways:

Heidi Steinecker, CDPH’s new deputy director, Center for Health Care Quality, deserves credit for bringing a fresh approach to the department in the hopes of creating statewide uniformity, reducing redundancy, and working more efficiently with hospitals. She wants input from hospitals and welcomes texts or calls on her cell phone at (916) 502-3773. 
In at least one district, CDPH seems willing to schedule visits to hospitals for facility-reported incidents — to minimize disruption to patient care resulting from unannounced visits.
Breakout sessions revealed many inconsistencies and concerns related to CDPH’s survey process; we will be working closely with the department to develop a more streamlined approach.

These inaugural two meetings were just the beginning. We intend to hold more, with agencies such as the Office of Statewide Health Planning and Development and the State Board of Pharmacy, so processes and interactions can be improved across multiple regulatory bodies.

Here’s why: We know this work will never dominate headlines like seismic safety compliance, or independent contractor laws, but it’s invaluable because it helps you focus more of your staff’s limited time in the right place — on the patients and communities entrusted to you.

— Carmela, Bryan, George, Dimitrios