[{"_1":2,"_112":-5,"_113":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88,100],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6330308,"mediaKeyId","2314633-c30796dc6618f76f04ba69428dbee1eb","parentId",2314633,"title","OCA staff seek feedback on data‑submission guide and options for defining a hospital sector target","audioSeconds",707,"startMs",2803000,"endMs",3510000,"viewUrl","/Search/View?dp=1&key=2314633-c30796dc6618f76f04ba69428dbee1eb&start=2803&end=3510","thumbnailUrl","https://assets.pipeline.soar.com/2314633-c30796dc6618f76f04ba69428dbee1eb/thumbnail_2803000.jpg","articleUrl","/articles/6330308/California/OCA-staff-seek-feedback-on-datasubmission-guide-and-options-for-defining-a-hospital-sector-target","mediaUrl","https://secure.pipeline.soar.com/6330308-c63286a8ad2ac0cff1903a129775e381/orig.mp4?Expires=1771180849&Signature=iJbdVS7u3ou7Y~gLS7Qi-QgekzTRKy0Jxddr956xCIHj8dkh2wIUumQhp0GyV3N6OS~pwIhtHEW4Z7nIJUttS6rqSDqQCS-nbPKu7d79Y4Y2ywquu4YzyHBq6CLOTSd3ZFP5VXUF88ffFmQi~xmp5OYe8VYV0RioOAvzlSo5dEKOKNOP1BTP4m6dbkoJ6oOGuE5Dd7DXb1mi9Ok~34yFTgm4-H5QAr3iAa~WA6LQEEPEmhZu5c2TSIb-JfmKr4RsNojzvrVCEnVodTbNsYz5nHNPGBQSBxSlT-iER9izSuAFaG5a3Nzbffpp6MvIc-hzmqciKjs7HF3nfakJ1cVYJg__&Key-Pair-Id=KUT5TJCACFTXG","author","Department of Health Care Access and Information","date","2025-02-13T00:50:58Z","article","OCA staff presented a revised data submission guide and timeline for 2025 data collection, and asked the advisory committee for input on defining a hospital sector and setting sector targets. Staff said draft regulations and the updated data submission guide were posted Jan. 8 and public comments are due Jan. 31; required submitters are expected to register in May and submit 2023–24 files by Sept. 1, 2025. Staff also described the measurement modules that will collect claims and non‑claims primary‑care and alternative‑payment model (APM) data, and reiterated the office’s plan to publish a second baseline report by June 1, 2026.

On sector definition, staff outlined four options for addressing high‑cost hospitals: (1) wait and defer sector target setting until 2027; (2) narrowly define a sector for three Monterey hospitals (as requested publicly) and set a target for them; (3) define a high‑cost hospital sector using facility attributes and financial thresholds; or (4) define “all hospitals” as a sector and allow the Board to adjust targets for selected hospitals (the staff recommendation if the Board wants sector targets effective for performance year 2026). Staff explained differences in how hospitals report to HCAI — Kaiser hospitals may submit consolidated statements by region — and noted that some hospitals can file limited data due to statutory or operational exemptions (state hospitals, county psychiatric health facilities, Shriners and long‑term‑stay hospitals).

Committee members raised multiple technical questions and concerns: how to measure outpatient activity (staff said current HCAI financial reporting lacks outpatient case weights and the office is exploring ways to incorporate outpatient intensity), how to handle small hospitals and volatility in multi‑year averages, and how to treat overlapping categories (teaching hospitals that also are children’s hospitals or part of integrated systems). Members urged the office to publish the underlying data spreadsheets, to show how exclusions change lists of high‑cost hospitals, and to consider sector‑level target options (e.g., academic medical centers, psychiatric hospitals, critical access) rather than ad hoc single‑hospital exceptions. Several committee members supported option 4 (define hospitals as a sector and allow targeted adjustments) because it preserves flexibility and can be implemented in time for 2026 targets; others urged caution and recommended waiting for better outpatient measurement and HPD data.

Staff said they will return with implementation details and options for target values; the Board will vote on any sector definitions and target values in the coming months and staff will proceed with data‑collection steps for the 2025 cycle whether or not the Board finalizes a hospital sector.","mediaType","Video","parentTitle","January 2025 | Health Care Affordability Advisory Committee Meeting","oneSentenceSummary","OCA staff presented the draft data submission guide and timeline, and sought feedback on four options to define a hospital sector and set sector targets, recommending an approach that defines all hospitals as a sector and permits targeted adjustments.","taxTitle","Department of Health Care Access and Information, Agencies under Office of the Governor, Executive, California","taxId",16207,"location","California","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6330313,"HCAI staff outline budget impacts, BH Connect waiver funding and HPD expansion",166,659000,825000,"/Search/View?dp=1&key=2314633-c30796dc6618f76f04ba69428dbee1eb&start=659&end=825","https://assets.pipeline.soar.com/2314633-c30796dc6618f76f04ba69428dbee1eb/thumbnail_659000.jpg","/articles/6330313/California/HCAI-staff-outline-budget-impacts-BH-Connect-waiver-funding-and-HPD-expansion","https://secure.pipeline.soar.com/6330313-30c84e412620cd3cceb3566cf3330d73/orig.mp4?Expires=1771180849&Signature=DQQICOCMY~sRUamlLZvTlCUAbcwU4RrAhRaliU0qkYzvT5pBGhkH870wvpvYlpq2wn6qmknVaeuYBJ~zE5kd06lU7yQP1ner9~qcp~e5S0fM5oLQqdBFUU~mSMT2LPw5jahVLEq9HM1aQxheyLAmdMFpig9lCahm7NlxHM-nzy1k0SPzSgsF4fezfnDRl3f40R4uINqc8o0tLYBmSxGh9sCy5idytZQU0S3c3-dbH8sdMBMUbMv3bPG7vV8a1jklP-62jF7PxzZJeEQSbTTEiSbKkaXbV0iOWBH2BeT~~B3Los4r9q8tOGZ13R-oE~xq3BseFpi32kMoaJABNd4WEA__&Key-Pair-Id=KUT5TJCACFTXG","HCAI staff briefed the advisory committee on how the governor’s proposed 2025–26 budget could affect the agency’s programs and workstreams. The staff member said the budget, released Jan. 10, proposes ongoing support for HCAI programs, but also reflects a two‑year framework of reductions including elimination of 6,500 state positions and nearly 8% operational cuts; HCAI will be directly affected. The staff member underscored that the budget is a proposal and subject to the legislative process.

Two large items cited by staff were a Medi‑Cal demonstration waiver known as “BH Connect” and proposed ongoing funding for the Health Care Payments Data Program (HPD). The staff member said the BH Connect waiver, awarded in December 2024, includes a workforce component through HCAI eligible for up to $1.9 billion over five years to support development of the behavioral‑health workforce, with an initial spring budget change proposal to follow. The staff member described BH Connect as focusing on children and youth, people at risk of or experiencing homelessness, and justice‑involved individuals, with statewide and county components.

On data infrastructure, staff said the governor’s budget proposes to provide an ongoing appropriation of $22 million per year and 47 positions to sustain HPD (California’s All‑Payer Claims Database), moving the program from one‑time funding to an ongoing base. Staff also announced that HPD had begun accepting applications for access to non‑public HPD data and that a webinar describing the process had strong interest; staff said the HPD public advisory committee would meet soon to plan 2025 strategies and a board presentation on HPD use was planned for March.

Other budget items staff noted included a legislative change package to implement hospital seismic‑safety and clinic building standards and a proposed diaper initiative that would provide a free three‑month supply of diapers for California newborns, administered by HCAI. The staff member also said the governor asked HCAI and other agencies to develop proposals on prescription‑drug cost drivers and affordability measures.

Committee discussion touched on the broader trends in national health expenditures and drivers of spending. Several committee members urged that the office continue to examine low‑value care, utilization trends tied to primary‑care access, and how consolidation and pricing interact with utilization to drive higher spending. Committee members also pressed HCAI staff to publish more granular hospital analyses and to plan how HPD and OCA’s measurement work will incorporate both inpatient and outpatient services over time.","Staff summarized the governor's proposed 2025–26 budget items affecting HCAI: BH Connect Medi‑Cal waiver workforce funding, ongoing funding for the Health Care Payments Data Program (HPD), seismic hospital implementation funding and a diaper program; staff also announced HPD is accepting requests for non‑public data.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6330318,"HCAI details response to Southern California wildfires, tracking evacuated nursing homes and federal prescription aid",112,338000,450000,"/Search/View?dp=1&key=2314633-c30796dc6618f76f04ba69428dbee1eb&start=338&end=450","https://assets.pipeline.soar.com/2314633-c30796dc6618f76f04ba69428dbee1eb/thumbnail_338000.jpg","/articles/6330318/California/HCAI-details-response-to-Southern-California-wildfires-tracking-evacuated-nursing-homes-and-federal-prescription-aid","https://secure.pipeline.soar.com/6330318-250827022928d68d21437764c5c9d66d/orig.mp4?Expires=1771180849&Signature=WpoRJgtrzAv124BdoBd7qk28yK8D1TZQBPfEwL8iDNu2SuSgYC14tKJHr3wN5NxmAn5VF0MAix0gDWy0oAWYnlL2L64beOuOV9nuCRYKAgrRNcWPai3XSrUoS8L36hKhWQj8SgzSLjzzxw82z-GBVuMoc964aolrZsm6WHmlu-dHgqXyzJSTiT23rbnltJbhJFhHTESScaloIpMYOETPbtM6s9wQfADCRcoBuTwZg5-S1Tic4TvlblUrSmPbCdAiISx0u1-CPhvE7emVjc5QuW8xSFb8ldgHN9jtgDgNMgNeWbGA4hU7union5135HAkxig~fKCYs-9yMcvq1bWrWA__&Key-Pair-Id=KUT5TJCACFTXG","A HCAI staff member opened the advisory committee meeting by describing actions the agency and state partners have taken in response to the Southern California wildfires, including inspections of long-term care facilities and steps to get medications and behavioral-health supports to affected residents. The staff member said HCAI was tracking 11 skilled-nursing facilities that had to evacuate; “1 was destroyed completely, another suffered severe damage,” and field teams are inspecting facilities before they are repopulated.

The staff member told the advisory committee that general acute hospitals in the fire area “defended in place” and did not require evacuation, while clinics, residential treatment programs, congregate living facilities, child-care centers and schools were among other locally impacted sites. The presentation emphasized the need for equitable recovery supports, noting historic displacement in some neighborhoods: “the Eaton Fire destroyed a historic black neighborhood in Altadena,” the staff member said, and added that language access and services for older adults and people with disabilities must be prioritized.

On access to medications, the staff member said Medi-Cal had simplified enrollment and renewal procedures “to get Medi-Cal members their prescription drugs and medical equipment,” and that the Department of Managed Health Care directed plans to assist impacted members in accessing services and published a resource guide. The speaker also said California received federal approval for an emergency prescription assistance program to help people in federally declared disaster areas who lack insurance obtain prescription drugs, equipment and vaccinations. HCAI staff pointed participants to a state resource page created for the fires (www.ca.gov/lafires) and said additional resources are being coordinated across state, local and federal partners.

Committee members and public commenters also raised operational issues during public comment and committee discussion: limited supply and distribution of respirators in evacuation centers; loss of durable medical equipment such as power wheelchairs and ways to replace them; and difficulty coordinating supplies across evacuation centers. Several committee members, including clinicians and county representatives, described ongoing local efforts to consolidate resources for affected medical practices and clinicians and urged continued attention to the needs of practice staff who were displaced or could not work because of closures.

The presentation concluded with reminders of near-term work at HCAI; staff said they are balancing disaster response with the agency’s other deadlines, including regulatory and data work continuing this spring.","Agency staff described inspections and enrollment assistance after Los Angeles fires, reported 11 evacuated skilled-nursing facilities and said federal emergency prescription assistance is available for disaster areas.",{"_33":101,"_35":36,"_37":38,"_39":102,"_41":103,"_43":104,"_45":105,"_47":106,"_49":107,"_51":108,"_53":109,"_55":56,"_57":58,"_59":110,"_61":62,"_63":64,"_65":111,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6330303,"OCA proposes focused behavioral‑health investment benchmark emphasizing outpatient and community services",556,8382000,8938000,"/Search/View?dp=1&key=2314633-c30796dc6618f76f04ba69428dbee1eb&start=8382&end=8938","https://assets.pipeline.soar.com/2314633-c30796dc6618f76f04ba69428dbee1eb/thumbnail_8382000.jpg","/articles/6330303/California/OCA-proposes-focused-behavioralhealth-investment-benchmark-emphasizing-outpatient-and-community-services","https://secure.pipeline.soar.com/6330303-e2ad771782e4ccca3925900f005a4cf0/orig.mp4?Expires=1771180849&Signature=UZ6htflgn~mFpJzGwbTXW44ue9JG4VcOcGQGKE103PT0PuhEMwjb-VqkkQrQ69uHs6uhAd8ui7nmtJ1uGg~7EAjBQ5~TwKMetWDJ80rKbWF~uZ~I94WoNEuvcj9Tg2CVVAqAxyIIzsGvtpb6o6dzD~5k5qDoYkrJyxjW5MEqlkZJHRrtxG7RlLDGsE0iLRhG4hj9p-jyIQcgy2vz4wB1~Xds83yjPUUsYnz4lIE1Bx73gzUFz9tqs36PjcWNFemxWJn65MTG3KXCYOkA49MXy8CNFhHd-dutW3natwU1FzFbNANW8q~1CQRqpmxxRDQwLHreimAt84GzmKEwFR844g__&Key-Pair-Id=KUT5TJCACFTXG","OCA staff presented a straw‑model approach for a behavioral‑health investment benchmark that distinguishes two concepts: (1) measurement of total behavioral‑health spending as a component of total health care expenditures, and (2) a focused benchmark intended to drive investment toward specific services and care settings.

For measurement of total behavioral‑health spending, staff proposed to start with payer data for commercial and Medicare Advantage plans (claims and non‑claims payments) and eventually incorporate Medi‑Cal managed‑care organization data as that reporting is further developed. Staff emphasized that total spending measurement and the benchmark are separate: total spending uses a broad definition that can include inpatient, residential, emergency and long‑term services, while the proposed benchmark would focus on a subset that advances policy goals.

The benchmark straw model staff proposed would promote “timely, high‑quality and culturally responsive care in more appropriate settings with less out‑of‑pocket spending” by focusing on covered, in‑network, outpatient and community‑based behavioral‑health services. Staff described community‑based services as including mobile clinics and supportive services delivered outside traditional clinical settings, and said the benchmark could exclude pharmaceutical spending for benchmark calculations while still measuring it in the overall behavioral‑health spending picture.

Staff cited policy alignment with existing statewide initiatives: Proposition 1’s Behavioral Health Services Act and Behavioral Health Infrastructure Bond, Senate Bill 855 (parity and out‑of‑network coverage when in‑network access is insufficient), and SB 221 (timely access standards for non‑physician mental‑health providers). The staff and the investment & payment work group noted these related laws and said the benchmark should complement — not duplicate — Proposition 1 infrastructure spending and county investments.

Work‑group feedback included broad support for an outpatient/community focus, strong interest in including screenings and assessments in the measurement definition, and debate about how to treat diagnoses such as autism, dementia and self‑harm (the work group favors including behavioral‑health services for those diagnoses but is mixed on including medical services for dementia and adverse self‑harm events). Staff said they will continue refining diagnostic and service definitions with the work group and will return with a recommendation to the board in July; they extended the internal timeline to allow more time for work‑group recommendations.

Committee members raised operational questions about network adequacy, the difference between in‑network telehealth and app‑based providers, continuity of care across therapists and levels of care, and how to monitor whether the benchmark achieves improved access and quality; several members urged tying benchmark implementation to HPD and claims data analyses.","Staff proposed a focused benchmark to encourage payer investment in in‑network outpatient and community behavioral health services, aligned with Prop. 1, SB 855 and SB 221; measurement of total behavioral health spending will remain broader.","actionData","errors"]

Article not found

OCA staff seek feedback on data‑submission guide and options for defining a hospital sector target

HCAI staff outline budget impacts, BH Connect waiver funding and HPD expansion

HCAI details response to Southern California wildfires, tracking evacuated nursing homes and federal prescription aid

OCA proposes focused behavioral‑health investment benchmark emphasizing outpatient and community services