[{"_1":2,"_111":-5,"_112":-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",[32,75,87,99],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":44,"_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":73},"mediaId",6318287,"mediaKeyId","2367680-209c601795bf4e30c5f57e6a3b27fbbb","parentId",2367680,"title","Office updates on material change reviews and 2025 data collection timeline","audioSeconds",0,"startMs",14636000,"endMs","viewUrl","/Search/View?dp=1&key=2367680-209c601795bf4e30c5f57e6a3b27fbbb&start=14636&end=14636","thumbnailUrl","https://assets.pipeline.soar.com/2367680-209c601795bf4e30c5f57e6a3b27fbbb/thumbnail_14636000.jpg","articleUrl","/articles/6318287/California/Office-updates-on-material-change-reviews-and-2025-data-collection-timeline","mediaUrl","https://secure.pipeline.soar.com/6318287-c4e42c0e349e4ec761b105d94c5915df/orig.mp4?Expires=1771170796&Signature=o5bv552UAbJUJX~yKlj8sbERt0vzFDdMaT08mKbHgKi3U3VkqJGJLXH3RuwBosC4x4uj8WBOAlne6NfjgRl3lMLVAIcHcEAvQbsze7ZuR00wYg05cpttWlS9t5bQWnf3euoW6FUU0b6trX8irfgeeIZkRgtVf0OeqWk~yNQE~u4B8HICWxLZfv3hDHrOUrJGQSFvVaXCJF3HearGWvzosLFBu1eoIB6aKoPyEWilqjxvPgKeJj57jElni-IWqlzVlcZxC9WCnWpqpY3m0yIfYVVl-N8buZU3NNhXptyl9DPGit9eQQGJP7IxJSl2rXcMMRvFAUMRPqRWP62g-45Njw__&Key-Pair-Id=KUT5TJCACFTXG","author","Department of Health Care Access and Information","date","2025-02-20T23:06:52Z","article","The Office of California Health Care Affordability reported on activity under the material change/merger review program (CMIR) and summarized the 2025 timeline for data collections used to measure spending and alternative payment model adoption.

CMIR activity: The office reviewed notices and inquiries submitted after the statute took effect. From April through December staff received notices and determined 10 transactions (16 complete submissions) required review; eight submissions received waivers and the average time to issue a waiver has been 22 working days. Examples included transfers of skilled‑nursing facilities and practice acquisitions in multiple counties; several submissions remain under staff review. The office said it will publish filings that are complete and that parties may ask questions through OCA’s CMIR inbox (cmir@hca.ca.gov).

Data collection and timelines: Staff outlined proposed changes to the Healthcare Total Cost (THC) Data Submission Guide (version 2), now released for public comment. Key elements:
• Alternative Payment Models (APMs): OCA will collect payment and membership data consistent with the expanded HCAI non‑claims data framework and aligned to HCP‑LAN adoption categories; OPMs linked to quality will be reported separately because those count toward adoption goals.
• Primary care spending: OCA will collect claims and non‑claims primary‑care spending by market and payer using a defined “primary care code set” (provider taxonomies, services, and places of service). Staff will collect professional capitation allocations and specified behavioral‑health services delivered in primary‑care settings as part of primary‑care spending.
• Calendar: draft regulations and Data Submission Guide 2 were released for comment; required submitters will register in May, may submit test files in June, prepare 2023 calendar‑year files in July–August, and file final data by Sept. 1, 2025. Staff plans a second baseline report to be published on or before June 1, 2026.

Why it matters: The CMIR program is the state’s principal way to surface market concentration and transaction risks for competition and affordability. The data collection timeline and guide shape the metrics OCA will use to measure sector and entity performance and to track progress on primary care investment and APM adoption goals.

","mediaType","Video","parentTitle","January 2025 | Health Care Affordability Board Meeting","oneSentenceSummary","Staff reported recent CMIR (Cost and Market Impact Review) filings and waivers and outlined the 2025 data submission timeline for alternative payment models and primary care spending, including a Sept. 1 data submission deadline for 2023 calendar‑year files.","taxTitle","Department of Health Care Access and Information, Agencies under Office of the Governor, Executive, California","taxId",16207,"location","California","headline","","shortSummary",{"_33":76,"_35":36,"_37":38,"_39":77,"_41":78,"_43":79,"_45":80,"_46":81,"_48":82,"_50":83,"_52":84,"_54":55,"_56":57,"_58":85,"_60":61,"_62":63,"_64":86,"_66":67,"_68":69,"_70":71,"_72":73,"_74":73},6318290,"Board hears budget and data updates: HPD funding, behavioral health dollars, diaper initiative",176,400000,576000,"/Search/View?dp=1&key=2367680-209c601795bf4e30c5f57e6a3b27fbbb&start=400&end=576","https://assets.pipeline.soar.com/2367680-209c601795bf4e30c5f57e6a3b27fbbb/thumbnail_400000.jpg","/articles/6318290/California/Board-hears-budget-and-data-updates-HPD-funding-behavioral-health-dollars-diaper-initiative","https://secure.pipeline.soar.com/6318290-2edb77b765b03ff024239378d6c84020/orig.mp4?Expires=1771170796&Signature=ajhxcU1WIV6cSbkPy9YkldonD5F1Q0iEIUBBmGA2HHQY7msd3g-Hs9LhrlNOMB3P1ECOJXpMSy0MOCQvlQoED4B3OhDNlyqmDyl~9oebip4MJ5xgN3FfY0mWgYycizdkblJsqdySTPAYzmH1EsKHyC8BApQ1bYlwg30dPtOsk21IzIKGtXaK7Kc-acOunN-TRMrTOiIdVF3AYz5QrrwZiTkG60Ww-BQueDA-km1QizGCUaeiY7Yd7QvcqmPl9-~DZdJQXQS-X9ba4duPnhUYV4-w4UQwC5dwHfSlCcHnwb1O2beX33VuNDnQrrvr69qeZ9-VwBwv0qMpGmc~m8ktzg__&Key-Pair-Id=KUT5TJCACFTXG","Staff and the secretary briefed the board on executive updates and budget items that affect OCA and HCAI work.

Key budget items cited by Director Landsberg and Secretary Kim Johnson:
• Healthcare Payments Data Program (HPD): staff said the governor’s proposed budget includes an ongoing appropriation of $22 million per year and 47 positions to sustain HPD beyond its one‑time start‑up funding. HPD is California’s all‑payer claims database and staff reported the HPD data release program has begun accepting applications from researchers for access to non‑public HPD data.
• BH Connect behavioral health waiver: staff said the Department of Health Care Services negotiated a multi‑year waiver that includes about $1.9 billion over five years to expand the behavioral‑health workforce serving Medi‑Cal members; HCAI will submit a budget change package describing any OCA/HCAI resources requested to implement related work.
• Diaper initiative: staff said the governor proposes a pilot for a free three‑month diaper supply for families with newborns and that HCAI would administer components of that program.

Staff also summarized national trends from the Centers for Medicare and Medicaid Services showing accelerated health spending growth in 2023, including especially rapid hospital spending growth (the national data were used as context for staff’s hospital analysis later in the meeting). Staff noted the HPD data release program and plans to demonstrate HPD use to the Office of Statewide Health Planning and Development and other partners at future meetings.

","Staff updated the board on state budget proposals and data program developments: the proposed budget adds ongoing funding for the Healthcare Payments Data Program, includes a major behavioral health workforce waiver, and tasks HCAI with a diaper initiative. Staff said HPD data access is beginning for researchers.",{"_33":88,"_35":36,"_37":38,"_39":89,"_41":90,"_43":91,"_45":92,"_46":93,"_48":94,"_50":95,"_52":96,"_54":55,"_56":57,"_58":97,"_60":61,"_62":63,"_64":98,"_66":67,"_68":69,"_70":71,"_72":73,"_74":73},6318295,"Board reappoints advisory‑committee subcommittee to recommend advisory members",724,1658000,2382000,"/Search/View?dp=1&key=2367680-209c601795bf4e30c5f57e6a3b27fbbb&start=1658&end=2382","https://assets.pipeline.soar.com/2367680-209c601795bf4e30c5f57e6a3b27fbbb/thumbnail_1658000.jpg","/articles/6318295/California/Board-reappoints-advisorycommittee-subcommittee-to-recommend-advisory-members","https://secure.pipeline.soar.com/6318295-307981459c7db24d73b0d404497a85c0/orig.mp4?Expires=1771170796&Signature=I8TygZPacBJch40tSj62BoIcoSPT1JWJxfZ2OE7vASewDYc2YMFTMumZvqM1UMqmWsJz5k10ispxlxcCFRzpUW8wHr7WLQ175iw~LVlKXoDxyWcHprQTHrGJ14xvBQG6aGUZKjL1ihjxCr~5IFIdgiatGub9EAOPCAue36MuF-Om-5FxycNnr1Iy65BXglyMVbF36u73DIzj6wfUx6rewVMUYdK9ZimzWhfeHFh~UINBItPwGy1Q6FU~0F9BaCiEYDUG3b6Y8hovkISrwzNHZir6b0u9zR9nT1cI9uWGHCH2-5nK8robmEhorci0M~NygxftKPVtoUahQ7Gy-nCD2A__&Key-Pair-Id=KUT5TJCACFTXG","The board voted to reappoint the existing subcommittee that handles solicitation and selection of advisory committee members. The motion to reappoint Board Members Richard Pan and Elizabeth Mitchell passed by voice vote, 6 ayes, 1 absent.

Staff overview: Megan Brubaker (Engagement and Governance manager) summarized the advisory committee composition and the statutory requirements for membership, including representation from payers, hospitals, medical groups, physicians, organized labor, consumers, health‑care workers and the state’s diversity of geography and demographics. Twelve advisory positions expire June 30; staff will open a public solicitation in February and accept applications through April. The subcommittee will review candidate applications in April–May and recommend appointments at the June board meeting; new or reappointed advisory members would begin in September 2025.

Why it matters: The advisory committee provides technical feedback that staff and the board use in designing metrics and programs. Members and some public commenters emphasized the value of lived experience representatives (patients, caregivers, retirees), small‑business and frontline workforce viewpoints, and the importance of collecting demographic data consistent with federal standards.

What the board decided: Reappoint Pan and Mitchell to the two‑member subcommittee for the current selection cycle. Staff will proceed with the public solicitation and return recommendations to the board in June.

","The board reappointed Dr. Richard Pan and Elizabeth Mitchell to the subcommittee that selects and recommends advisory committee members; staff outlined the solicitation schedule and eligibility criteria.",{"_33":100,"_35":36,"_37":38,"_39":101,"_41":102,"_43":103,"_45":104,"_46":105,"_48":106,"_50":107,"_52":108,"_54":55,"_56":57,"_58":109,"_60":61,"_62":63,"_64":110,"_66":67,"_68":69,"_70":71,"_72":73,"_74":73},6318300,"Affordability board defines hospitals as a sector, directs staff to craft target methodology",7436,2372000,9808000,"/Search/View?dp=1&key=2367680-209c601795bf4e30c5f57e6a3b27fbbb&start=2372&end=9808","https://assets.pipeline.soar.com/2367680-209c601795bf4e30c5f57e6a3b27fbbb/thumbnail_2372000.jpg","/articles/6318300/California/Affordability-board-defines-hospitals-as-a-sector-directs-staff-to-craft-target-methodology","https://secure.pipeline.soar.com/6318300-78c2fa8f561fd7307d041f32fd6f281e/orig.mp4?Expires=1771170796&Signature=NkQoeLICGkFeo0qQL4tZKFKpWAhZfb1C8mg1YpOM-k6703~fTDXy~7FkXo1fUHBkDQaOlGqVoMdfMyqY-iREbAVG-sZL4pwRgZS938JEySIVzrBD-Up5~pcXR6CCfCYBr4g-~M8Nn~MVXfWhCkrPVvbzjO5AkgjnKoo1rWAWWyXaxEmC~z5iEQROr0rZ-x7b7zT~ZUZOuiKEyHTvA27dBLm1yRyOvCBPkN9NYiFidNhOqmp4Ek9wVoi0eLENZ9c4ErPqfhs3V2vkQ3veddEEPiPLovx4pNsZWleke3LDavsuqQa4xRppBpF94YOVT72RqMmVV0qKBnD3AWwScqmsKw__&Key-Pair-Id=KUT5TJCACFTXG","The Office of California Health Care Affordability voted to define hospitals as a health-care sector, a procedural step that lets the board set hospital-specific spending targets separate from the statewide target. The board approved the motion by voice vote, 6 ayes, 1 absent.

The designation does not itself set a numeric target. Staff told the board they will return with recommended methods and proposed target values for discussion at the February meeting, publish a 45‑day public comment period, and seek formal adoption before the statutory deadlines for sector work later this year.

Why it matters: Hospitals account for a large share of state health spending and for significant variation in prices across California markets. Defining hospitals as a sector lets the office apply methods tailored to hospital inpatient and outpatient spending and to adjust requirements for facilities the office determines are “disproportionately high cost.” Supporters said acting now balances urgency for relief with time to refine measurement; opponents urged more analysis before special rules are created.

Staff presentations summarized two candidate price measures used in analysis: inpatient commercial net patient revenue per case‑mix‑adjusted discharge (NPR per CMAD) and a commercial‑to‑Medicare payment‑to‑cost ratio. Board members and advisory committee members raised concerns about each measure’s limitations, the need to avoid misclassifying hospitals with atypical payer mixes (for example, safety‑net or specialty hospitals), and the potential for small hospitals to generate volatile averages.

Board discussion emphasized process and transparency. Board member Richard Kronick urged speed and clarity: “This seems like a no brainer. I mean, hospitals are a sector.” Several members and public commenters pressed staff to include Kaiser hospital data at the hospital level where available and to examine system‑level payments when hospitals are part of larger integrated organizations. Staff said HCAI currently collects some facility‑level Kaiser reporting beginning in 2021 and will extend analysis as more Kaiser data become available. Staff also said they will consider system‑level context when reviewing individual entity performance as part of any enforcement or performance improvement process.

The board asked staff for clearer thresholds and measures for deciding which hospitals would merit an adjusted, lower target and for options on how long any adjusted target would apply. Staff presented three identification options for “disproportionately high‑cost” hospitals: repeat outliers by unit price (commercial NPR per CMAD), repeat outliers by relative price (commercial to Medicare payment‑to‑cost ratio), or hospitals that are repeat outliers on both metrics. Staff showed the sensitivity of each approach (different percentile cutoffs yield between about 5 and 23 hospitals identified as outliers, depending on thresholds and volume filters).

Staff reiterated schedule and next steps: staff will return with a recommended methodology and proposed target values in February, open a 45‑day public comment period, and seek any regulatory adoption necessary to implement targets. Staff noted statutory timing: the board must define initial healthcare sectors on or before Oct. 1, 2027, and establish sector targets by June 1, 2028, though the board may move earlier, as it did by defining hospitals now.

Votes at a glance: The board’s formal vote to define hospitals as a sector passed 6–0 with 1 member absent. The minutes and other procedural items were approved earlier in the meeting (see separate actions). Staff will return with a detailed target‑setting proposal and values for Board consideration in February.

Looking ahead: The board’s action opens a formal, public rulemaking and comment cycle on hospital target methodology and on any adjustments for individual hospitals or hospital groups. Staff signaled it will engage advisory stakeholders and publish comparisons that include Kaiser facility data as more years become available.

","The state Office of California Health Care Affordability voted to designate hospitals as a distinct sector so the board can set sector-specific spending targets. The board asked staff to return with a methodology and target proposals, while debate focused on metrics, Kaiser reporting, and protecting access.","actionData","errors"]

Article not found

Office updates on material change reviews and 2025 data collection timeline

Board hears budget and data updates: HPD funding, behavioral health dollars, diaper initiative

Board reappoints advisory‑committee subcommittee to recommend advisory members

Affordability board defines hospitals as a sector, directs staff to craft target methodology