[{"_1":2,"_100":-5,"_101":-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],{"_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",6076655,"mediaKeyId","2968347-e52f39e603ac4a16aae7f1dabb42c2fb","parentId",2968347,"title","Board member David Carlisle to leave Healthcare Affordability Board; colleagues praise his service","audioSeconds",362,"startMs",218000,"endMs",580000,"viewUrl","/Search/View?dp=1&key=2968347-e52f39e603ac4a16aae7f1dabb42c2fb&start=218&end=580","thumbnailUrl","https://assets.pipeline.soar.com/2968347-e52f39e603ac4a16aae7f1dabb42c2fb/thumbnail_218000.jpg","articleUrl","/articles/6076655/California/Board-member-David-Carlisle-to-leave-Healthcare-Affordability-Board-colleagues-praise-his-service","mediaUrl","https://secure.pipeline.soar.com/6076655-ddf7037f115ff7108b99a7e70a56ae87/orig.mp4?Expires=1771145576&Signature=EbCaB3TE9hD33Mvr1sso5xELHlCv4U5J7rZV1gaiZMSxMJQFLFLGdTXiznAoGoesOR6EtfoW0rUCkOZQlYrfYKLYtEOI8UEbxhsP8Nhfl1ISPXnwhLwqXEIRmIfjTDQsmFHBKX6U448VOCizIzPNZBGWp-e3Gm10aU4VKmsZ~N0b0thcLhEt47dUV2MBzLWnjrVGunZPjZToqf4Mbu~NYWzbFow4WFm5IaRX9cVTri0hUpNr47IKq001lr7U4nAmpDmw4FWtsOQdIwAjCxH4S12QUBHgPXED0qKzotw9PEZ8QQ5Jq3Vt7-GO9ziYbmB2rJrBSuih9YEhAjVcACMcjQ__&Key-Pair-Id=KUT5TJCACFTXG","author","Department of Health Care Access and Information","date","2025-04-11T22:31:25Z","article","Board leadership announced at the start of the March 12 meeting that Dr. David Carlisle notified them he will resign from the Healthcare Affordability Board and that the meeting was his final session. Director Landsberg and Secretary Kim Johnson each thanked Carlisle for his service, noting his long career in medical education and public service and prior leadership of the predecessor agency OSHPD.

Why it matters: Carlisle was a governor‑appointed, Senate‑confirmed member whose public‑facing contributions included expertise on clinical quality, health disparities and hospital finance. Board members offered personal remarks and best wishes for his continued work with Charles R. Drew University.

Key remarks: Director Landsberg recounted Carlisle’s role as a former director of OSHPD and his leadership at Charles R. Drew University. Secretary Kim Johnson thanked Carlisle for “bringing comprehensive approaches and the best information possible” to the board. Carlisle said, “It has indeed been an honor and a privilege to serve on this board,” and that he will remain engaged in Sacramento.

Ending: The board did not announce a replacement at the meeting and will proceed with the scheduled agenda. Staff and board members said they will follow the statutory appointment process for the vacant seat.","mediaType","Video","parentTitle","March 2025 | Health Care Affordability Board Meeting","oneSentenceSummary","The board acknowledged the resignation of Dr. David Carlisle, who said he will step down to devote more time to his role at Charles R. Drew University; colleagues and staff thanked him for his contributions.","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},6076660,"HCAI reports progress on California Health Care Payments Database; adds public reports and opens regulated data‑release process",4473,13306000,17779000,"/Search/View?dp=1&key=2968347-e52f39e603ac4a16aae7f1dabb42c2fb&start=13306&end=17779","https://assets.pipeline.soar.com/2968347-e52f39e603ac4a16aae7f1dabb42c2fb/thumbnail_13306000.jpg","/articles/6076660/California/HCAI-reports-progress-on-California-Health-Care-Payments-Database-adds-public-reports-and-opens-regulated-datarelease-process","https://secure.pipeline.soar.com/6076660-2b446c28238cf6712e97611abfbe0b09/orig.mp4?Expires=1771145576&Signature=Sh3JAfOWLFso3DWXTTZvkSxhAYFhn9bUToCgwCexJD03-GKwy4~bYbKHb9xAO0vYAIxvZzddPDpQoepoHOEM6e~FHhviIsf1b0hZqpzLN0Tsr4vBgbgv0LPngTSg4RZOozIqK1npe-Zyz6-FnN8q5Uk~9ukB2XVsDqqFo6AkstNe-wlti2jrixaXOyE86FsBcVYoDpE0YjHN3pTn3hkuLae7u5m-xUIYXHqlYao-hRIUgbffueGX5HRN5RsedgDnuuhYP9nxp8ImSHobW6SA7X4-WJBRcT5dJoS0Y6L1seS~L~crUyUTp1eC4hNE8LeYdxW~y9gQo0TX6zYZDXs-1w__&Key-Pair-Id=KUT5TJCACFTXG","The Department of Health Care Access and Information (HCAI) told the Healthcare Affordability Board on March 12 that California’s Health Care Payments Database (HPD) has reached several implementation milestones and is now producing public reports while standing up a regulated data‑release program for qualified researchers.

HCAI Deputy Director and CIO Michael Valle said the HPD now ingests three payer sources: Medi‑Cal (Department of Health Care Services), Medicare fee‑for‑service (CMS), and commercial plans (mandatory submitters defined as plans covering 40,000 or more lives, plus all Covered California plans). Valle noted the HPD currently covers roughly 32.6 million covered lives across payer types and contains detailed claims records useful for utilization, price and prescription drug analysis.

Why it matters: the HPD is intended to give policymakers and researchers a detailed, multi‑payer view of healthcare spending and utilization in California. Board staff and outside researchers will use the HPD to evaluate cost drivers, monitor the effects of any sector targets, and analyze equity impacts.

Recent public releases and analytics: doctor Chris Krawczyk, Chief Analytics Officer, described public visualizations and reports already available on HCAI’s website: the HPD Snapshot and Measures dashboards (first and second‑generation releases), a fee‑for‑service prescription drug cost visualization for the commercial market, a services visualization that counts common procedures by setting, and a newly published out‑of‑pocket costs for chronic conditions report (released the week of the meeting). Krawczyk demonstrated the drug and out‑of‑pocket visualizations during the meeting, showing how a small share of prescriptions account for a large share of pharmacy spending and how county‑level median out‑of‑pocket burdens vary.

Data quality and gaps: Dionne Evanstein, Chief Data Programs Officer, said HPD data completeness is high for operational billing fields (procedure codes, dates, dates of service, national drug codes) but lower for optional demographic items such as race/ethnicity in commercial files. She warned that provider roster fields (NPI, address, entity type) sometimes contain inconsistencies across submitters, requiring enterprise data‑quality work and NPIs to be matched to federal NPIs (NPPES) for cleanup.

Non‑claims payments and timelines: Evanstein said HCAI is moving to adopt rules to collect non‑claims payment data (monthly capitation files, annual non‑claims payments and pharmacy rebates) using a standardized layout developed in coordination with national partners. If OAL approves the regulation, HCAI expects to begin testing in fall 2025 and accept production non‑claims submissions in fall 2026.

Data‑release program launched: HCAI also announced the HPD data‑release regulations were adopted in November 2024 and the program launched December 17, 2024. The office has received multiple data‑release requests and held an informational webinar in January 2025; HCAI expects its data‑release committee to review the first request in its May 2025 meeting. The data‑release pathway enables non‑public, identifiable or de‑identified HPD extracts to be shared with approved researchers and government partners under regulatory safeguards.

Examples of current analytic work: Margaretta Brand (OCA) described an HPD‑based behavioral‑health spending analysis that uses a Millbank/Friedman methodology to classify claims as mental‑health or substance‑use disorder spending by care setting, and which will feed OCA’s deliberations on how to set a behavioral‑health investment benchmark.

Public comments and next steps: public commenters praised the HPD for transparency and urged sustained state funding; HCAI reminded the board that the HPD’s initial implementation funding expires in June 2025 and invited support for ongoing appropriation. HCAI said the HPD team will continue to refine data quality, expand reporting (2022–2023 data updates were scheduled for release in the second quarter of 2025) and partner with OCA on cost‑driver work and equity measures.

Ending: HCAI said the HPD is now productive for public reporting and research and will broaden its value when non‑claims payment files are added and voluntary ERISA/ self‑insured submissions increase through outreach.","Staff from the Department of Health Care Access and Information (HCAI) summarized recent Health Care Payments Database (HPD) releases, data‑quality work, plans to collect non‑claims payments (capitation, rebates) and the newly launched data‑release process for qualified researchers and government partners.",{"_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},6076666,"Healthcare Affordability Board revisits hospital-sector target method after hospitals urge changes and warn on access",6524,1276000,7800000,"/Search/View?dp=1&key=2968347-e52f39e603ac4a16aae7f1dabb42c2fb&start=1276&end=7800","https://assets.pipeline.soar.com/2968347-e52f39e603ac4a16aae7f1dabb42c2fb/thumbnail_1276000.jpg","/articles/6076666/California/Healthcare-Affordability-Board-revisits-hospital-sector-target-method-after-hospitals-urge-changes-and-warn-on-access","https://secure.pipeline.soar.com/6076666-481879a7a6f717be1bd4bb26258de182/orig.mp4?Expires=1771145576&Signature=UEtKG37ByI58P8rvazauHYrRuHYqFrgrrIBtsSRTTptZHWA0CTPMaIXI2Vu0Kqp75L0VrcA8EqF3o4IEGE16CaUNyUxbf~h0wm9pa5xqhP82TF76QBykfrAz4juIwk59dZKbDEiwtYjz7AmomyVomR5fT~YliiGWGo45Tg-tFInUK2NcdCuBQgO-Ny~eGECwvMNsPtcUNQwYymv-CYVWg86c-~yO9aVfxpMz3wM1MGaIMkNOOGnPoGF1QmlFTMl~UPheNuV38E4KXxJkNsO88ZWH0m8DvVyk02g6sULxcfrGAwZDT2gjNHEmxpW-Xek6DqdbTCORNXQ6BGEVT-0FJA__&Key-Pair-Id=KUT5TJCACFTXG","The Healthcare Affordability Board on March 12 reviewed staff follow-up on the proposed hospital-sector target methodology, presented additional hospital feedback and advisory committee input, and heard extended public comment from hospital officials, community representatives and unions.

Board staff said they met with more than a dozen hospitals and health systems to test options for identifying “disproportionately high-cost hospitals” and to consider measures that would justify a lower spending target for some facilities. Vishal Pagani, Deputy Director for the Office of Cost and Analysis (OCA), told the board, “By the end of this month, we plan to post an advance notice of emergency rulemaking for the regulatory proposal online,” and explained the Office would submit the package to the Office of Administrative Law for review.

Why it matters: the board is working to translate the statewide spending benchmark into sector- and provider-level signals that identify outlier hospitals whose prices or growth substantially exceed peers. Hospitals, public hospitals and county advocates argued the current proposals risk harming access to care in small and rural communities and urged the board to refine definitions, add thresholds for low-discharge facilities, and account for system-level finances.

Most of the board discussion focused on technical choices that determine which hospitals appear as “high cost,” including (1) whether to reinstate a discharge threshold to exclude very small facilities, (2) whether to evaluate operating margins at the system versus the facility level, (3) how to treat Medicare Advantage and capitation revenue, and (4) whether to add measures such as charity care, graduate medical education (GME) funding or seismic retrofit costs as contextual modifiers.

Board members pressed staff on data reliability and fairness. Ian Lewis (board member) said the role of health systems in the calculation was “striking” because systems can be used to argue opposite outcomes — either to spread fixed costs or to mask higher prices — and asked staff to return with a clearer approach. Staff described a case study with North Bay Medical Center, whose reported commercial revenue fell after 2021 when a new reporting firm reclassified Medicare Advantage receipts into Medicare categories; staff said they validated the shift and flagged the hospital’s plan to resubmit corrected prior-year filings.

Hospitals and public hospital groups asked for a narrower approach to enforcement. Representatives repeatedly warned that some small hospitals carry fixed costs that cannot be spread across many discharges and that workforce, local cost of living and union contracts materially raise operating costs. Dr. Candry Yee, Vice President of Hospital Operations at Barton Health, told the board: “We are not just a hospital. We're the sole provider of essential healthcare services for thousands.” Barton officials described Barton as a small, geographically isolated provider with a 63‑bed license, an average daily census of about 18 and outpatient growth they say they subsidize to preserve access; the hospital noted it plans more than $6 million in clinic expansion to add mental health and addiction services.

Advisory-committee input and data improvements: the OCA advisory committee generally supported the multi-measure approach but recommended additional geographic balancing and technical assistance. The advisory group favored the board’s approach to identify repeat outliers across multiple years (OCA’s current 3‑of‑5 rule was discussed) and suggested exploring rolling three‑year averages to capture recent trends. Several committee members urged OCA to study low-cost outlier hospitals as potential models for replication.

Public comment was extensive. Multiple rural and district hospitals, Dignity Health and other systems warned that aggressive targets could trigger service reductions or closures; union and consumer groups urged speed and called out wide price variation across counties. Small-business advocates described how steep premiums affect employers’ benefits decisions.

Where the board left off: staff recommended finalizing the hospital-sector definition in regulation to preserve the board’s option to set sector-specific target values later. CJ Howard, Assistant Deputy Director for Healthcare Spending Targets, summarized public comment submitted on the draft sector regulation as falling into two camps — those who said it was premature to single out hospitals and those who supported adopting a hospital-sector definition consistent with the statute and noted that inclusion in the sector does not automatically mean an entity will receive a different target value.

What’s next: staff said OCA will post the advance notice of emergency rulemaking, accept public comment, and submit the regulatory package to OAL. Meanwhile, the office will continue data-validation work and outreach to submitters to correct reporting anomalies and to explore adding non‑claims payments (capitation) to the Health Care Payments Database (HPD) to better measure total payments.

Ending: Board members repeatedly stressed the need to balance affordability objectives with stable access, particularly in rural and safety‑net communities. Several members pressed for additional data and clearer criteria before finalizing any facility‑level target values.","Board staff summarized follow-up work on the proposed hospital-sector methodology and values, reported meetings with hospitals and advisory committee feedback, and heard public comments warning that rigid targets could threaten small, rural and safety-net hospitals.","actionData","errors"]

Article not found

Board member David Carlisle to leave Healthcare Affordability Board; colleagues praise his service

HCAI reports progress on California Health Care Payments Database; adds public reports and opens regulated data‑release process

Healthcare Affordability Board revisits hospital-sector target method after hospitals urge changes and warn on access