[{"_1":2,"_124":-5,"_125":-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",[32,76,88,100,112],{"_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",6167457,"mediaKeyId","5411017-8d7c43932ff5d45990f11a327f3b1dd5","parentId",5411017,"title","OCA finds commercial behavioral‑health claims rose but recommends delay in setting investment benchmark","audioSeconds",3351,"startMs",7587000,"endMs",10938000,"viewUrl","/Search/View?dp=1&key=5411017-8d7c43932ff5d45990f11a327f3b1dd5&start=7587&end=10938","thumbnailUrl","https://assets.pipeline.soar.com/5411017-8d7c43932ff5d45990f11a327f3b1dd5/thumbnail_7587000.jpg","articleUrl","/articles/6167457/California/OCA-finds-commercial-behavioralhealth-claims-rose-but-recommends-delay-in-setting-investment-benchmark","mediaUrl","https://secure.pipeline.soar.com/6167457-ee29f959020f61afa1b97645b71ff0c3/orig.mp4?Expires=1770664849&Signature=DxZs1GGT~ihdrFH5yQT0rWTBCwIYy1OrhxYAHdf46fq7bZ2cU8sOMj6tQ3N2HD86K3pAtxHqrInQroTSW~IcIN9tM53ft5rsqxTHO8U5tR3BdXbBiFXNY6ca8iVHCYkwiOhhsWDnClb60r5gp12g~ZoGzWLr6wSyGf8a4vyRpXfLiGHQ8IZ2pL3-JHdm1-7e~0r~f0uA~4lRd-EDWXxx8bt7kfCZhSfTi9kp9FYUf7cUfVKn9BJxfkqkZtF9qxsyU0NjFKJuuUc8Cym5JK-3cU2fjLzuWAhfAwD9oVUt6evpZe~ondtNXRdB4-GO0nM~sdczaQTNIt0Yt2rkqnNJxQ__&Key-Pair-Id=KUT5TJCACFTXG","author","Department of Health Care Access and Information","date","2025-07-17T01:19:22Z","article","The Office of Health Care Affordability (OCA) briefed the advisory committee on June 16 about behavioral health spending trends and recommended deferring adoption of a statewide behavioral‑health investment benchmark until OCA completes further data collection and analysis.
What OCA found: Using a Milbank/Federal consensus code set applied to HPD commercial claims, OCA's preliminary analysis showed behavioral health spending in the commercial market rose from 6.6% of total claims spending in 2018 to about 8.2% in 2023. Much of the increase was concentrated in in‑network outpatient professional and facility services—\"outpatient non‑primary care professional services\" grew from about 33% to 43% of behavioral health spending during that period.
Methods and limits: OCA and committee members emphasized that the HPD analysis covers the commercial market and voluntary self‑insured submitters; it does not yet include Medi‑Cal or fee‑for‑service Medicare. The analysis suppresses cells with fewer than 30 claims to protect privacy, and the Milbank approach counts a claim as behavioral health if the primary diagnosis is a behavioral health code or the claim includes specific behavioral health screening/assessment service codes; pharmacy claims are counted if the NDC is on OCA's behavioral drug list.
Benchmark recommendation and rationale: OCA had earlier proposed a two‑phase benchmark that would require payers to increase spending on in‑network outpatient and community‑based behavioral health by specified annual percentages beginning with a 2025 baseline. After the May work group and the board discussion, OCA recommended delaying formal adoption of a benchmark until spring 2028, with a possible reassessment in 2026 if HPD analyses provide sufficient evidence. The stated reasons: (1) payer starting points vary; (2) HPD and payer submissions need further validation and refinement; and (3) several state behavioral‑health reforms (e.g., children and youth behavioral health initiatives, CalAIM changes) are being implemented now and will affect spending patterns.
Committee input: Members raised several concerns: measurement gaps where behavioral health is embedded in primary care visits (secondary diagnoses and coding practices may undercount primary‑care–delivered behavioral health); the need to include county specialty mental health (Medi‑Cal specialty services) and corrections/county care where relevant; the importance of distinguishing mental health from substance use disorder (SUD) spending; and the desire to compare California to other states (Massachusetts, Rhode Island) that measure behavioral health spending.
OCA next steps: OCA will continue HPD analyses, coordinate with DHCS to include Medi‑Cal specialty mental health where feasible, finalize a behavioral‑health definition and code set with the investment & payment work group in July/August, publish those definitions for public comment, and return to the committee in September with a refined measurement proposal. The agency also plans supplemental analyses (drivers, diagnoses, price vs. utilization, payer variation) before resetting any long‑term benchmark.","mediaType","Video","parentTitle","June 2025 | Health Care Affordability Advisory Committee Meeting","oneSentenceSummary","OCA presented HPD and other analyses showing commercial behavioral‑health spending rose between 2018 and 2023—driven mainly by outpatient professional services—and recommended delaying a statewide investment benchmark until further data collection and validation are complete.","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},6167462,"OCA reports transaction trends under Cost and Market Impact Review program; skilled‑nursing and lab deals spike",610,6691000,7301000,"/Search/View?dp=1&key=5411017-8d7c43932ff5d45990f11a327f3b1dd5&start=6691&end=7301","https://assets.pipeline.soar.com/5411017-8d7c43932ff5d45990f11a327f3b1dd5/thumbnail_6691000.jpg","/articles/6167462/California/OCA-reports-transaction-trends-under-Cost-and-Market-Impact-Review-program-skillednursing-and-lab-deals-spike","https://secure.pipeline.soar.com/6167462-78d7cbb3c7b5eeada1b31536b4713e6f/orig.mp4?Expires=1770664849&Signature=GWTrSJ2xV3Z41oHpLpByVhFOPs7qKr0iAmNXACZ2cssmYJjaH9Ke4VuB9zTZuvjw~bBFarRaJFRSDA-a8z~7~fv138yMGvw9w1Tx~W4duIKQXERASU4qq-DEupdVpmtvO5mkaQMH66y6Z17eeBlOUh0hSapeKyiP~TK0jSYrDbdaCia9rNygfd4HSuj890P-i1DYsE~DBsGQTO37a4XI10XOtzgzmvw13ZhJogASCjXBSJ12AyJO2bFj~ugbeLs1tY7Uj~ZeNcMLZqzqdP9DTOXtSBw1V-VKYDRFKIOBjKpY2sS0ALYy27NV~T0OMzHgVyUa7QGCs-5uxYV~bFq9NA__&Key-Pair-Id=KUT5TJCACFTXG","The Office of Health Care Affordability's compliance team told the advisory committee on June 16 that California's Cost and Market Impact Review (CMIR) program has received rising transaction notices since its April 1, 2024 launch and that certain transaction types—especially skilled‑nursing facility and laboratory acquisitions—have become more frequent.
Bridal Kearns, assistant chief counsel for OCA's compliance division, summarized activity: the program handled 10 transactions in 2024 with 16 material change notices and 26 pre‑filing meetings, and continued activity into 2025 with at least six transactions and 10 notices already filed. To date the agency said it has issued waivers for all notices reviewed but remains actively monitoring the market.
Monitoring approach and public tips: OCA described a market surveillance approach that includes public reporting, interagency coordination and a CMIR inbox for tip‑offs. Staff said they have investigated transactions that appeared not to have been filed and have sent inquiry letters when filings appeared required; at least one inquiry spurred a later filing.
Types of deals and examples: The slideshow listed a range of recent filings and transactions—buyers included corporate operators and national chains—and highlighted multiple skilled‑nursing deals, acquisitions of clinical laboratories (Quest Diagnostics, Laboratory Corporation of America / BioReference), and transactions involving provider groups and county health entities. Several filings were under active review at the time of the presentation.
Why it matters: The CMIR program is designed to identify transactions that may adversely affect cost, quality, equity or access by increasing market concentration. OCA staff noted that comparable agencies (Massachusetts Health Policy Commission; Oregon Health Authority) have conducted relatively few comprehensive reviews despite many filings, and that CMIR reviews are therefore uncommon but important when market facts warrant deeper analysis.
What the committee asked: Members asked about public resources (flowcharts, FAQs) and how OCA evaluates complex ownership chains; staff emphasized that submitters are asked to provide organizational charts and ownership flows and said those charts have been instrumental to their assessment work.
What's next: OCA staff said they will continue outreach, refine guidance and use public leads to identify potential non‑filings. The agency encouraged public messages to cmir@hca.ca.gov when community members suspect a transaction should have been filed.","OCA's compliance division reported increased use of the Cost and Market Impact Review (CMIR) process since April 2024, with a notable rise in skilled‑nursing facility and laboratory acquisition notices. Officials said they have waived reviews to date but are actively monitoring suspected unreported transactions and encouraging public tip‑lines.",{"_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},6167467,"OCA outlines approach to measure hospital spending; seeks work‑group input on outpatient intensity adjustment",1139,4332000,5471000,"/Search/View?dp=1&key=5411017-8d7c43932ff5d45990f11a327f3b1dd5&start=4332&end=5471","https://assets.pipeline.soar.com/5411017-8d7c43932ff5d45990f11a327f3b1dd5/thumbnail_4332000.jpg","/articles/6167467/California/OCA-outlines-approach-to-measure-hospital-spending-seeks-workgroup-input-on-outpatient-intensity-adjustment","https://secure.pipeline.soar.com/6167467-510051bc28bda13dd5227d2c44a5c4d7/orig.mp4?Expires=1770664849&Signature=M8tkYU77Y3Ei1H4sML4txPEYjhk88sadxpKgxzHnpkuKY~k3bWkYPQAZ7knQoKZhFahSNRNyh2wrRAsfR7MarW-LzXzTkfm3ujPiZsCmjVeVnYydZvgQMHCHRJt~O5i4aXlVPFGM6jey0~ecxI9GzdPH7OeNQ3BO1rHZBRq-Z5b9~7jLGCrtjfbTPzVlOjWqslUsjBjz~KaF5vueFjP5ROFKlzL3H-iSq8VHyiJwKJDJ0XYhUmgdcgXrp5pI753YfwZWRXWTWWL8bTe7dKkUJGRC1fQXAvru6pZSIU~twmsuHSu0WVZKtAUVKtF15GbTieSAF9cIpNsAugWhqea7ag__&Key-Pair-Id=KUT5TJCACFTXG","The Office of Health Care Affordability (OCA) briefed its Health Care Affordability Advisory Committee on June 16 on a new approach to measuring hospital spending that would adjust for case complexity in inpatient care and for variable intensity in outpatient services.
The most important change: OCA plans to produce a per‑unit price measure for hospitals that separates volume and case intensity from price. For inpatient services, OCA will use the well‑established case mix index (CMI) to convert discharges into case mix adjusted discharges (CMADs) and then divide inpatient net patient revenue by CMADs to calculate inpatient revenue per case‑mix‑adjusted discharge.
Why it matters: Hospital spending accounts for a large share of health care costs, but simple measures that count each inpatient or outpatient visit equally can mask underlying changes in service mix and intensity. The proposed method aims to isolate price changes from changes in utilization or patient complexity.
On outpatient care, OCA told the committee that it will develop an outpatient intensity adjustment (OIA) because outpatient services vary widely in complexity—emergency visits, imaging, infusion or outpatient surgery are not equivalent. OCA is considering two technical approaches to compute weights from HPD claims data: (1) CMS outpatient prospective payment system APC weights, a public grouper, and (2) the 3M Enhanced Ambulatory Patient Group (EAPG) grouper, which is proprietary but can produce payer‑specific weights.
The OCA presentation flagged tradeoffs: APCs are transparent and publicly documented but are Medicare‑based and may underrepresent intensity for children's hospitals or maternity care; EAPGs can reflect all‑payer use but are proprietary and less transparent. OCA staff said their preference is to prioritize a public grouper where feasible but to explore EAPG if APCs fail validation checks.
Validation and data sources: OCA will use its Health Care Payments Data (HPD) all‑payer claims database to apply the chosen grouper to hospital outpatient claims, sum relative weights to produce an average outpatient weight per hospital, and then multiply hospital‑reported outpatient visit counts (from hospital financial reports submitted to HCAI/OCA) by the weight to reach adjusted outpatient visits. Per‑unit outpatient revenue would then be outpatient net patient revenue divided by adjusted visits.
OCA reported initial validation work showing the HPD captures roughly 80% of California utilization (82% of total population, 89% of insured population) and similar aggregate utilization and revenue trends to hospital financial data. The agency will continue correlation analyses, compare CMI calculated from HPD against patient discharge datasets, and evaluate representativeness by payer type and service line.
Next steps and governance: OCA will reconvene the hospital spending measurement work group this summer to obtain input on the outpatient intensity approach, continue validation against hospital financial reports and patient discharge datasets, and present updated methodology to the OCA board and public later this year.
What was not decided: No final methodological choice was made; OCA asked the work group for feedback about APCs versus EAPG and how to handle special facilities (children's hospitals, psychiatric or long‑term acute care).
","OCA described a methodology for measuring hospital spending that adjusts inpatient discharges with a case mix index and proposes developing an outpatient intensity adjustment using either CMS APC weights or a proprietary EAPG grouper. OCA will validate methods with HPD claims and hospital financial reports and reconvene a work group this summer.",{"_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},6167473,"California officials press for more pharmacy data, expand CalRx authority to curb drug costs",855,1635000,2490000,"/Search/View?dp=1&key=5411017-8d7c43932ff5d45990f11a327f3b1dd5&start=1635&end=2490","https://assets.pipeline.soar.com/5411017-8d7c43932ff5d45990f11a327f3b1dd5/thumbnail_1635000.jpg","/articles/6167473/California/California-officials-press-for-more-pharmacy-data-expand-CalRx-authority-to-curb-drug-costs","https://secure.pipeline.soar.com/6167473-a561b69f58ea17f8385e1cf317c89739/orig.mp4?Expires=1770664849&Signature=GG4uyxlvhySea6t7F~zSDq2St2oUzFflkejDR2No3eVEH~7ngLrqcKSNsSVHG~0mBznM6VcYa-3k9IArn0wFFH5cXvw17w-HfOhElxC7dZ8d0DPK953rg78QnOoPsOaQHsOS~OdPN0ylFxZ14ZV16SoQWWoZf2hpZaxbDza8FDtOp-~VdBYiaFC1zJbp2fS~Xn5T-PnTdrKx0Z~RCkzqgSgcDnR9r3n~Wtwoo6DKdvVdpTQ2BfGzpsg5Vuxp6mv58Ydlh-4PM73RNU66bqNNc4pPL6ABt2V5673LQpEDgvcieZETrn0wdwE0eTJz2JjC2pwR6V6uRbVLHNTM70EKlw__&Key-Pair-Id=KUT5TJCACFTXG","California health policy officials told the Health Care Affordability Advisory Committee on June 16 that prescription drugs are a major and growing driver of health spending and that the state needs better data and tools to curb rising costs.
The Office of Health Care Affordability (OCA) and the Health Care Affordability Initiative (HCAI) outlined a series of steps: add pharmacy benefit manager (PBM) data to the Health Care Payments Data program if the budget provision is enacted; expand the state's CalRx initiative to allow partnerships with brand-name manufacturers; and begin collecting richer non-claims pharmacy payment data starting in September 2025.
Why it matters: Committee members and staff said high and rapidly rising drug prices—especially new classes of medicines such as GLP-1 weight-loss drugs and very costly cell-and-gene therapies—are straining hospitals, employers and patients. Without better transparency into PBM contracts, rebates and spread pricing, officials said they lack the information needed to assess how much of list-price growth is passed to consumers and plans.
Vishal Fishel, an HCAI presenter, summarized evidence and policy steps. He said, “Pharmaceuticals are a Cost Driver,” and walked the committee through research on prescription spending growth, the distribution chain (manufacturers, wholesalers, pharmacies, PBMs, payers), and common market failures such as rebate walls, patent thickets and spread pricing.
Fishel described OCA's two workstreams for drug policy: (1) support for OCA's ongoing spending-target and cost-driver analyses, including whether specific drug costs should be treated as allowable factors for exceeding targets; and (2) broader research and policy work that could support programs such as CalRx. He said OCA is building a small in-house pharmaceutical policy team for both buckets.
On data and near-term actions, the committee heard that the May Revision to the state budget proposes requiring PBMs to be licensed by the Department of Managed Health Care and to provide drug cost, rebate and distribution channel information to the HPD. If enacted, those filings would give OCA access to PBM payments to PBM-owned pharmacies, rebate amounts, scripts counts and other distribution detail.
The presentation noted existing statutory and regulatory authorities OCA already uses: the SB 17 manufacturer advance-notice reporting requirement (price increases and new high-cost drugs) and OCA's authority to collect non-claims payment information under the HPD. Fishel said the HPD has posted more than 7,500 manufacturer reports to date and that the agency will begin collecting non-claims payment data, including rebate information, later in 2025.
Committee members described practical barriers that patients and clinicians face. Several clinicians and committee members described lengthy prior-authorization processes and situations where patients have been left without essential medications because of formulary or supply issues; one clinician said a patient had been out of insulin for months. Committee members urged OCA to track expanded clinical uses for existing drugs and to measure non-claims and out-of-pocket spending as part of affordability work.
The director of HCAI noted CalRx's proposed expansion in the May Revision to allow state partnerships with brand-name manufacturers and a $5 million emergent response fund to respond to supply shocks or market manipulation. Officials said OCA would use HPD claims and other data (Census-based demographic data, Board of Pharmacy location data) to plan equitable distribution for CalRx products when they become available.
What's next: OCA plans to collect additional rebate and PBM data as part of the HPD non-claims data collection beginning September 2025 if the budget proposal is enacted. Staff said they will continue to analyze HPD claims and non-claims data and to provide follow-up briefings to the committee.
","OCA and HCAI officials updated the advisory committee on escalating prescription drug spending, plans to collect more pharmacy benefit manager data into the Health Care Payments Data program (HPD), and proposed expansion of the CalRx generic-drug procurement program to include brand-name partnerships and an emergency response fund.",{"_33":113,"_35":36,"_37":38,"_39":114,"_41":115,"_43":116,"_45":117,"_47":118,"_49":119,"_51":120,"_53":121,"_55":56,"_57":58,"_59":122,"_61":62,"_63":64,"_65":123,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6167452,"OCA baseline report: California health spending rose 8.2% in 2023; admin costs and profits drew scrutiny",787,12513000,13300000,"/Search/View?dp=1&key=5411017-8d7c43932ff5d45990f11a327f3b1dd5&start=12513&end=13300","https://assets.pipeline.soar.com/5411017-8d7c43932ff5d45990f11a327f3b1dd5/thumbnail_12513000.jpg","/articles/6167452/California/OCA-baseline-report-California-health-spending-rose-82-in-2023-admin-costs-and-profits-drew-scrutiny","https://secure.pipeline.soar.com/6167452-8e238645c4d143cc15dafff77760bc11/orig.mp4?Expires=1770664849&Signature=UVKirPBWXaw2VSonlg4NXhwDI82BpBikSmv2Lyieau9Ha30lObV5pUdU0UF2B2Oya4VjgjsKGt1uAkSgSI4r8GErndXe0FzXCl1D2lBjPaWtBF4MDUgHVLhVOTLgMVVqrUTLCZgW7HYCAkcIXa9yOzB66Rkvmc4o1o0g98Um6yDdLA2NxAMUSDLlCWC1wOMc9CBvUk4D5h6BJdXaEKlrAVeoVWmss9PRRQdSO075cLpzp3P4FHSvmbPFQ7xa8KGzoc9yBwwpg2JoG~diW6VX2Ws-926zQZ5EhlMtyZGquZXvAIeDGhjMUKstMzKhJ4~tG9NBrSwgI3fv1OnsCruCtw__&Key-Pair-Id=KUT5TJCACFTXG","OCA staff presented key findings from its inaugural baseline report to the advisory committee on June 16: total statewide health care expenditures (THCE) rose from about $377.6 billion in 2022 to $408.6 billion in 2023, an 8.2% increase; per‑capita THCE rose from $9,676 to $10,847 (an 8.4% increase).
Breakdowns by market: The report showed 2023 shares and growth by major market: commercial spending rose 5.8% to $127.8 billion (about 31% of statewide THCE), Medicare (non‑dual) grew 6.0% to $112.6 billion (28% share), and Medi‑Cal grew 6.5% to $134.1 billion (33% share). Dual‑eligible spending reported separately rose 35% year over year, from $6.5 billion to $8.8 billion, driven in part by changes in how dual‑eligible services were reported.
Per‑member measures and drivers: Total medical expense (TME) per member per year increased most rapidly in the commercial market (roughly 5% growth PMPY), while Medi‑Cal TME PMPY rose more slowly (about 1.2%). Service categories contributing most to recent TME growth included retail pharmacy, outpatient hospital services and capitation. Retail pharmacy spending growth was repeatedly cited in committee discussion as a key driver.
Administrative costs and profits: A slide showing payer administrative costs and profits per member attracted substantial attention: OCA used medical loss ratio (MLR) filings (for large insurers) and department financial filings (for smaller Medicare Advantage payers) to estimate administrative cost & profit components. For example, commercial administrative costs and profits per member rose from $463 to $580 year over year (a 25% increase) and accounted for about 8% of commercial THC in 2023; Medi‑Cal managed care administrative costs and profits rose from ~$495 to $625 (about 15% of Medi‑Cal THC). Several committee members and a public commenter asked OCA to probe drivers of that increase and to explain reporting differences across markets.
Data collection notes: OCA collected TME directly from commercial and Medicare Advantage payers (mandatory submitters) and worked with DHCS to capture Medi‑Cal managed care and fee‑for‑service spending. OCA noted the baseline report understates commercial administrative cost and profit spending because some self‑insured plans did not report admin/profit detail. OCA published an accompanying data book showing payer‑level figures, age and diagnosis adjustments, and formulas used to derive PMPY and per‑capita figures.
Next steps: OCA staff said they will keep improving the baseline data (resolve classification of some DHCS spending, refine admin/profit reporting, and add subsequent years) and will use the validated baseline as the starting point for monitoring the statutory health care spending target.","OCA's baseline report showed statewide total health care expenditures rose to $408.6 billion in 2023 (an 8.2% increase from 2022); per‑capita THCE rose to $10,847. Committee members and public commenters questioned a notable rise in payers' administrative costs and profits and asked OCA for further analysis.","actionData","errors"]

Article not found

OCA finds commercial behavioral‑health claims rose but recommends delay in setting investment benchmark

OCA reports transaction trends under Cost and Market Impact Review program; skilled‑nursing and lab deals spike

OCA outlines approach to measure hospital spending; seeks work‑group input on outpatient intensity adjustment

California officials press for more pharmacy data, expand CalRx authority to curb drug costs

OCA baseline report: California health spending rose 8.2% in 2023; admin costs and profits drew scrutiny