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OCA adopts aligned quality and equity measure sets; will consider hospital safety (HAI) measures with sibling agencies
Summary
OCA presented the proposed quality and equity measure set it will use to monitor performance as spending targets are implemented. Staff recommended adopting existing public measure sets — DMHC’s health equity and quality measures for payers, the Office of the Patient Advocate (OPA) Report Card subset for physician organizations, and the HCAI
OCA staff presented the office’s recommended quality and equity measure set and described how it plans to coordinate with sibling state departments on hospital patient safety measures.
What the office proposed
OCA will adopt or align with three publicly maintained measure sets rather than creating a new standalone set: the Department of Managed Health Care (DMHC) health equity and quality measure set for payers; a subset of the Office of the Patient Advocate (OPA) Healthcare Quality Report Card measures for physician organizations; and the HCAI hospital equity measures reporting program for hospitals. Fully integrated delivery systems will be measured across the three sets where applicable.
Margaret Abbrandt, Assistant Deputy Director for Health System Performance, described the statutory basis: OCA is required to adopt a single standard measure set for assessing quality and equity across payers, hospitals and physician organizations, to rely on recognized clinical quality, patient experience and safety measures, and to limit administrative burden by aligning with existing reporting where possible.
Hospital patient safety and healthcare‑associated infections (HAIs)
Several commenters and advisory committee members urged OCA to add healthcare‑associated infection (HAI) measures and other patient safety metrics. Jana King (Health Equity and Quality Performance Group Manager) told the board that OCA will work with sibling agencies — notably the California Department of Public Health (CDPH), CalPERS, and Covered California — to develop a prioritized set of hospital patient safety measures for cross‑agency alignment. Staff indicated they will return in fall 2025 with a recommendation on hospital patient safety and potential HAI measures to add to the OCA set.
Equity stratification and data gaps
OCA will adopt the stratification (race, ethnicity, language, age, gender identity, disability where available) specified by each measure set and said it will monitor opportunities to expand stratification as demographic data quality improves. Board members and public commenters highlighted incomplete race/ethnicity/language reporting, and requested targeted work to improve those data because measurement of disparities depends on complete demographic reporting.
Reporting, use and enforcement
Staff emphasized that OCA does not directly enforce the quality and equity set independent of the spending‑target enforcement framework; instead, performance on the OCA measures will inform director decisions on performance improvement plans and on whether proposed approaches to meet targets would erode access, quality or equity. OCA will publish results in its annual spending performance reports beginning with data required before June 1, 2027.
Ending
Staff described the measure set as iterative and dependent on ongoing alignment with DMHC, OPA and HCAI program updates. OCA will return with a fall 2025 recommendation for hospital patient safety measures and intends to incorporate improved stratification and new validated measures over time.
