Ben Johnson, representing the California Hospital Association, told the Department of Health Care Access and Information board during public comment that a major national health plan is leveraging pending targeting against small rural and independent hospitals and threatening automatic termination of contracts if those hospitals do not reduce rate adjustments to meet spending targets.

"These aggressive tactics are endangering care in communities that have really no all health care alternatives," Johnson said. He described many affected hospitals as critical access facilities with operating margins "as low as negative 20%" and public payer mixes exceeding 90%, and said hospitals have experienced roughly 11% cost growth over recent years. "While reduced rates wouldn't be a blip for the health insurance companies, they'd be devastating for these effective hospitals," he said.

Johnson urged the office to push back against payer tactics and to clarify that actions taken to sustain access to threatened health services would not be penalized retroactively by the office. "So we asked COCA to push back against these strong-arm tactics and before it's too late, clarify that actions to sustain access to threatened health care services in communities across California will not be penalized retroactively by the office," he said.

Staff closed the public comment period after no further attendees sought to speak. A board member thanked advocates and noted the governor's announcement about lowering insulin costs effective Jan. 1; the meeting was then adjourned.