Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Medicaid Payment Reform topic
No spam. Unsubscribe anytime.
House passes Medicaid payment changes aimed at steering nonemergency care out of emergency departments
Summary
House Bill 141, a stakeholder-backed, revenue-neutral differential payment plan to encourage Medicaid patients to use primary and urgent care instead of emergency departments for nonemergent needs, passed the House 73-0; implementation is delayed to allow system changes.
The Utah House on March 4 unanimously passed House Bill 141, which establishes a revenue-neutral differential payment framework designed to encourage delivery of nonemergent care in primary or urgent care settings rather than hospital emergency departments.
Representative Kennedy, sponsor and a family physician, told colleagues the bill aims to realign incentives so that appropriate care is delivered in lower-cost settings. He illustrated the cost differential on the floor: "the average emergency department visit is $600 and your average primary care doctor's office visit is anywhere from $100 to $200." Kennedy and supporters said the measure will let accountable care organizations and the Department of Health develop quality measures and an auto-assignment process that routes patients to high-performing organizations.
Members questioned implementation timing and the availability of primary-care capacity. Representative Chavez Houck asked how delayed implementation would affect access; Kennedy responded that a delayed February implementation date was intended to allow systems time to develop care capacity and quality measures so patients would not be left without options. Supporters emphasized the bill is intended to be revenue neutral and to spur investment in expanded primary and urgent care capacity.
The bill passed the House by voice and recorded tally (73-0) and will be transmitted to the Senate for its consideration.
