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Board weighs hospital sector target options as Monterey commenters cite sharp premium spikes
Summary
After reviewing hospital financial metrics, OCA staff presented four options for sector targets including a staff‑recommended approach defining hospitals as a sector with adjustable targets; multiple Monterey County employers and unions urged immediate action, citing employer premium increases and large claims hits tied to three local hospitals.
The Office of Health Care Affordability presented data and policy options for adopting sector targets for hospitals, prompting a sustained exchange between board members, staff and numerous public commenters from Monterey County who urged quick action to address what they described as disproportionately high local hospital prices.
CJ Howard, assistant deputy director for health care spending targets, described a two‑step rulemaking process: the board must first define sectors (to be codified in regulation) and then establish target values. Staff reviewed four illustrative hospital metrics for 2018–2022—average inpatient net patient revenue per case‑mix adjusted discharge (NPR/CMAD), annual growth in NPR/CMAD, operating margin, and average payment‑to‑cost ratios (third party vs Medicare)—and produced top‑30 lists and comparisons under alternative exclusions (critical access, psychiatric, children's, small, long‑stay, Kaiser).
The d…
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