BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                    AB 2670


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          Date of Hearing:  April 27, 2016


                        ASSEMBLY COMMITTEE ON APPROPRIATIONS


                               Lorena Gonzalez, Chair


          AB  
          2670 (Roger Hernández) - As Introduced February 19, 2016


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          Urgency:  No  State Mandated Local Program:  NoReimbursable:  No


          SUMMARY:


          This bill requires the Department of Health Care Services (DHCS)  
          to administer, on an annual basis, the Consumer Assessment of  
          Health Care Providers and Systems (CAHPS) Health Plan surveys,  
          as developed by the federal Agency for Healthcare Research and  
          Quality for all Medi-Cal managed care plan (MCP) populations.   
          Specifically, this bill:  










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          1)Requires DHCS to annually administer the CAHPS survey to all  
            MCP models, including county organized health systems (COHS),  
            two-plan models, and geographic managed care plans.  



          2)Requires DHCS to translate the CAHPS survey in all Medi-Cal  
            threshold languages and requires DHCS to administer the CAHPS  
            survey in all Medi-Cal threshold languages in each county.



          3)Requires DHCS to stratify the results in order to identify  
            disparities in the quality of care provided to Medi-Cal  
            managed care enrollees based on all of the following factors:
             a)   Geographic region;
             b)   Primary language;
             c)   Race;
             d)   Ethnicity;
             e)   Gender; and,
             f)   To the extent data is available, sexual orientation and  
               gender identity.



          4)Requires DHCS to annually prepare and make publicly available  
            a report on the results of the surveys on the DHCS Website.   
            Provides that the report will include all of the following:
             a)   Aggregated data on MCP results compared to national  
               Medicaid data;
             b)   Aggregated MCP results stratified by the factors set  
               forth as specified; and,
             c)   Plan results at the county level, including results for  
               all MCP models, as specified.

          FISCAL EFFECT:

          1)Costs, likely in the range of $500,000- $1 million annually to  
            conduct the survey every year in multiple languages. The  








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            survey is currently conducted every three years and costs  
            $500,000 to administer in English and Spanish.


          2)Unknown, significant one-time costs to translate surveys into  
            thirteen threshold languages. As discussed further below,  
            costs would depend on whether validated translations exist or  
            would have to be developed, and the extent of field testing  
            prior to implementation.    


          3)Unknown, significant ongoing costs associated with the  
            requirement to stratify by a number of variables.  Performing  
            an estimate of the increased sample size needed to ensure the  
            ability to stratify results to identify disparities in care is  
            beyond the scope of this analysis, but costs could be very  
            high if a high level of oversampling is required in order to  
            ensure results can be meaningfully stratified. 


          COMMENTS:


          1)Purpose. The author states that this bill gives us the  
            opportunity to assess California's most diverse populations  
            and different health care needs.  Furthermore, the author  
            states that Medi-Cal's quality measures must be consistent and  
            reflect everyone's health care experience, as one in three  
            Californians is now enrolled in Medi-Cal.  


          2)Background. The CAHPS survey assesses both patient  
            satisfaction and perceptions of access to care, and the survey  
            exists for hospitals, managed care plans, and other providers.  
            In Medi-Cal managed care, CAHPS measures assess the  
            experiences of surveyed managed care plan members in the prior  
            six months. Members are asked questions like, "How often was  
            it easy to get necessary care, tests, or treatment?" or "How  
            would you rate your health plan?"  Currently, DHCS conducts  








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            the CAHPS survey once every three years in two languages,  
            English and Spanish.  DHCS publishes the results on its  
            website and uses results as part of its Medi-Cal Managed Care  
            Program Quality Strategy and to recognize plan quality  
            improvement. 


          3)Staff Comments.  Data collection can provide valuable insight  
            into program operation, but does come with a cost.  The  
            requirements of this bill address several items:  


             a)   This bill increases the frequency of the CAHPS survey.   
               This is consistent with LAO recommendations and appears  
               warranted given significant changes in enrollment,  
               networks, and overall impacts on Medi-Cal managed care plan  
               operations.  


             b)   This bill also requires the survey to be translated into  
               all Medi-Cal threshold languages, and administered in each  
               county in all Medi-Cal threshold languages in that county.   
                This is beneficial because it allows the opinion of  
               Medi-Cal enrollees who do not speak English or Spanish to  
               be counted in the poll.  However, it is unclear whether  
               validated translations exist in languages other than in  
               Spanish.  Survey instruments must be validated through  
               psychometric testing, and surveys such as CAHPS have been  
               very well-tested.  The agency for Healthcare Research and  
               Quality, which houses CAHPS, offers guidelines for  
               translating CAHPS surveys into other languages. These  
               include the use of two simultaneous translators and a  
               translation review to ensure the quality and cultural  
               appropriateness of the translated instrument, as well as  
               subject the translated instrument to qualitative analysis  
               and psychometric testing to gauge the reliability,  
               validity, and equivalence of the instrument in measuring  
               the health needs of various subgroups. Thus, while  
               translation is certainly possible, translating a survey is  








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               quite involved.  Questions and responses translated into  
               each threshold languages are not guaranteed to directly map  
               to the English version without significant effort to  
               carefully translate and test the surveys. It should be  
               noted a small number of Medi-Cal enrollees would be sampled  
               for any CAHPS survey, making the chances small that some  
               languages would be represented. 


             c)   Finally, this bill requires stratification of results in  
               order to identify disparities in the quality of care  
               provided to Medi-Cal managed care enrollees based on the  
               factors: geographic region, primary language, race,  
               ethnicity, and gender, as well as sexual orientation and  
               gender identity to the extent data is available.   
               Stratification is different than simply including a diverse  
               population in the sample, as addressed in (b) above.  
               Stratification would theoretically allow one to measure,  
               for example, how persons of a particular ethnic group  
               perceive care in a particular plan.   


               CAHPS is designed to measure enrollees' recent experiences  
               with health plans and their service, to support consumers  
               in choosing a plan, and identify areas of quality  
               improvement for plans.  However, the LAO report notes that  
               DHCS has not even been able to stratify by health plan  
               given the sample size they've used, let alone by  
               subpopulations within a plan.  Depending on the goals,  
               stratification by these sub-categories may likewise either  
               be impossible due to limited sample size or, if sample size  
               was increased in order to collect enough data to allow  
               stratification for the many variables of interest, data  
               collection could become prohibitively expensive.  For  
               example, to compare perceptions about the timeliness of  
               care between Fresno County Hmong-speaking individuals and  
               persons speaking other languages, the survey would need to  
               include a sufficient number of Hmong speakers from Fresno  
               County.   Without oversampling small populations of  








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               interest, it is difficult to collect enough data to report  
               anything meaningful about members of these small  
               populations.  


               For comparison's sake, the California Health Interview  
               Survey is conducted in English, Spanish, two Chinese  
               dialects, Korean, and Vietnamese.  Other languages can be  
               added on a pilot basis, and Korean and Vietnamese, as  
               smaller language groups, are oversampled.   


               Given the potentially high cost of requiring sufficient  
               sample sizes to be able to stratify by the listed  
               variables, staff recommends the author consider clarifying  
               that stratification is only required if the sample size is  
               large enough to report meaningful results. Special one-time  
               surveys could be conducted whereby certain populations of  
               interest are oversampled, allowing for stratification if  
               there are particular areas of concern, instead of requiring  
               a costly level of data collection on an ongoing basis.       
                


          Analysis Prepared by:Lisa Murawski / APPR. / (916)  
          319-2081