BILL ANALYSIS Ó
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
SB 435 (Pan) - Medical home: health care delivery model
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|Version: April 6, 2015 |Policy Vote: HEALTH 7 - 1 |
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|Urgency: No |Mandate: No |
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|Hearing Date: May 4, 2015 |Consultant: Brendan McCarthy |
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This bill meets the criteria for referral to the Suspense File.
Bill
Summary: SB 435 would require the Secretary of the Health and
Human Services Agency to convene a working group to identify
appropriate payment methods to align incentives in support of
patient centered medical homes.
Fiscal
Impact:
Likely one-time costs of $150,000 to $300,000 to provide staff
support and technical assistance to the workgroup (General
Fund or other fund source).
Unknown costs for the workgroup to design and compose pilot
projects or to establish common patient centered medical home
initiatives (General Fund or other fund source). In addition
to requiring the working group to provide recommendations to
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the Legislature, the bill gives the working group broad
authority to undertake activities that appear more like
program development and implementation than traditional study
activities undertaken by working groups. The bill does not
provide much detail on these authorized activities, so
estimating the cost to exercise those authorities is unknown.
Background: In concept, a patient centered medical home is a method of
providing coordinated health care, using a team of providers, to
meet all of the patient's health care needs in a more
coordinated, effective, and cost efficient manner.
Current law authorizes the Department of Health Care Services to
develop a pilot project for a patient centered medical home for
certain high-risk Medi-Cal beneficiaries. This pilot would take
advantage of authority in the Affordable Care Act that provides
enhanced matching funds for patient centered medical home
programs. The Department is currently in the process of
developing the pilot.
Proposed Law:
SB 435 would require the Secretary of the Health and Human
Services Agency to convene a working group to identify
appropriate payment methods to align incentives in support of
patient centered medical homes.
Specific provision of the bill would:
Require the Secretary to convene a working group of public
payers, private health insurance carriers, third-party
purchasers, and health care providers;
Require the working group to identify appropriate payment
methods to align incentives in support of patient centered
medical homes;
Require the working group to report to the Legislature;
Authorize the working group to develop consensus strategies
for implementing patient centered medical home care models;
Authorize the working group to create alignment regarding
payment, reporting, and infrastructure investments;
Authorize the working group to design and compose pilot
projects;
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Authorize the working group to utilize public and private
purchasing power and enable competing payers to work together
to establish patient centered medical home models;
Authorize the working group to propose participation in
federally funded pilot and demonstration models;
Require the state to use existing resources and federal funds
or solicit outside funds to implement the bill.
Staff
Comments: As noted above, the bill gives the working group very
broad authority to undertake what appear to be program
development and implementation activities, in addition to
developing strategies and reporting to the Legislature. The bill
does not provide detail on the scope of those activities.
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