Health care cost targets.

Plain English Breakdown

The official source material does not provide specific details on how cost targets will be adjusted or if there will be additional funding for these adjustments.

Health Care Cost Targets

AB-1474 requires health care cost targets to be adjusted for prescription drug costs and makes technical updates to the community-based perinatal care system.

What This Bill Does

• Requires the Office of Health Care Affordability to adjust health care cost targets if prescription drug costs are expected to grow faster than current targets.
• Makes technical changes to the goals and implementation details for community-based perinatal care programs.

Who It Names or Affects

• Health care providers who must adjust their cost targets if prescription drug costs rise faster than expected.
• The Office of Health Care Affordability, which will need to update its methodology for setting health care cost targets.
• Women and infants eligible for community-based perinatal care programs.

Terms To Know

Office of Health Care Affordability

A department within the California Department of Health Care Access and Information that works to lower health care costs and ensure affordability.

Community-based perinatal care

Health care services provided in local communities for pregnant women and infants, aimed at reducing mortality and morbidity rates.

Limits and Unknowns

• The bill does not specify how much the cost targets will be adjusted.
• It is unclear if there will be additional funding provided for these adjustments in prescription drug costs.

Official Summary Text

AB 1474, as amended, Patterson.
Community-based perinatal care.
Health care cost targets.
Existing law, the California Health Care Quality and Affordability Act, establishes within the Department of Health Care Access and Information, the Office of Health Care Affordability to analyze the health care market for cost trends and drivers of spending, develop data-informed policies for lowering health care costs for consumers and purchasers, set and enforce cost targets, and create a state strategy for controlling the cost of health care and ensuring affordability for consumers and purchasers.
Existing law requires the board to establish statewide health care cost targets for health care entities that meet specified requirements, including promoting the goal of improved affordability for consumers and purchasers of health care, while maintaining quality
and equitable care. Existing law also requires the office to develop a methodology, for approval by the board, to set health care costs. Existing law requires the methodology to review historical trends and projects and requires the methodology to allow the board to adjust target costs downward when warranted, among other things.
This bill would require the cost targets to be adjusted for a provider or fully integrated delivery system, as appropriate, upon a showing that prescription drug costs are projected to grow faster than the rate of any applicable cost targets. The bill would require the methodology to require the board to adjust cost targets for a provider or fully integrated delivery system, as appropriate, to account for increased expenditures related to prescriptions drugs.
Existing law establishes the State Department of Public Health and sets forth its powers and duties, including, but not limited to, implementation and administration of a community-based system of comprehensive perinatal care for eligible women and infants. Existing law states the goals of the community-based comprehensive perinatal health care system as decreasing and maintaining the decreased level of perinatal, maternal, and infant mortality and morbidity and supporting methods of providing comprehensive prenatal care that prevent prematurity and the incidence of low birth weight.
This bill would make technical, nonsubstantive changes to those goals.

Current Bill Text

Download Bill PDF