Voluntary employees’ beneficiary association pilot program.

Plain English Breakdown

The official source material does not provide specific details on expected changes in cost savings and patient outcomes.

Voluntary Employees’ Beneficiary Association Pilot Program

This law extends and expands a pilot program that allows certain health care providers to work with large employee groups in California to test new ways of paying for healthcare.

What This Bill Does

• Extends the end date of an existing pilot program from December 31, 2027, to December 31, 2030.
• Expands the pilot program from southern California to cover all of California.
• Requires health care providers and employee groups in the program to report cost savings and patient outcomes to a state agency.
• Asks the state agency to submit an interim report on the findings before January 1, 2029.

Who It Names or Affects

• Health care providers in California
• Large employee groups with more than 100,000 members
• The Department of Managed Health Care

Terms To Know

Voluntary employees’ beneficiary association (VEBA)

A group that provides health benefits to its members.

Risk-bearing arrangements

Agreements where healthcare providers take financial responsibility for the care of patients.

Limits and Unknowns

• The bill does not specify how many new participants will join the program.
• It is unclear what specific changes in cost savings and patient outcomes are expected from this expansion.

Official Summary Text

AB 2594, as amended, Lowenthal.
Voluntary employees’ beneficiary association pilot program.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care. Existing law authorizes the Director of the Department of Managed Health Care to authorize a pilot program in southern California under which approved providers may undertake risk-bearing arrangements with a voluntary employees’ beneficiary association with enrollment of more than 100,000 lives, as specified, beginning no earlier than January 1, 2022, to December 31, 2027, inclusive, if certain criteria are met. Existing law requires the association and each participating health care provider to report to the department information regarding cost savings and clinical patient outcomes compared to a fee-for-service payment model. Existing law requires the department to report those findings to the Legislature
after the termination of the pilot program and before January 1, 2027. Existing law repeals these provisions on January 1, 2030.
This bill would extend that repeal date to January 1,
2033.
2031.
The bill would
authorize the pilot program to be throughout California and would
extend the end date of the pilot program to December 31,
2032.
2030.
The bill would instead require the department to submit an interim report of the findings to the Legislature before
December 31,
January 1,
2029.

Current Bill Text

Download Bill PDF