Exchange Board Lays Out the Landscape

In yesterday’s meeting of the California Health Benefit Exchange, Executive Director Peter Lee laid out the Board’s work plan for the next 6 months, which includes several “landscape sessions” where the Board will engage a broad array of stakeholders in in-depth discussions on specific topics. Lee’s complete presentation can be accessed here but in brief, the Board plans to wrestle with a number of topics with a few deadlines in mind:

February Board Meeting: Landscape for Delivery Reform

March Board Meeting: Outreach and Assistance Landscape Discussion (NOTE – this meeting will be held in Fresno)

April Board Meeting: Discussion on Basic Health Plan, ServiceCenter, SHOP

May Board Meeting: Presentations on a number of issues that the Board will make decisions on in June in preparation for Level II Grant submission and other work.

June Board Meeting: Decisions related to Level II Grant.

June 29: Submission of Level II Grant Application

July and August: Polices related to QHP and Assisters/Navigators and preparation for release of solicitations.

Fall 2012: Release solicitation for plans

Yesterday’s meeting was the first of the “landscape discussions”, focused on delivery reform. All of the presentations and handouts are available on the Exchange website.

The discussion included 3 panels:
Panel 1: An Overview of the California Market, Regulatory Structure, and Major Purchasing Strategies
Panelists painted a picture of the current health insurance market, including where Californians are getting insurance, who is paying for it, how that insurance is regulated, and how health plans control costs.
Panel 2: Purchasing in Action: Examples of Major Purchasing Strategies
Representatives from agencies that do large scale purchasing of insurance spoke about their purchasing strategies, and in some cases, how they were able to use purchasing to drive better health. Health Access’ own Beth Abbott served as the consumer reactor on this panel, highlighted the importance of adequate networks to serve consumers in an affordable and accessible way, and of the balancing act insurers must perform in order to innovate and implement utilization management strategies that improve care rather than simply providing barriers to access.
Panel 3: Plan, Provider and Consumer Reactors
This panel included health plans, physicians, and hospitals providing their perspectives on important considerations for Qualified Health Plans, and our colleagues at Small Business Majority and the California Pan Ethnic Health Network explained important considerations for small businesses and communities of color.

Board member Belshe commented that consumers will have a larger role to play in the new system and asked the Board to consider ways in which the Exchange could help consumers make meaningful choices.
At the end of the 3 panels, stakeholders made a number useful comments for the board’s consideration, including the importance of affordability, that more is not always better when it comes to choices of health plans, the importance of standardizing plans, importance of adopting evidence based practices that improve care (not just save money), and the importance of including safety net providers and Medi-Cal Managed Care Plans.
The next meeting of the Exchange will be on March 22 in Fresno. In the meantime, those interested in the Exchange are invited to answer the stakeholder questionnaire related to Qualified Health Plans, and to peruse the Quarterly Report on the Level I Exchange Planning Grant that the board has submitted to the federal government.
Health Access California promotes quality, affordable health care for all Californians.
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