AHCA and CA | Rx legislation | Marty and Mohit

We are six weeks way from our annual 2017 Northern California State of Reform Health Policy Conference and things are coming together nicely.  In fact, the items on our watch list this month are items you’ll see on our agenda next month!

We hope to see you on April 27th at the Sacramento Convention Center, and – as always – thank you for reading our stuff.

1.  The AHCA, CBO and impact to CA

The Congressional Republicans’ reform bill, the American Health Care Act, is step one in the House reform strategy, according to Paul Ryan. House Republicans have announced a set of additional bills that will come out next week. Lots of ink has been spilled on the CBO score and the impact of the reform bill, but you should read the CBO memo for yourself.

Notably, of the 23 Congressional districts carried by Clinton with a Republican incumbent, 7 are in California.  Those 7 districts average 24k beneficiaries of Exchange subsidies. They also average 59k Medicaid expansion enrollees with Rep. Valadao (10th) having the second highest expansion enrollment of any Republican member at 115,600.

2.  Hernandez Rx bill a new flashpoint

A new version of his prescription drug transparency bill (SB 17) was released by Sen. Ed Hernandez yesterday, and has consumer advocates and health plans buzzing.  “This is a viable bill. It has legs” one lobbyist told me. Anthony Wright of Health Access says the bill has “new momentum.” The bill requires 90 days advance notice of any price hikes of prescription drugs.

Sen. Hernandez said he was “tired of seeing the pharmaceutical industry literally rape the American people at the expense of the tax payer.” A PhRMA spokesperson said “market-based solutions that better align payment with the value to the patient” would be a better approach. It seems clear that this issue of Rx costs, pricing, and return on investment is not going away, even if this bill passes.

3.  2017 NorCal State of Reform agenda is out

The Topical Agenda for our 2017 Northern California State of Reform Health Policy Conference is out!  And, with all of the moving parts in health policy today, we think the timing couldn’t be any better. You can take a look at video highlights from last year’s conference for a sense of what to expect.

The conference will have hundreds of senior health care executives and health policy leaders in the room – but it won’t be a real party without you there, too!  We’d be honored to have you with us in six weeks.  “Early Bird” rates have ended but you still have time to register before the “Last Minute” rates hit.

4.  Video:  Relationships with payers, providers

We have two videos for you this edition, both of which speak to the challenges and opportunities of deepening the relationships between payers and providers.  Mohit Ghose, the Vice President of Government Contracts and Policy at Molina, talks through the pathway to quality coming via closer collaboration between plans and providers.

Marty Gallegos is the Senior Vice President at the Hospital Association of Southern California. He puts the challenge in punchier terms: “Whatever you do had better be high quality and demonstrate value or you’re not going to get paid as much as someone else that can demonstrate that value…”

5. Launching the State of Reform Podcast

State of Reform tries to bridge the gap between the world of health care and that of health policy. We do this in part by providing a platform for the voices of senior executives and health policy leaders. The content generated by them is then shared across multiple discreet information channels, providing insights wherever consumers access their information most easily: web, email, social, video, small-run book publishing, and conferences.

Today, we add a podcast to that list of channels where you can learn directly from senior members of the health care and health policy world. This is content in their voice, reflective of their thinking. Expect to hear stories ranging from Honolulu to Baton Rouge – and of course California.

In our first podcast episode, we go to Texas, perhaps the staunchest state-opponent to the Affordable Care Act. We wondered: Is a Trump presidency good news for Texas health care?  What we heard was a range of answers – but some acute anxiety.