5 Things California: AB 1249, Topical Agenda, LA biotech

Our work at State of Reform includes bringing you our market and policy coverage from throughout California.  This newsletter comes out twice a month, and is developed by a number of us here at State of Reform. It’s funded entirely through your attendance and sponsorship of our now three annual conferences in California.

Our LA conference is in September, after session.  Our San Diego conference is in December, following the election.  But, our Sacramento event is right in the heat of the legislative session, set this year for May 9th.

So, if you like reading our newsletter, I really think you’ll get a tremendous amount from attending one of our conferences.  Keep ’em in mind when you’re looking to network with some of the smartest people in California health care and health policy.


DJ 5 Things Signature

With help from Marjie High and Emily Boerger



1. Opioids are largely a “white person” issue

From 2011 to 2015, almost 1 in 4 Californians (23%) over the age of 15 received an opioid prescription. In low-income white communities, the rate jumped to almost 1 in 2,  or 44.2%. Noting that the opioid epidemic has disproportionately impacted low-income white communities, researchers examined data from the CURES registry to try and determine whether prescribing practices could be a contributing factor.

Analysis demonstrated that across the board controlled medications were much more likely to be prescribed to individuals living in majority-white areas. Though these discrepancies may have shielded communities of color from the brunt of the opioid epidemic, the findings suggest this may be symptomatic of cultural and racial issues baked into the system of health care delivery.


  2. AB 1249 and risk-based contracting

In a move that could expand risk-based contracting in the state, Assemblymember Brain Maienschein, a recent convert to the Democratic Party, introduced AB 1429 just under the legislative cutoff.  With support from APG and California Schools VEBAthe bill would allow self-funded employer health plans and union trusts to contract directly with provider groups in risk-bearing contracts through a 5-year pilot study to measure the cost savings.

Currently, self-funded employer plans and union trusts must employ the more costly fee-for-service cost structure. The pilot would test the savings possible by expanding integrated managed care to the close to 8 million Californians that are covered under self-funded and union trust plans. Under the plan, the Department of Managed Health Carewould monitor the financial solvency and operations of the contracted risk-bearing providers much like state-licensed health plans, providing more oversight than the current law.

3.  Social determinants and mental health in committee

Chaired by Sen. Holly Mitchell, the new Senate Select Committee on Social Determinants of Children’s Well-Being held the first in a planned series of meetings to consider how to improve health outcomes for children. The inaugural hearing addressed the impacts of housing and homelessness on kids. Strategies presented to reduce harm encompass increasing housing subsidies, prohibiting rental discrimination based on source of income, increasing affordable housing units, and re-examining zoning codes to encourage more multi-family housing.

Meanwhile, the Joint Senate and Assembly Committees on Health heard recommendations to improve the Medi-Cal mental health system in the second of two informational hearings. Two panels of experts outlined delivery challenges, tying them to specific suggestions that fell loosely into 5 themes. Themes for improvement include: reducing administrative burdens, funding BH pilots, investing in health information exchanges, strengthening the crisis system, and supporting virtual consultation.

4.  Our Topical Agenda is now out!

In case you missed it, we recently released our Topical Agenda for the 2019 Northern California State of Reform Health Policy Conference. With over 400 senior health care executives and health policy leaders expected, State of Reform has become a “can’t miss” event. We’ll be exploring policy and politics in healthcare, evaluating opportunities and setbacks in reform, and diving deep into costs, disruptions, and care delivery.

Check out our Convening Panel to get an idea of those who helped put our agenda together. As always, if you have any suggestions on what we should include or potential speakers, you can send those my way. If you haven’t already registered, we’d be honored to have you join us!


5. LA bioscience sector poised to increase impact

Since 2015, LA County has targeted the bioscience industry as a priority for growth through the LA County Bioscience Initiative. It’s getting a lot of orgs named “BIO” to show for the work. Recently, PhRMA, along with Supervisor Mark Ridley-Thomas, announced a three-year $750,000 investment in life science accelerator BioLA.

Separately, LA BioMed celebrated a $70 mil gift from philanthropists Melanie and Richard Lundquist. Together with shared laboratory network operator BioLabs, it will open the 78,000-square foot $63-million building that includes, the 18,000 BioLabs LA BioMed center to hold up to 30 new companies. The facility offers startups access to state-of-the-art lab and office facilities, more than $1 million in shared scientific equipment, and scalable co-working space to launch and grow emerging innovations.