Covered California Imposes New Quality, Cost Conditions On Plans

Covered California Imposes New Quality, Cost Conditions On Plans

California Healthline, Published April 8, 2016 By Ana B. Ibarra and David Gorn

Moving into a realm usually reserved for health care regulators, Covered California Thursday unveiled sweeping reforms to its contracts with insurers, seeking to improve the quality of care, curb its cost and increase transparency for consumers.

Among the biggest changes: Health plans will be required to dock hospitals at least 6 percent of their payments if they do not meet certain quality standards, or give them bonuses of an equal amount if they exceed the standards.

The plan, to be implemented over seven years, is based on a similar strategy pursued by the federal agency that oversees the government-run Medicaid and Medicare health insurance programs.

The California Hospital Association, in a statement issued late Thursday, said it supported the exchange’s decision to phase in the plan incrementally.

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