United States: A California agency wants insurance companies to spend 15% of their money on primary care by 2034. This goal is part of a plan to grow the number of primary care doctors and help more people get preventive health care services.
In October, the board of the state Office of Health Care Affordability set its benchmark above the industry’s current 7 percent primary care spending rate in an effort to improve Californians’ health and reduce the need for more expensive care in the future.
Eventually, she added, it’s ‘ambitious but achievable’ ensuring that no new public dollars are spent unless operational revenue ‘does not cover the cost of the organization’s lease obligations and regular fund program investments.’ “They need time to put the infrastructure in place to really change the way they provide care.”
As reported by the Medicalxpress, California’s target arrives just six months after an affordability board that oversees health care spending set a 3.5 percent per year limit on the growth of spending overall, leaving insurers squeezed on two fronts.
We do not know how these two policies will interact and we believe it is important not to lose sight of our larger goal of containing the growth of health care costs, said Mary Ellen Grant, a spokesperson for the California Association of Health Plans.
Because insurers negotiate payment with providers, the affordability agency says they are the most equipped to spur more spending on preventive care services. The incentives could include giving health plans higher rates of reimbursement for primary care givers or paying for wide ranging care as opposed to individual visits, Landsberg said.
The spending target, if successful, would expand the primary care workforce through the hiring of staff, and the agency says it would help more patients better manage their health, prevent disease, and get patients to early diagnosis and treatment.
There has been little such care available for people because California has a shortage of primary care providers. California has parts of the state where there isn’t a doctor to meet people’s needs — and 6 million Californians live there, according to a new data analysis by KFF, which includes KFF Health.