By Hunter W. Collins
On February 24, 2022, the Department of Managed Health Care’s (DMHC) Health Equity and Quality Committee (Committee) held its first meeting via Zoom. AB 133 (Committee on Budget) (Chapter 143, Statutes of 2021), which became effective January 1, 2022, requires DMHC to establish the Committee to make recommendations regarding standard health equity and quality measures, including annual benchmark standards for assessing equity and quality in health care delivery. [27:1 CRLR 38]
According to DMHC’s Committee Overview, the Committee will consider various quality measures; effective ways to measure health outcomes in the absence of quality measures; approaches to stratifying reporting of results by factors, including age, sex, geographic region, race, ethnicity, language, sexual orientation, gender identity, and income; alternative methods to measure physical and behavioral health outcomes; and measures of social determinants of health. Pursuant to section 1399.870 of the Health and Safety Code, the Committee is comprised of 17 voting members, including consumer representatives, experts, researchers, and community members who are engaged in the development of alternative approaches to measuring health equity, consumer experience, and health outcomes, and five ex officio representatives from DMHC, Covered California, California Department of Insurance, California Public Employees Retirement System, and the California Department of Healthcare Access and Information. It must submit its final recommendations to the DMHC Director by September 30, 2022.
DMHC will establish standards for health plans to comply with starting in 2023 and DMHC may assess administrative penalties relating to health plan data collection, reporting, and corrective action implementation or monitoring requirements. The standard measures and annual benchmarks shall sunset every five years at most and may be continued as long as DMHC conducts a public assessment at least one year before sunset. In 2025, DMHC will publish the first annual Health Equity Quality Compliance Report and may begin assessing administrative penalties for failure to meet the health equity and quality benchmarks. It is anticipated that the measures and benchmarks will be codified in regulation by 2026.
The next Committee meeting is scheduled for Wednesday, April 20, 2022, in Sacramento, California, from 1:00 to 4:00 p.m.