New­som signs bill re­quir­ing Kaiser to share hos­pi­tal fi­nan­cial data

The Fresno Bee (Sunday) - - News - BY CATHIE AN­DER­SON can­der­[email protected] Cathie An­der­son: 916-321-1193, @CathieA_SacBee

Cal­i­for­nia Gov. Gavin New­som signed into law on Fri­day a mea­sure that will re­quire Kaiser Per­ma­nente to join other in­sur­ers in pro­vid­ing more detailed in­for­ma­tion on ex­penses and rev­enue at each of its hos­pi­tals and med­i­cal fa­cil­i­ties.

State Sen. Richard Pan, D-Sacramento, in­tro­duced the leg­is­la­tion, Se­nate Bill 343, on be­half of Kaiser’s largest union, the Ser­vice Em­ploy­ees In­ter­na­tional Union. SEIU-United Health­care Work­ers West has been in con­tract ne­go­ti­a­tions with Kaiser for about a year, and the union is part of a coali­tion vot­ing on whether to launch a strike in Cal­i­for­nia, seven other states and the District of Columbia.

“This law arms em­ploy­ers and oth­ers with the in­for­ma­tion they need to fully un­der­stand why the cost of their health in­sur­ance with Kaiser Per­ma­nente may be ris­ing,” Pan said in a news re­lease is­sued Fri­day.

SB 343 also has been backed by the Cal­i­for­nia Pub­lic Em­ploy­ees’ Re­tire­ment Sys­tem, con­sumer groups such as Health Ac­cess Cal­i­for­nia, busi­ness groups such as Small Busi­ness Ma­jor­ity, and other la­bor groups.

As part of the leg­is­la­tion, Kaiser will have to break out ex­penses and rev­enue for each of its fa­cil­i­ties; break out rev­enue by type of payor (Medi­care, Medi-Cal or pri­vate in­sur­ance) at each fa­cil­ity; and break out rate in­creases by type of ser­vice (hos­pi­tal, physi­cian ser­vices, phar­macy, ra­di­ol­ogy and lab­o­ra­tory).

“We think it’s an im­por­tant trans­parency mea­sure,” said An­thony Wright, the ex­ec­u­tive di­rec­tor of Health Ac­cess Cal­i­for­nia. “Right now, we do re­quire rate re­view of our in­sur­ers, and Kaiser has had a fairly broad ex­emp­tion from much of the rate re­view pro­cesses that other in­sur­ers have to fol­low, and what this bill does is fairly sim­ple. It en­sures Kaiser is pro­vid­ing the same types of in­for­ma­tion jus­ti­fy­ing their rates as other health in­sur­ers have to do.”

Pan has said he in­tro­duced the leg­is­la­tion be­cause it’s im­por­tant to hold Kaiser to the same rules as its com­peti­tors. But in let­ters to leg­is­la­tors, Kaiser has stated that what is be­ing char­ac­ter­ized as an ex­clu­sion by SEIU, is merely an ac­knowl­edg­ment that Kaiser has al­ways done its busi­ness and its record-keep­ing dif­fer­ently from other health-care in­sur­ers since its in­cep­tion in 1945.

“Be­cause of our unique model, we re­quested and re­ceived lan­guage in the two laws that are the sub­ject of SB 343 so we could ac­cu­rately file re­ports that re­flect our un­der­ly­ing op­er­at­ing model,” wrote Teresa Stark, Kaiser’s se­nior di­rec­tor, gov­ern­ment relations, in a let­ter dated April 15. “Our fil­ings are not in­fe­rior or in­com­plete, they are sim­ply dif­fer­ent be­cause we are dif­fer­ent. We do not build rates and calculate cost trend in the same way as other claims-based sys­tems or cap­i­tated (fee per patient) sys­tems.”

She stated that SB 343 would re­quire the com­pany to de­con­struct its model and es­tab­lish an en­tirely new struc­ture to look at unit costs for pro­vi­sion of care.

Later, in a July 3 let­ter, Stark thanked Pan and SEIU for work­ing with Kaiser to make changes to the leg­is­la­tion that omit­ted fil­ing of two fi­nan­cial state­ments that the com­pany could not pro­vide by fa­cil­ity be­cause of its le­gal struc­ture. She also thanked them for delaying the start of an­nual re­port­ing re­quire­ments and noted that, if they also would de­lay the start of quar­terly fi­nan­cial fil­ing, that the com­pany would with­draw its op­po­si­tion to the leg­is­la­tion.

Those changes, how­ever, were not in­te­grated, so Kaiser will have to start re­port­ing the quar­terly in­for­ma­tion later this year. That means the com­pany will have to im­me­di­ately make arrangemen­ts for changes to its com­puter soft­ware and staffing to ac­com­mo­date the new re­port­ing re­quire­ments.

CalPERS staff, in a June 19 back­ground doc­u­ment sub­mit­ted to board mem­bers, noted that SB 343 “may pro­vide an ad­di­tional tool for CalPERS to use to ver­ify that the in­for­ma­tion it does re­ceive is ac­cu­rate. In ad­di­tion, it may in­crease other pur­chaser’s abil­ity to ac­cess health­care pric­ing and uti­liza­tion data, which could help them de­velop cost con­tain­ment measures that are sim­i­lar to those em­ployed by CalPERS.”

Mark Her­bert, the Cal­i­for­nia Di­rec­tor of Small Busi­ness Ma­jor­ity, a small busi­ness ad­vo­cacy or­ga­ni­za­tion, said the or­ga­ni­za­tion’s sci­en­tific opin­ion polling in­di­cates that the cost of health in­sur­ance re­mains a chal­lenge for small busi­ness when try­ing to at­tract and re­tain tal­ent.

“We re­cently re­leased a poll a few months ago that showed 91 per­cent of Cal­i­for­nia’s small busi­ness own­ers be­lieve there should be more trans­parency in the health-care mar­ket­place, and we be­lieve SB 343 does just that.”

ELAINE CHEN [email protected]

Work­ers in the Coali­tion of Kaiser Per­ma­nent Unions march in down­town Sacramento on Sept. 2 as they protest amid con­tract ne­go­ti­a­tions. Gov. Gavin New­son has signed a bill re­quir­ing Kaiser Per­ma­nente to pro­vide more detailed fi­nan­cial in­for­ma­tion.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.