On October 14, the State Office of Health Care Affordability (OHCA) adopted ambitious benchmarks for how much health plans and other payers must spend on primary care. The new benchmark requires an annual increase in spending on primary care of 0.5 percentage points to 1 percentage points and a requirement that payers reach a 15 percent spend on primary care by 2034.
Data shows that spending on primary care decreases costs and improves outcomes, yet, less than one in ten dollars in health care is spent on primary care. The California Academy of Family Physicians (CAFP) has long advocated for an increase in primary care spend and was actively engaged in the development of these benchmarks. OHCA will collect and report on payers achieving this benchmark, however, OHCA authority does not include levying fines or fees should payers not achieve these benchmarks.
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