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First Substitute H.B. 140

Representative Stewart Barlow proposes the following substitute bill:


             1     
CONSUMER-FOCUSED HEALTH DELIVERY AND PAYMENT

             2     
DEMONSTRATION PROJECT

             3     
2013 GENERAL SESSION

             4     
STATE OF UTAH

             5     
Chief Sponsor: Stewart Barlow

             6     
Senate Sponsor: Peter C. Knudson

             7     
             8      LONG TITLE
             9      General Description:
             10          This bill directs the Department of Health to work with relevant entities for the purpose
             11      of coordinating a demonstration project on the subject of consumer-based health care
             12      delivery and payment reform.
             13      Highlighted Provisions:
             14          This bill:
             15          .    instructs the Department of Health to coordinate with health insurers to develop a
             16      demonstration project for consumer-based health care delivery and payment reform;
             17          .    directs the Department of Health to convene and consult with relevant entities and
             18      organizations to facilitate the development of a demonstration project for
             19      consumer-based health care delivery and payment reform;
             20          .    directs the Department of Health to supervise efforts of participating entities
             21      regarding:
             22              .    applying for and obtaining grant and other funding for this type of
             23      demonstration project;
             24              .    obtaining and analyzing information related to current health system utilization
             25      and costs to consumers; and


             26              .    consulting with the health care providers and health care payers who elect to
             27      participate in the project; and
             28          .    requires the executive director of the Department of Health to report to the Health
             29      System Reform Task Force regarding the progress towards consumer-based health
             30      delivery and payment reform by January 1, 2015.
             31      Money Appropriated in this Bill:
             32          None
             33      Other Special Clauses:
             34          None
             35      Utah Code Sections Affected:
             36      ENACTS:
             37          26-23a-115, Utah Code Annotated 1953
             38     
             39      Be it enacted by the Legislature of the state of Utah:
             40          Section 1. Section 26-23a-115 is enacted to read:
             41          26-23a-115. Consumer-focused health care delivery and payment reform
             42      demonstration project.
             43          (1) The Legislature finds that:
             44          (a) current health care delivery and payment systems do not provide system wide
             45      incentives for the competitive delivery and pricing of health care services to consumers;
             46          (b) there is a compelling state interest to encourage consumers to seek high quality, low
             47      cost care and educate themselves about health care options;
             48          (c) some health care providers and health care payers have developed
             49      consumer-focused ideas for health care delivery and payment system reform, but lack the
             50      critical number of patient lives and payer involvement to accomplish system-wide
             51      consumer-focused reform; and
             52          (d) there is a compelling state interest to encourage as many health care providers and
             53      health care payers to join together and coordinate efforts at consumer-focused health care
             54      delivery and payment reform that would provide to consumers enrolled in a high-deductible
             55      health plan:
             56          (i) greater choice in health care options;


             57          (ii) improved services through competition; and
             58          (iii) more affordable options for care.
             59          (2) (a) The department shall meet with health care providers and health care payers for
             60      the purpose of coordinating a demonstration project for consumer-based health care delivery
             61      and payment reform.
             62          (b) Participation in the coordination efforts is voluntary, but encouraged.
             63          (3) The department, in order to facilitate the coordination of a demonstration project
             64      for consumer-based health care delivery and payment reform, shall convene and consult with
             65      pertinent entities including:
             66          (a) the Utah Insurance Department;
             67          (b) the Office of Consumer Health Services;
             68          (c) the Utah Medical Association;
             69          (d) the Utah Hospital Association; and
             70          (e) neutral, non-biased third parties with an established record for broad based,
             71      multi-payer and multi-provider quality assurance efforts and data collection.
             72          (4) The department shall supervise the efforts by entities under Subsection (3)
             73      regarding:
             74          (a) applying for and obtaining grant funding and other financial assistance that may be
             75      available for demonstrating consumer-based improvements to health care delivery and
             76      payment;
             77          (b) obtaining and analyzing information and data related to current health system
             78      utilization and costs to consumers; and
             79          (c) consulting with those health care providers and health care payers who elect to
             80      participate in the consumer-based health delivery and payment demonstration project.
             81          (5) The executive director shall report to the Health System Reform Task Force by
             82      January 1, 2015, regarding the progress toward coordination of consumer-focused health care
             83      system payment and delivery reform.


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