26B-8-511. Consumer-focused health care delivery and payment reform demonstration project.
| (1) |
The Legislature finds that:
Terms Used In Utah Code 26B-8-511- Plan: means the plan developed and adopted by the Health Data Committee under Section 26B-1-413. See Utah Code 26B-8-501
- State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
| (a) |
current health care delivery and payment systems do not provide system wide incentives for the competitive delivery and pricing of health care services to consumers; |
| (b) |
there is a compelling state interest to encourage consumers to seek high quality, low cost care and educate themselves about health care options; |
| (c) |
some health care providers and health care payers have developed consumer-focused ideas for health care delivery and payment system reform, but lack the critical number of patient lives and payer involvement to accomplish system-wide consumer-focused reform; and |
| (d) |
there is a compelling state interest to encourage as many health care providers and health care payers to join together and coordinate efforts at consumer-focused health care delivery and payment reform that would provide to consumers enrolled in a high-deductible health plan:
| (i) |
greater choice in health care options; |
| (ii) |
improved services through competition; and |
| (iii) |
more affordable options for care. |
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| (2) |
| (a) |
The department shall meet with health care providers and health care payers for the purpose of coordinating a demonstration project for consumer-based health care delivery and payment reform. |
| (b) |
Participation in the coordination efforts is voluntary, but encouraged. |
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| (3) |
The department, in order to facilitate the coordination of a demonstration project for consumer-based health care delivery and payment reform, shall convene and consult with pertinent entities including:
| (a) |
the Utah Insurance Department; |
| (b) |
the Office of Consumer Services; |
| (c) |
the Utah Medical Association; |
| (d) |
the Utah Hospital Association; and |
| (e) |
neutral, non-biased third parties with an established record for broad based, multi-provider and multi-payer quality assurance efforts and data collection. |
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| (4) |
The department shall supervise the efforts by entities under Subsection (3) regarding:
| (a) |
applying for and obtaining grant funding and other financial assistance that may be available for demonstrating consumer-based improvements to health care delivery and payment; |
| (b) |
obtaining and analyzing information and data related to current health system utilization and costs to consumers; and |
| (c) |
consulting with those health care providers and health care payers who elect to participate in the consumer-based health delivery and payment demonstration project. |
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Renumbered and Amended by Chapter 306, 2023 General Session
