HEALTH SERVICES COMMITTEE AGENDA
Date: June 14, 2023
Time: 10:00 a.m.
Locations: Centennial Ballroom, UCLA Luskin Conference Center Teleconference meeting conducted in accordance with California Government Code §§11133
Agenda – Closed Session
Action: Approval of the Minutes of the Meeting of April 12, 2023
H1(X) Discussion: Acquisition of Assets of a General Acute Care Hospital, Los Angeles Campus
Note: There is no indication of what hospital this is. UCLA has already acquired a hospital in the mid-city area of West LA for use as a mental health facility. This new proposed acquisition presumably refers to some other facility.
H2(X) Discussion: UC Health Litigation Update and Conflicts of Interest in the Health Enterprise
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Agenda – Open Session
Public Comment Period (30 minutes)
Action: Approval of the Minutes of the Meeting of April 12, 2023
H3 Discussion: Update from the Executive Vice President of UC Health
H4 Discussion Systemwide Strategic Investment Plan and UC Health Division Fiscal Year 2023-24 Budget, Office of the President*
H5 Discussion Community Benefit and Community Impact Annual Report
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From H4 above: The outcome of the working group’s deliberations and recommended priorities for the next few years is documented in the attached UC Health Strategic Investment Plan. The plan identified four strategic priorities, within which the future direction of several systemwide efforts were discussed.
• Partner with the State to realize access and health improvements
o Medi-Cal
o Workforce and education
• Increase access to health care in the Inland Empire and Central Valley
o UC Riverside education and clinical care delivery
o UC Merced education and clinical care delivery
• Advance clinical operations and research excellence through advanced analytics and consortia
o Center for Data Driven Insights and Innovation (CDI2)
o Cancer Consortium
o Population and quality health consortia
• Facilitate collaborative initiatives that increase fiscal resilience
o Integrated commercial payer strategy
o Medicare Advantage strategy*
o Leveraging Scale for Value
...
From the Strategic Plan: 4.2 Explore Medicare Advantage Entry**
Currently Medicare Advantage represents 58% of Medicare lives in the counties with UC locations, but only 12% of health systems’ patient population. Becoming effective at managing population health and financial risk is critical to evolving towards the value-based payment models of the future and ensuring market relevance in a market that is migrating towards managed care.
4.2.1 Support Medicare Advantage Direct Entry Feasibility Assessment and Business Planning: Coordinate business planning and best practice sharing for direct entry into Medicare Advantage and evaluate opportunities to leverage common risk and population health management infrastructure.
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*From p. 2 of https://regents.universityofcalifornia.edu/regmeet/june23/h4.pdf.
**From p. 21 of https://regents.universityofcalifornia.edu/regmeet/june23/h4attach1.pdf.
The full agenda for the June 14th meeting is at https://regents.universityofcalifornia.edu/regmeet/june23/hs.pdf.
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Medicare Advantage Issues
We highlight the Medicare Advantage element of the Strategic Plan here. Seemingly unknown to those folks who advocate "Medicare for All" as a government-run single-payer plan, the federal Medicare program is in fact being privatized. As the language notes, 58% of those under Medicare in areas served by UC health facilities are already under private Medicare Advantage plans. Nationwide, the number is close to 50%. Under its retiree health program, UC offers a Medicare Advantage option. Although the language in the Strategic Plan appears to refer to UC Health as a supplier of services to the private insurance companies that offer Medicare Advantage, there is a possibility that in competing for Medicare Advantage business, there may be pressure by UC Health to move more UC retirees to Medicare Advantage.
In theory, Medicare Advantage plans are supposed to duplicate traditional Medicare coverage, eligibility, and decision making. There seems to be a consensus among healthcare experts that the reason for Medicare Advantage's rapid growth is that Congress is effectively overpaying the private carriers. Thus, the private carriers actively compete for the Medicare Advantage business with TV ads, mailers to older Medicare recipients, etc., and offer extra frills such as gym memberships as enticements to join. The Medicare Advantage plans tend to be cheap compared to traditional Medicare wrap-around policies due to the overpayment. There is concern that when serious and expensive health situations arise, the private carriers may be more resistant than traditional Medicare to authorize treatment. Put bluntly, the frills such as gym memberships may not compensate enrollees for delays and denials of critical medical procedures.
When UC initially had internal discussions about offering Medicare Advantage to retirees, there apparently was some planning to scrap all other options and push everyone into Medicare Advantage. Outcries from emeriti and retirees halted that planning and Medicare Advantage was instead offered as an option along with the traditional wrap-around policies such as Anthem Blue Cross and others. However, Medicare Advantage has been a popular choice among UC retirees because it is cheap and because of the extra frills. Whether it remains cheap in part depends on whether Congress eventually decides to address the seeming overpayment to private providers. Given the current dysfunction in Congress, that issue may not be addressed for awhile. By that time, the privatization of Medicare may be largely complete.
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Note: Back in 2019, we expressed concern to the Regents about the planning by UCOP for Medicare Advantage:
Or direct to https://www.youtube.com/watch?v=SXnNt4MwztY.
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