Utah Code 26B-8-511. Consumer-focused health care delivery and payment reform demonstration project
Current as of: 2024 | Check for updates
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(1) The Legislature finds that:
Terms Used In Utah Code 26B-8-511
- Plan: means the plan developed and adopted by the department under this part. 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
(1)(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;
(1)(b) there is a compelling state interest to encourage consumers to seek high quality, low cost care and educate themselves about health care options;
(1)(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
(1)(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:
(1)(d)(i) greater choice in health care options;
(1)(d)(ii) improved services through competition; and
(1)(d)(iii) more affordable options for care.
(2)
(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.
(2)(b) Participation in the coordination efforts is voluntary, but encouraged.
(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:
(3)(a) the Utah Insurance Department;
(3)(b) the Office of Consumer Services;
(3)(c) the Utah Medical Association;
(3)(d) the Utah Hospital Association; and
(3)(e) neutral, non-biased third parties with an established record for broad based, multi-provider and multi-payer quality assurance efforts and data collection.
(4) The department shall supervise the efforts by entities under Subsection (3) regarding:
(4)(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;
(4)(b) obtaining and analyzing information and data related to current health system utilization and costs to consumers; and
(4)(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.