RD616 - Summary Report of the HB 248 Work Group – November 1, 2022

Executive Summary:

Chapter 646 (the Act) of the 2022 Acts of Assembly (House Bill 248), included in this report as Appendix A, requires the Department of Health, in consultation with the State Corporation Commission, Bureau of Insurance (Bureau), to establish a methodology to measure and evaluate the efficiency and productivity of insurance carriers, managed care health insurance plans and health care providers.

The purposes of the Act are to: (i) foster transparency and competition among carriers and health care providers and (ii) provide information on the Virginia Health Information (VHI) website at VHI.org. Virginia Health Information is the nonprofit organization described in § 32.1-276.4 of the Code of Virginia that assists consumers in making educated decisions about options for health care coverage and access.

The Bureau convened a stakeholder group to begin the work outlined in the Act. The group included Delegate Glenn R. Davis – the bill patron – and representatives from:

Virginia Department of Health
Virginia Health Information
Virginia Association of Health Plans
Virginia Hospital and Healthcare Association
Medical Society of Virginia
Virginia Health Benefit Exchange
Mercer, representing employers

While the Bureau and VHI staffed and facilitated the stakeholder group, this summary represents the perspectives of the participating stakeholders.

Stakeholder Group Meetings

The first meeting was held on August 29, 2022. Delegate Davis explained that his intent in sponsoring House Bill 248 was to have an easily understood dashboard of certain health care data that brings transparency and comparability to consumers on a website maintained by VHI.

The stakeholder group determined the following scope of work:

• Identify a central location to make the health care information available to consumers or other interested parties.

• Identify how to provide currently available data to consumers and other interested parties on one website.

• Have the data reporting efforts focus on the fully insured commercial market regulated by the Bureau, consisting of comprehensive medical insurance for Individual, small, and large group markets.

• Have the provider focus be on hospital and physician groups and not delve into many of the ancillary health care professions.