This explainer discusses current network adequacy standards for enrollees in California-regulated plans and policies, related federal and state regulations, and new and evolving issues that impact accessibility and coverage of health care for enrollees in California’s state-regulated insurance markets.
Explainer
Network Adequacy and Health Care Access Regulations in California
Because many disparities in health outcomes have their roots in systemic racism, it is important to explore the impact that systemic racism has on health policies, practices, structures, systems, and the information available to CHBRP.
Funded by the California Health Care Foundation, CHBRP conducted a rapid literature review of literature published between January 2021 and October 2022 examining the effectiveness of telehealth as compared with in-person care. The findings are available on CHCF's website.
External Publication
Telehealth Outcomes and Impact on Care Delivery: A Review of Evidence
CHBRP, drawing on multi-disciplinary faculty and researchers based at the University of California, provides the California Legislature with timely, independent, and rigorous evidence-based analyses of introduced health insurance benefits-related legislation.
This issue brief is part of a two-brief series that provides background on EHBs in California and how they could change in future years. This issue brief explains what defrayal is and what triggers defrayal; how defrayal costs are determined; how mandates may be introduced without triggering defrayal; and also provides an example of two states that introduced the same mandate that exceeded EHBs in different ways.
Issue Brief
Essential Health Benefits: Exceeding EHBs and the Defrayal Requirement
This issue brief is part of a two-brief series that provides background on EHBs in California and how they may change in future years. This brief provides an overview of how EHBs are defined at the federal level and in California, including how HHS regulations allow a state to alter its selection of its benchmark plan and thus make some alterations to its definition of EHBs.
Issue Brief
Essential Health Benefits: An Overview of Benefits, Benchmark Plan Options, and EHBs in California
