HI HR123

Request the Insurance Commissioner to report on capitated payment models used by healthcare insurance plans, specifically analyzing HMSA's planned conversion from fee-for-service to capitated reimbursement for primary care providers.

Report must analyze impacts on healthcare quality and accessibility, primary care physician services, provider operating costs, reimbursement adequacy, formation of new practices, EUTF procurement costs, and insurance rates.

Include examination of capitated payment reimbursement rates in other states; HMSA's model would pay an average of $24 per patient per month.

Submit final report with findings and recommendations and conduct public informational briefing no later than 20 days before the 2019 Regular Session convenes.

Recommend that healthcare insurance carriers not implement capitated payment models unless the Insurance Commissioner's report and public support at the briefing favor the model.