Study of the Political, Legal and Organizational Influences on the Development of the California Health Facilities Commission

摘要

This study examines California's attempts to create institutions and policies for containing health facility cost, a goal that has been elusive for both federal and state governments. Cost containment pressures prompted the California hospital industry to sponsor legislation, enacted in 1971, creating the California Health Facilities Commission and empowering it to implement a mandatory accounting, reporting, and public disclosure system for hospitals. The system was later applied to nursing homes. Unsuccessful attempts have been made both to expand the Commission's authority to regulate facility rates and capital expenditures, and also to abolish it altogether. The study describes the history and fate of these attempts, along with the Commission's implementation of its statutory charge. Essentially, this is a study of how California confronted the issue of health facility cost inflation in the context of political conflict and change, and under conditions of uncertainty about the effectiveness of government regulatory approaches to cost containment. Conclusions are drawn about the primary influences on the California health facility regulatory process, and about future state legislation and the role of state agencies, physicians, and consumers in cost containment.