UC Regents health committee warn of One Big Beautiful Bill Act’s potential impacts
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UC Regents health committee warn of One Big Beautiful Bill Act’s potential impacts
The UC Board of Regents Health Services Committee held its bimonthly meeting Tuesday to Thursday at UCLA. The committee discussed ways to lower pharmacy expenditures, ensure quality medical school curricula and the impact of the reconciliation bill on California’s health care delivery system. The bill is estimated to decrease federal Medicaid spending by about $1 trillion over a decade, a UC official said. The board also discussed accreditation requirements in medical education and the role of the Academic Senate in maintaining oversight of the curriculum. The meeting was the first since President Donald Trump signed the budget reconciliation bill into law on July 1, the committee’s agenda said. It is estimated that Medi-Cal, the Medicaid provider for California residents, serves as an important revenue source for the University of California Health centers, an official said at the meeting. It has experienced an 8-10% year-over-year increase in pharmacy expenditures over the past five years due to price escalations fueled by greater uses of outpatient care, according to the presentation.
The committee discussed ways to lower pharmacy expenditures, ensure quality medical school curricula and understand the impact of the reconciliation bill on California’s health care delivery system at the Regents’ July meeting. The board held its bimonthly meeting from Tuesday to Thursday at UCLA.
Tam Ma, the UC’s associate vice president for health policy and regulatory affairs, updated the committee on federal and state health policy.
President Donald Trump signed the budget reconciliation bill following approval from the United States Senate and the House of Representatives.
Ma said the bill is estimated to decrease federal Medicaid spending by about $1 trillion over a decade. She added that Medi-Cal, the Medicaid provider for California residents, serves as an important revenue source for the UC’s academic health centers.
Ma also said changes to Medicaid eligibility and enrollment rules may lead to reductions in health care coverage in California. She said she anticipates lowered access to primary, specialty and inpatient care, as well as challenges to providers’ financial sustainability – such as layoffs and facility closures, according to a presentation given at the meeting – and increased waits for care at UC academic health centers.
Ma added that many implementation details are not yet known, and UC Health will track administrative developments that pertain to Medicaid.
“We’ll be sure to engage with the state as it starts to implement these provisions and deal with the fiscal impacts” she said. “If there are opportunities available, we’ll advocate for (the) delay of these funding cuts.”
Chad Hatfield, the chief pharmacy officer at UC Davis Health, said pharmacy costs are increasing across the country and becoming a major category of spending in the health sector. He added that factors driving this trend are curative therapies – which aim to cure illnesses and achieve full patient recovery, according to the National Institutes of Health – and outpatient settings, such as clinics, infusion centers and specialty retail spaces, which provide medical services without requiring hospitalization.
UC Health’s total operating expenditures reached $21 billion as of April, with pharmacy costs representing the second-largest spending area at $2.6 billion annually, Hatfield said. It has experienced an 8-10% year-over-year increase in pharmacy expenditures over the past five years due to price escalations fueled by inflation and greater uses of outpatient care, according to the presentation.
“There’s really a growing need, as we look at the growth pattern of drug therapies and the cost of it, and how we are trying to curb, really, the overall expansions of this inflation,” Hatfield said.
Cedric Terrell, the chief pharmacy officer of UC Health, said there are several ways to mitigate these costs, such as the 340B Drug Pricing Program. The federal initiative allows providers like UC Health to obtain discounted medications for underserved communities, according to the discussion item.
Terrell added that a UC-led pharmacy benefits manager system could be of value to UC Health. Pharmacy benefit managers, or PBMs, serve as intermediaries between drug manufacturers, payers and pharmacies to manage expenses, but many keep rebates, according to the meeting agenda.
“There’s this middle part that is impacting a way that we can drive down our total cost within our own health plan,” Terrell said. “That’s where we see the next wave of opportunities for us in the pharmacy space is to work closer with our own health plan and look at ways that we can provide some of these services that, right now, we contract through other PBMs.”
California’s Office of Health Care Affordability seeks to reduce pharmacy expenditures by implementing annual cost growth targets, beginning at 3.5% in 2026, according to the discussion item. Cost growth targets are benchmark values that control how much a state’s health care spending can increase – according to the National Academy for State Health Policy – and can impact the type of care that patients receive, according to Terrell.
Terrell said these targets do not consider the effects of the high-cost, curative therapies that UC Health offers, such as treatments for Duchenne muscular dystrophy and certain cancers. He added that UC Health can respond through advocacy efforts – including consultations with OHCA – that emphasize the novelty of its therapies.
The committee also discussed accreditation requirements in medical education and the UC Academic Senate’s role in maintaining curriculum oversight. Dr. Deena Shin McRae, the associate vice president for Academic Health Services, said the University seeks to find a balance between these requirements and opportunities for instructors to apply innovation and creativity in their teaching.
McRae said she believes adherence to accreditation guidelines is essential to meet the academic standards of the UC and provide communities with the best care CQ4.
“There must be reliable processes to ensure that our medical students are exposed to the necessary curriculum and experiences in order to attain and demonstrate competency,” she said. “There are many policies and procedures in place to continuously monitor and assess the curriculum, with effective quality-improvement processes to ensure that the UC medical schools continue to be top-ranked medical schools in the nation.”
Dr. Steven Dubinett, the dean of the David Geffen School of Medicine, discussed the strengths and challenges of current accreditation methods – including collaborative oversight in curriculum reform and data collection in program evaluations, respectively. He said a series of committees within the medical school examine data, course feedback and educational results to regularly improve curricula.
Dubinett added that the Liaison Committee on Medical Education – the official accrediting body for medical education programs resulting in medical degrees in the U.S. – adjusts its expectations for educational excellence to incorporate developments in health care.
“Staying ahead of these shifts, while maintaining our high standards in teaching and clinical care, requires adaptive leadership and robust internal review processes,” he said. “Our approach at the David Geffen School of Medicine centers on transparency, shared governance, continuous quality improvement and faculty-driven innovation.”
UC Regents health committee warn of One Big Beautiful Bill Act’s potential impacts
The UC Board of Regents Health Services Committee held its bimonthly meeting Tuesday to Thursday at UCLA. The committee discussed ways to lower pharmacy expenditures, ensure quality medical school curricula and the impact of the reconciliation bill on California’s health care delivery system. The bill is estimated to decrease federal Medicaid spending by about $1 trillion over a decade, a UC official said. The board also discussed accreditation requirements in medical education and the role of the Academic Senate in maintaining oversight of the curriculum. The meeting was the first since President Donald Trump signed the budget reconciliation bill into law on July 1, the committee’s agenda said. It is estimated that Medi-Cal, the Medicaid provider for California residents, serves as an important revenue source for the University of California Health centers, an official said at the meeting. It has experienced an 8-10% year-over-year increase in pharmacy expenditures over the past five years due to price escalations fueled by greater uses of outpatient care, according to the presentation.
The committee discussed ways to lower pharmacy expenditures, ensure quality medical school curricula and understand the impact of the reconciliation bill on California’s health care delivery system at the Regents’ July meeting. The board held its bimonthly meeting from Tuesday to Thursday at UCLA.
Tam Ma, the UC’s associate vice president for health policy and regulatory affairs, updated the committee on federal and state health policy.
President Donald Trump signed the budget reconciliation bill following approval from the United States Senate and the House of Representatives.
Ma said the bill is estimated to decrease federal Medicaid spending by about $1 trillion over a decade. She added that Medi-Cal, the Medicaid provider for California residents, serves as an important revenue source for the UC’s academic health centers.
Ma also said changes to Medicaid eligibility and enrollment rules may lead to reductions in health care coverage in California. She said she anticipates lowered access to primary, specialty and inpatient care, as well as challenges to providers’ financial sustainability – such as layoffs and facility closures, according to a presentation given at the meeting – and increased waits for care at UC academic health centers.
Ma added that many implementation details are not yet known, and UC Health will track administrative developments that pertain to Medicaid.
“We’ll be sure to engage with the state as it starts to implement these provisions and deal with the fiscal impacts” she said. “If there are opportunities available, we’ll advocate for (the) delay of these funding cuts.”
Chad Hatfield, the chief pharmacy officer at UC Davis Health, said pharmacy costs are increasing across the country and becoming a major category of spending in the health sector. He added that factors driving this trend are curative therapies – which aim to cure illnesses and achieve full patient recovery, according to the National Institutes of Health – and outpatient settings, such as clinics, infusion centers and specialty retail spaces, which provide medical services without requiring hospitalization.
UC Health’s total operating expenditures reached $21 billion as of April, with pharmacy costs representing the second-largest spending area at $2.6 billion annually, Hatfield said. It has experienced an 8-10% year-over-year increase in pharmacy expenditures over the past five years due to price escalations fueled by inflation and greater uses of outpatient care, according to the presentation.
“There’s really a growing need, as we look at the growth pattern of drug therapies and the cost of it, and how we are trying to curb, really, the overall expansions of this inflation,” Hatfield said.
Cedric Terrell, the chief pharmacy officer of UC Health, said there are several ways to mitigate these costs, such as the 340B Drug Pricing Program. The federal initiative allows providers like UC Health to obtain discounted medications for underserved communities, according to the discussion item.
Terrell added that a UC-led pharmacy benefits manager system could be of value to UC Health. Pharmacy benefit managers, or PBMs, serve as intermediaries between drug manufacturers, payers and pharmacies to manage expenses, but many keep rebates, according to the meeting agenda.
“There’s this middle part that is impacting a way that we can drive down our total cost within our own health plan,” Terrell said. “That’s where we see the next wave of opportunities for us in the pharmacy space is to work closer with our own health plan and look at ways that we can provide some of these services that, right now, we contract through other PBMs.”
California’s Office of Health Care Affordability seeks to reduce pharmacy expenditures by implementing annual cost growth targets, beginning at 3.5% in 2026, according to the discussion item. Cost growth targets are benchmark values that control how much a state’s health care spending can increase – according to the National Academy for State Health Policy – and can impact the type of care that patients receive, according to Terrell.
Terrell said these targets do not consider the effects of the high-cost, curative therapies that UC Health offers, such as treatments for Duchenne muscular dystrophy and certain cancers. He added that UC Health can respond through advocacy efforts – including consultations with OHCA – that emphasize the novelty of its therapies.
The committee also discussed accreditation requirements in medical education and the UC Academic Senate’s role in maintaining curriculum oversight. Dr. Deena Shin McRae, the associate vice president for Academic Health Services, said the University seeks to find a balance between these requirements and opportunities for instructors to apply innovation and creativity in their teaching.
McRae said she believes adherence to accreditation guidelines is essential to meet the academic standards of the UC and provide communities with the best care CQ4.
“There must be reliable processes to ensure that our medical students are exposed to the necessary curriculum and experiences in order to attain and demonstrate competency,” she said. “There are many policies and procedures in place to continuously monitor and assess the curriculum, with effective quality-improvement processes to ensure that the UC medical schools continue to be top-ranked medical schools in the nation.”
Dr. Steven Dubinett, the dean of the David Geffen School of Medicine, discussed the strengths and challenges of current accreditation methods – including collaborative oversight in curriculum reform and data collection in program evaluations, respectively. He said a series of committees within the medical school examine data, course feedback and educational results to regularly improve curricula.
Dubinett added that the Liaison Committee on Medical Education – the official accrediting body for medical education programs resulting in medical degrees in the U.S. – adjusts its expectations for educational excellence to incorporate developments in health care.
“Staying ahead of these shifts, while maintaining our high standards in teaching and clinical care, requires adaptive leadership and robust internal review processes,” he said. “Our approach at the David Geffen School of Medicine centers on transparency, shared governance, continuous quality improvement and faculty-driven innovation.”