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The CHCF Blog

The California Health Care Foundation draws on experts from within and outside CHCF to share their health policy insights on this blog. We encourage readers to join the conversation by using the comments feature at the bottom of each article.

  1. New Reports Highlight the Potential Economic Impacts of ACA Repeal

    Amy Adams, Senior Program Officer, Improving Access
    Amy Adams
    Amy Adams

    The proposed repeal of the Affordable Care Act (ACA) without a simultaneous comparable replacement will put health coverage for millions of Californians in jeopardy. According to two recent reports, it will also put a lot of jobs in jeopardy. California stands to lose more than any other state because it has the largest population and because it fully embraced opportunities to expand coverage through the ACA.

    Recent research from George Washington University, supported by the Commonwealth Fund, projects that the US would lose 2.6 million jobs in 2019, the year repeal is assumed to take effect. California is projected to lose 334,000 jobs — 225,000 more than the next most-affected state, Florida. The report also details declines in state and local taxes, gross state product, and other economic indicators across the country and by state if no replacement plan is in place between 2019 and 2023.

  2. How CHCF Is Responding to the Changing Landscape

    Sandra R. Hernández, President & Chief Executive Officer
    Sandra Hernandez
    Sandra R. Hernández

    The inauguration of Donald Trump as our next president seems likely to bring significant change to the health care system. While we at the California Health Care Foundation (CHCF) can only guess how the story will play out, the intense debate highlights to us that the foundation's core mission — improving the health and care of all Californians, especially the underserved — is more important than ever.

    We are proud of California's gains from the Affordable Care Act (ACA). Five million more Californians are now covered, the uninsured rate has been cut in half, financial stability has increased for families and health care institutions, and thousands of jobs have been created.

  3. When It Comes to Seeing a Doctor in California, the Uninsured Still Fare Worst

    Janet Coffman, Associate Professor, UCSF School of Medicine, Institute for Health Policy Studies
    Janet Coffman
    Janet Coffman

    With repeal of the Affordable Care Act (ACA) on the horizon, and no replacement plan in sight, millions of Californians are at risk of losing their coverage. Approximately 5 million Californians are currently covered under the ACA. The state's uninsured rate, which hit a historic low under the ACA, could start to rise again depending on what happens in Washington in the coming weeks and months.

    It's worth remembering the multiple barriers that people without insurance face in our health care system. I am reminded of some key findings from a 2015 survey of California physicians that the University of California, San Francisco, released last fall with support from the California Health Care Foundation.

  4. DHCS Academy: First-in-the-Nation Experiment Is a Big Success Story

    Karen Johnson, Chief Deputy Director, California Department of Health Care Services,
    Eric Douglas, Founder and Senior Partner, Leading Resources
    Karen Johnson
    Karen Johnson
    Eric Douglas
    Eric Douglas

    Inside Sacramento's historic library building, 30 managers from California's Department of Health Care Services are working in small groups to resolve a thorny issue: how to structure value-based payments to providers that result in better health outcomes for people with complex needs.

    This is DHCS Academy, the first program of its kind in the nation, where leaders of the state's Medi-Cal program gather every month to engage in case studies, work on leadership projects, and wrestle with innovations in financing, delivery system reform, and health care integration.

  5. Rescuing Hospice Patients

    Mike Taigman, Project Manager, Ventura County EMS/Hospice Partnership Project
    Mike Taigman
    Mike Taigman

    Community paramedicine (CP) is a locally designed, community-based, collaborative model of care that leverages the skills of paramedics and emergency medical services (EMS) systems to take advantage of collaborations between EMS and other health care and social service providers. Community paramedics receive specialized training in addition to general paramedicine training and work within a designated program under local medical control as part of a community-based team of health and social services providers.

    In California, many people facing a terminal illness decide to sign up for hospice care. Hospice care focuses on relieving the pain and suffering sometimes associated with the final days and weeks of life, and is provided in a place of a person's choosing, often in the home.

  6. Moving from Stigma to Science in Treating Addiction

    Xenia Shih Bion, Program Associate
    Xenia Shih Bion
    Xenia Shih Bion

    Despite the availability of new ways to treat millions of people trapped by addiction to opioids, the news has not been good. "The epidemic of deaths involving opioids continues to worsen," said Tom Frieden, director of the US Centers for Disease Control and Prevention in response to new data that show the death toll from opioids continued to climb in 2015.

    People are dying despite evidence-based addiction treatment that works. Medication-assisted treatment (MAT) combines drugs with counseling to help people with opioid use disorders break the cycle of addiction. MAT can dramatically reduce the risk of overdose death. After the approach was widely adopted in France, overdose deaths declined by nearly 80%.

  7. Handing Over the Keys Is Bittersweet

    Maribeth Shannon
    Maribeth Shannon
    Maribeth Shannon

    For 12 years, the California Health Care Foundation operated CalQualityCare.org, an interactive, consumer-oriented website with quality ratings of both the state's hospitals and long-term care facilities. Recently, CHCF handed over its keys to a pair of carefully chosen new owners intimately familiar with the inner workings of this website. Each of these longtime partners of the foundation played an important role in producing CalQualityCare.org.

    Now, when consumers visit CalQualityCare.org to view ratings for long-term care providers and facilities, they will find a site managed by a team at the University of California, San Francisco (UCSF). This group has collected, analyzed, and provided the ratings since the service began.

  8. Diving into State's Open Data Sets – With Help

    Andrew Krackov, Vice President for Strategy and Partnerships, LiveStories
    Andrew Krackov
    Andrew Krackov

    I'm a champion of open data, but I'll be the first to admit that viewing data on a portal sometimes can be unsatisfying. Scanning simple lists of data sets — and even the maps and charts you can create out of them — doesn't really show how the liberation of government information can benefit communities.

    To fully realize the data's meaning and potential, it's essential to bring the information to life with the help of local collaborations, news coverage, and smartphone apps that unlock information and services. When it comes to leveraging data mined from state portals in ways that improve the use and delivery of services, raise broad awareness of issues, and inform local and statewide policymaking, it takes people to make that happen. It wasn't enough to use health data from California's open-data portal to create stories about measles-immunization rates for kindergarteners in the Golden State. This story came to life only when journalists deployed this information to maximum effect, as the New York Times did with this mapping project. Data just sitting in a public data library can't do that.

  9. Thank You, California Voters

    Sandra R. Hernández, President & Chief Executive Officer
    Sandra Hernandez
    Sandra R. Hernández

    The health care agenda is certain to be dominated for some time by the national debate over the future of the Affordable Care Act (ACA), but I want to take a moment to recognize several important state and local health policies that were overwhelmingly backed by California voters.

    While some on the national scene favor a rollback in the public commitment to health care for all, Californians stepped up on November 8 and demonstrated strong support for low-income communities having reliable access to health care when and where they need it. California voters also demonstrated they understand that growing consumption of sugary drinks and widespread use of tobacco products increase the disease burden on our families and the health care system that cares for them. Please note that the California Health Care Foundation does not take positions on ballot initiatives nor do we work to support or oppose any initiatives.

  10. Dynamics of Decline: The Truth About HMOs

    Maribeth Shannon
    Maribeth Shannon
    Maribeth Shannon

    California's commercial health maintenance organization population shrank from 11.9 million to 9.8 million enrollees between 2004 and 2015 (see figure below), a 17.5% decline. But the decline has not been consistent across all HMOs — Kaiser's commercial enrollment has actually grown during this period.

    Two new publications from CHCF take a closer look at how commercial managed care enrollment (including individual enrollment) and the public sector's embrace of managed care are shifting the way physician organizations are paid — important trends that could affect California's delivery system.

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