From the President

Dr. Sandra R. Hernández became president and CEO of the California HealthCare Foundation in January 2014. In her monthly column she reflects on her experiences as a physician and philanthropic leader to comment on the latest reports and projects from CHCF.
What Do We Know About Outpatient Surgery Centers?

Sandra R. Hernández, President & Chief Executive Officer

August 11, 2015
Sandra Hernandez, President & Chief Executive Officer
Sandra R. Hernández

After comedian Joan Rivers died a year ago during a reportedly minor outpatient procedure, a flood of news stories raised questions about the safety of ambulatory surgery centers.

Is the care delivered in these facilities equivalent to that provided in outpatient departments of hospitals? Are regulatory standards comparable? And how can patients and families research the quality of these centers before scheduling a procedure?

More than 54 million outpatient procedures are done each year in the US, a three-fold increase in the last 30 years. An increasing number are done in freestanding centers, many of which are owned by physicians.

Medi-Cal Comes to Main Street

Sandra R. Hernández, President & Chief Executive Officer

July 15, 2015
Sandra Hernandez, President & Chief Executive Officer
Sandra R. Hernández

When Amber Truong came to California from Vietnam, she couldn't afford to buy health insurance or see a doctor when she was ailing. While generally in good health, Amber feared she was one accident or illness away from the kind of financial disaster that could damage her and her boyfriend's business, a nail salon in suburban Sacramento.

After years of anxiety about being uninsured, Amber was surprised and relieved to learn in 2014 that the Affordable Care Act had expanded eligibility for Medi-Cal, California's Medicaid program for people with physical or mental disabilities, long-term care needs, or limited incomes. She eagerly joined the more than two million Californians who signed up for Medi-Cal under the new law. Now her savings are safe, and she knows that medical bills will not drive her into bankruptcy or threaten the family's business. The 27-year-old's enrollment was followed by a pregnancy, and she is now receiving prenatal care for her first child, due in September. The health benefits provided by Medi-Cal make it more likely that Amber and her baby will enjoy long, healthy, and productive lives.

Technology for the Way We Work

Sandra R. Hernández, President & Chief Executive Officer

June 02, 2015
Sandra Hernandez, President & Chief Executive Officer
Sandra R. Hernández

This post was originally published by the HIMSS blog on May 8, 2015.

Whether it's electronic medical records, computerized physician order entry, or e-prescribing, clinics and hospitals have historically approached health information technology (HIT) purchases as they would any other major piece of medical equipment — find it, buy it, and then figure out how to re-engineer the nature and flow of clinical care in order to use it.

Twenty years ago I did the same when I made the case to the San Francisco Board of Supervisors that a major investment in an electronic health system for our county hospital and clinics to share clinical data was a necessary capital investment. The budget was approved, the vendor was chosen, and we implemented the system only then to realize that we hadn't thought about the intensely personal perspective of care delivery — the "people processes" of care.

Reducing the Complexity of Complex Chronic Conditions

Sandra R. Hernández, President & Chief Executive Officer

May 20, 2015
Sandra Hernandez, President & Chief Executive Officer
Sandra R. Hernández

The Affordable Care Act (ACA) and expansion of Medi-Cal hold the potential to improve the lives of millions of Californians, especially those with asthma, diabetes, heart disease, depression, and other chronic illnesses. Yet coverage by itself is no guarantee that these patients, who face many daily physical and emotional challenges, will start to receive high-quality care tailored to their needs, since access and cost issues may prevent them from receiving timely care.

Ensuring High-Value Care, one of CHCF's three new goal areas, is focused on delivering better outcomes and lowering costs for the 5% of the population that accounts for 50% of medical spending. We will be working specifically on the "high-utilizer" population — those with untreated mental illness or substance use disorders leading to poor medical outcomes. This population uses emergency services frequently and has difficulty accessing coordinated medical, behavioral, and social services that could stabilize and improve their lives.

Taking Stock, Moving Forward

Sandra R. Hernández, President & Chief Executive Officer

April 08, 2015
Sandra Hernandez, President & Chief Executive Officer
Sandra R. Hernández

As we mark the fifth anniversary of the passage of the Affordable Care Act and are well into the second year of full implementation, we have much to celebrate as we contemplate the long road ahead. California has been a leader in embracing the opportunity and possibility of health coverage expansion and care improvements. Hard-coding and institutionalizing the early successes and sustaining the gains is now our collective responsibility.

As I began my tenure in 2014 as CHCF's second president, I joined a highly respected organization that had distinguished itself through the dissemination of high-quality, policy-relevant analyses and research, and the development of innovative approaches to care improvement. Over the past year, we have taken stock of CHCF's considerable resources and reputation, including our staff and board expertise; our long-standing and deep partnerships with policymakers, advocates, academics, and delivery system leaders; our financial resources, which give us the ability to make grants and investments; and our position as an independent, nonpartisan organization. We have sought to identify how we could further sharpen and focus our work toward sustained and meaningful impact around our mission of promoting the availability of and access to quality and affordable health care.