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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.
  1. Charting CHCF's Course for 2016

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

    Before the Affordable Care Act (ACA) was enacted nearly six years ago, American health care was like a car speeding precariously toward the edge of a cliff. Health costs and insurance premiums were steadily climbing. Safety-net institutions were staggering under the weight of demand for uncompensated care. Health insurance companies routinely denied coverage to people with pre-existing health conditions. Nearly 50 million Americans were uninsured, and millions of others who carried health plan membership cards had threadbare benefits that left them one accident or illness from financial disaster. While the ACA was certainly not a panacea for all that ails American health care, it's fair to say that it sparked important health policy changes that steered the health care system away from the cliff.

    Here in California millions of people gained protection from medical bankruptcy for themselves and their families. Eligibility expansions enabled by the law have begun to benefit overlooked and underserved communities. Since implementation began two years ago, more than 2 million Californians enrolled in Medi-Cal, and 1.3 million people purchased subsidized private health plans through Covered California just this year. And Governor Jerry Brown recently signed into law the Health for All Kids Act, allowing up to 250,000 undocumented children in the state to be transitioned into comprehensive Medi-Cal coverage. In this new health care model, insurers must issue coverage to anyone regardless of medical condition, buyers of coverage are eligible for tax credits to help pay monthly premiums, and there must be parity between mental health and physical health services.

  2. California Expands Latino Enrollment and Access to Coverage and Care

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

    Over half a century, the Medicare and Medicaid programs have transformed, modernized, and reorganized American health care. Likewise, the Affordable Care Act (ACA) has brought about important health policy changes that will reverberate for decades to come — and many of the changes have special importance for the health of California's Latino community.

    Eligibility expansions enabled by the law have benefited populations long overlooked and underserved. Since implementation began two years ago, more than 2 million Californians have signed up with Medi-Cal, and now almost half of its 12.4 million enrollees are Latino. Covered California enrolled 1.3 million people this year; nearly 300,000 were Latino. And last month Governor Jerry Brown signed into law the Health for All Kids Act, which will enable up to 250,000 undocumented children in the state — most of them Latino — to transition into comprehensive Medi-Cal coverage.

  3. Making Ideas Move

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

    Here's something mind boggling: Three of the technologies that have changed how the world communicates are only about 10 years old. Facebook, which now has more than 1.3 billion monthly active users, was started in 2004. YouTube, with more than 1 billion users a month, was started a year later. And Twitter, which now has more than 500 million tweets posted daily, is the baby of the three, launched in 2006.

    Two weeks ago I participated in a roundtable discussion of foundation CEOs as part of the annual conference of the Communications Network, an organization devoted to helping foundations and nonprofits use communications to create change.

    The theme of this year's conference was "Making Ideas Move," and the panelists agreed that organizations that commission research and promote ideas must expand beyond the usual channels they've traditionally used to reach audiences if they hope to achieve measurable impact. This requires us to adapt to new ways that people seek and consume information — on smartphones and through social networks, both online and in person.

  4. In the Drive for Better Access to Care, This Is the Moment

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

    This is a special moment for people in the business of ensuring that low-income Californians get the health care they need when they need it. Although it's now more than five years old, the Affordable Care Act continues to reverberate across the health care system — especially in California, which went further than any other state in embracing opportunities created by the law. As a result, millions of people in our state have for the first time gained health insurance membership cards. This should aid in reducing social inequality by giving more Californians health and financial security, while strengthening California's burgeoning economy.

    But this opportunity also brings challenges. The sudden and remarkable growth in the insured population has created a new burden for health care providers who are struggling to keep pace with the demand for care. CHCF-supported studies have documented that within the Medi-Cal program, which serves more than 12 million low-income Californians, many of whom have disabilities or complex, chronic health conditions, there are not enough primary care doctors to adequately meet their patients' needs.

  5. What Do We Know About Outpatient Surgery Centers?

    Sandra R. Hernández, President & Chief Executive Officer
    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.

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