California Health Care Foundation:
30 Years of Impact
For three decades, the California Health Care Foundation has worked to improve the health care system for all Californians, especially people with low incomes.
The Foundation set out to improve how health care is financed and delivered in California, with a steadfast focus on the safety net — a commitment that continues to guide our work today.
The progress reflected below belongs to the many partners, advocates, providers, and policymakers who share our commitment to a more just health care system. Thank you for being part of the work.
1996
Created to Improve California Health Care
Following the conversion of Blue Cross of California from a nonprofit health plan to a for-profit corporation, the California Health Care Foundation was established under founding president and CEO Mark Smith, MD.
1998
Quality News for California Health Leaders
We created California Healthline to keep health care leaders informed on the news shaping the state. In 2025, California Healthline joined KFF Health News as its California Bureau – with our continued support.
2001
Transforming Health Care Leaders
We launched the CHCF Health Care Leadership Program to equip mid-career clinicians with management and leadership skills. More than 700 alumni now lead hospitals, clinics, state health agencies, and Medi-Cal managed care plans statewide.
2005
Pioneering Health Data Exchange
We were an early believer in health information technology, piloting a data exchange in Santa Barbara when the concept was still new. The Foundation’s continued research and analysis helped pave the way for California’s statewide Data Exchange Framework, created in 2021.
2005
Connecting the Dots Across the State
We established the California Improvement Network to accelerate the spread of good ideas across California’s health care system. The network has grown into a robust learning and action community that connects health care organizations — providers, payers, and supporters — with community-based and social service organizations.
2006
Reducing Maternal Mortality
With maternal mortality rates rising across the country, we worked with partners statewide to address this crisis. CHCF was an early, substantial investor in the Maternal Data Center, the engine behind statewide quality improvement. California’s maternal mortality rate declined by 65% between 2006 and 2016, while the national rate continued to climb. Cesarean section rates also fell sharply.
2007
Advancing Access to Palliative Care
We began a 17-year effort to help advance palliative care – specialized care for people with serious illnesses to improve quality of life. Today, the Medi-Cal program provides access to palliative care (the first state in the nation to do so), and home-based palliative care is available in all counties.
2010
Investing in Technology for the Safety Net
Long before Medicaid was seen as fertile ground for innovation, we made a bold bet that mission-driven start-ups could bring new solutions to Californians with low incomes. The CHCF Innovation Fund has committed more than $30 million to 40 companies improving care for underserved communities.
2014
A Milestone Leadership Transition
After 18 years at the helm, founding CEO Mark Smith, MD, announced his retirement from the Foundation, and Sandra R. Hernández, MD, was named as CEO.
2017
The Health Workforce of Tomorrow
Facing a looming workforce shortage, we joined other leading philanthropies to convene the California Future Health Workforce, which developed a decade-long strategy to build the health workforce California needs.
2019
Bridging Health Care and Homelessness
We launched a major initiative to improve health care for people experiencing homelessness. With our support, partners expanded street medicine and medical respite statewide, connected health systems with homeless and housing service providers, and gave providers new ways to address patients’ housing needs.
2020
Mobilizing for COVID-19
As the pandemic upended California’s health care system overnight, we moved quickly. Twelve days after the state’s shelter-in-place order, the Foundation published its first weekly survey of residents and providers to inform state agencies of urgent needs. We also approved $6 million to advance telehealth in the safety net, helping providers reach patients when in-person care wasn’t possible.
2022
Listening to Black Californians
As part of its commitment to ending health inequities, we supported a qualitative and quantitative study that listened to more than 3,500 Black Californians via in-depth interviews, focus groups, and a statewide survey.
2022
Championing CalAIM Implementation
When California embarked on the most ambitious transformation of Medi-Cal in a generation, we moved quickly to support implementation, providing the state, health plans, providers, and community-based organizations with data and technical assistance to turn policy vision into tangible care.
2024
Leveraging AI in Health Care
As AI rapidly transforms health care, we launched an initiative to focus on AI in the safety net. AI technologies hold the potential to improve efficiency, enhance provider satisfaction, and most importantly, expand access to high quality care. We work to ensure safety net providers have access to these tools.
Looking to the Future
There is still much more work to do. To mark our 30th anniversary, we are focusing the conversation on a foundational element of good and effective health care: trust.
Without trust, patients don’t seek care when they need it. Communities remain isolated from life-saving resources. Systems stay siloed, and progress stagnates.