“To explore the prevalence of geographical variation in greater detail, the California Health Care Foundation (CHCF) made a research grant to Stanford health economics professor Laurence Baker. The focus was on elective treatments, including heart procedures, joint replacement, mastectomy, and vaginal birth after cesarean, where providing more information to patients could affect their decisionmaking around whether to opt for a certain treatment. His work revealed that rates of elective surgeries for a range of procedures in California varied widely depending on location, even after adjusting for areas with less-healthy populations, and noted that overuse is not always the issue; underuse can be a problem too.
“If gathering the data was the first step, making it useful was the second. Our goal was to present the research in a clear and compelling way to prompt policymakers and the medical community to question why their areas were outliers and take action to address these differences.”
Dr. Sandra R. Hernández is president and CEO of the California Health Care Foundation. Prior to joining CHCF, Sandra was CEO of The San Francisco Foundation, which she led for 16 years. She previously served as director of public health for the City and County of San Francisco. She also co-chaired San Francisco’s Universal Healthcare Council, which designed Healthy San Francisco, an innovative health access program for the uninsured.
Sandra is an assistant clinical professor at the University of California, San Francisco, School of Medicine. She practiced at San Francisco General Hospital in the AIDS clinic from 1984 to 2016. She was appointed by Governor Jerry Brown to the Covered California board of directors in February 2018. She currently serves on the Betty Irene Moore School of Nursing Advisory Council at UC Davis and the UC Regents Committee on Health Services. Sandra served on the External Advisory Committee at the Stanford Center for Population Health Sciences in 2016. Sandra is a graduate of Yale University, the Tufts School of Medicine, and the certificate program for senior executives in state and local government at Harvard University’s John F. Kennedy School of Government.
Steven Birenbaum is a senior communications officer at CHCF, where he promotes the foundation’s reports and initiatives to key audiences and manages a portfolio of public media grants.
Prior to joining CHCF in 2005, Steven was executive writer at Blue Shield of California, where he wrote speeches, presentations, op-eds, and byline articles for the CEO and senior executives, helped produce the company’s annual report and its monthly internal communications newsletter. Previously, he was a senior writer and account manager at Chandler Chicco Agency, a public relations firm, where he provided product promotion and issues management support to leading pharmaceutical companies. As a writer, his work has been published in the New York Times, Newsday, and KQED, among other news outlets. Steven received a bachelor’s degree in political science and history from the University of Wisconsin-Madison and a master’s of public affairs from the LBJ School of Public Affairs at the University of Texas, Austin.