“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.”
To read the complete article, visit the Stanford Social Innovation Review website.
Sandra R. Hernández, MD, 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 cochaired San Francisco’s Universal Healthcare Council, which designed Healthy San Francisco. It was the first time a local government in the US attempted to provide health care for all of its constituents.
In February 2018, Sandra was appointed by Governor Jerry Brown to the Covered California board of directors. In December 2019, she was appointed by Governor Gavin Newsom to the Healthy California for All Commission, which is charged with developing a plan to help California achieve a health care delivery system that provides coverage and access through a unified financing system. She also serves on the UC Regents Health Services Committee and the UC San Diego Chancellor’s Health Advisory Board and on the board of the company 23andMe. Sandra practiced at San Francisco General Hospital in the HIV/AIDS Clinic from 1984 to 2016 and was an assistant clinical professor at the UCSF School of Medicine.
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 focused on CHCF’s work to improve care for patients with complex chronic conditions, including older adults and people experiencing homelessness. As a grantmaker he sets strategy to strengthen and support non-profit journalism in California, overseeing grants to public media outlets, a data fellowship program and the daily news digest California Heathline. He also leads CHCF’s investments in podcasting. Steven was interviewed at the 2020 Knight Media Forum by PBS NewsHour Weekend’s Hari Sreenivasan about CHCF’s health care journalism grantmaking.
Prior to joining the foundation, Steven was executive writer at Blue Shield of California. As a writer, his work has been published in The New York Times, Newsday, the Stanford Social Innovation Review and KQED Radio, among other 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.