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 longstanding 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.
Last month CHCF’s board endorsed three broad priorities for us for the next five years. These goal areas build upon CHCF’s strengths and reflect the rising importance of Medi-Cal as a source of coverage for low-income Californians, the opportunity to improve behavioral health care delivery and services, and the recognition that engaged consumers are key to system transformation. Our three overarching goals are:
Improving access to coverage and care for low-income Californians (organized around coverage and navigation, safety-net capacity, and consumer-focused care)
Ensuring high-value care that aligns with patient preferences, has been proven to be effective, and is affordable (focused on maternity care, complex behavioral health and medical conditions, and end-of-life care)
Informing decisionmakers (provide policymakers and other decisionmakers with the information needed to change the health care system)
There is urgency in our quest to improve care, especially for those not well served by our current system. In more than 30 years as a practicing physician, I have seen pervasive inequality that confronts poor and disenfranchised people who want the opportunity to live without disease, and when illness comes, to receive care from competent clinicians in their communities. I have seen waste and inefficiency that threaten the health not only of our health care system, but also of our society at large.
These focal areas represent significant and meaningful challenges in our delivery system. Like-minded organizations and individuals are working to make improvements in each of these areas. While these priorities build on CHCF’s historic areas of expertise, our work toward these goals will lead us into new coalitions, new collaborations — new partnerships. We look forward to working with our colleagues in the shared purpose of ensuring access and improving care.
There has never been a better time for the foundation to deploy its people, resources, and reputation to ensure high-value health care for all the people of California. They deserve nothing less.
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. She also serves on the Betty Irene Moore School of Nursing Advisory Council at UC Davis and on the UC Regents Health Services Committee. Sandra is an assistant clinical professor at the UCSF School of Medicine. She practiced at San Francisco General Hospital in the HIV/AIDS Clinic from 1984 to 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.