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Public Coverage

California’s health system includes statewide public coverage programs and special county-based programs: Medi-Cal, Healthy Kids/Healthy Families, and others created under Section 1115 of the Social Security Act.

On the Eve of Reform: Hospitals, Clinics and the Safety Net (2008-2011)

These reports are analyses of the Office of Statewide Health Planning & Development’s hospital and community clinic data that examines utilization and financing during the height of the Great Recession.  It looks into inpatient and outpatient care (hospitals), Medi-Cal utilization trends, county indigent care, as well as hospital utilization/financing trends […] more

Improving Birth Outcomes: Better Coordinating Care and Coverage for Pregnant Women

Download the full report here:   After expanding coverage for prenatal care and expanding perinatal services in California, we have achieved remarkable reductions in premature births, low birth-weight, reduced smoking rates of pregnant women and important increases in access to timely prenatal care.[1] California covers care for pregnant women through Medi-Cal […] more

Primary Care Rate Increases: Why Are They Important and What’s the Reason for the Delay in Implementation in California?

Download the full report here:   California could be the last state in the nation to implement the primary care improvements of the ACA, but if so, let’s at least make it the most successful, transformative and enduring. The ACA requires states to increase their Medi-Cal reimbursements for primary care […] more

Bridge Plan Legislation – Summary of SB X1 3 (Hernandez)

Download the PDF here:   SB X1 3 (Hernandez) sets the rules for Bridge Plans (Medi-Cal managed care plans) that can offer low cost continuation coverage in the Exchange for individuals losing Medi-Cal eligibility, and whole family coverage for families where the children are on Medi-Cal and the parents eligible […] more

Safety Net Integration – Can it Happen Here?

Download the PDF here:   The ACA requires and rewards integration of services. Accountable care organizations, bundled payments, pay for performance, penalties for excessive hospital readmissions and patient centered medical homes are examples. In California, Kaiser is the best (and only remaining) model of fully integrated delivery system.   Safety […] more

Summary of California Assembly Bill 85

Summary of AB 85: The Budget Trailer Bill Governing County Health Realignment This bill transfers realignment  funds from county health to social services with a 5% CalWorks increase in aid payments on March 1, 2014. It reduces county health realignment funds by an average of 60% beginning in January 1, […] more

Summary of Medicaid Expansion: SB X 1 1 and AB X 1 1

Download the full summary here: Executive Summary Eligibility Coverage of Parents and MIAs up to 133% of FPL (MAGI, Modified Adjusted Gross Income eligibles) MAGI applies to all individuals and families, except the aged and disabled. Consolidation of all income disregards to a 5% uniform disregard for all MAGI eligibles, […] more

The Reckoning

I have been haunted for the last decades by David Halberstam’s book, “The Reckoning” which details the decline and fall of the Big Three Detroit automakers who forgot the basics of design, engineering, and quality while focusing obsessively on “finance”. As a result Japanese automakers flourished while “made in Detroit” […] more

Visions for Reaching an Agreement on Expanding Medi-Cal

California is one of the nation’s leaders in implementing the Affordable Care Act for its 7 million uninsured residents. In December 2012, the Governor’s Let’s Get Healthy California Task Force issued its report delineating California’s goals and steps to improve the health of all Californians, to become the healthiest state […] more

ITUP Analysis of OSHPD Data about Safety Net Hospital and Clinic Utilization and Revenue

This ITUP analysis uses data from the California Office of Statewide Health Planning and Development to asses safety net hospitals’ and clinics’ utilization and revenue. The charts and tables provide data by payer and display trends over the last several years. The data are available for hospitals (inpatient and outpatient […] more