The California State Profile

New State Health Data Released: How Does California Compare?

A report, developed by the Center for Studying Health System Change (HSC), identifies three market changes and their impact on California's ability to provide cost effective quality health care through its current system. California's insurance industry has operated under what the authors refer to as a "delegated model," in which providers accept fixed per-member payment rates from insurers in exchange for accepting responsibility for ensuring proper utilization of resources and oversight of medical personnel. This model was considered the source of California's prior success in controlling the rise of health care costs - for providers, insurers, as well as consumers - and the development of high quality, efficient medical practices. However, the HSC report suggests that three recent market developments threaten the continued existence of this model.
 

Paul. B. Ginsburg, Ph.D.,  President of the Center for Studying Health System Change and a nationally recognized scholar in health economics and health policy, studied how California's providers have leveraged their joint bargaining power in an attempt to increase reimbursement rates and its effect driving up costs. Ginsburg believes that expanding health insurance coverage to the more than 45 million uninsured Americans is a key U.S. policy goal, but that  expanding coverage without steps to contain rapidly rising health care costs is a recipe for failure. His analysis of how California providers have implemented various strategies that have strengthened their leverage in negotiating prices with private health plans provides a cautionary tale.

Cost Efficiency At Hospital Facilities In California
This report, developed for the Pacific Business Group on Health (PBGH) by Milliman, Inc., provides comparative data on California inpatient hospital costs, which will help California residents, advocacy organizations and providers better understand the relative cost differences among California hospitals.

Creating a High Value Health Care System for California
In a report released by the New America Foundation, with the support of the Blue Shield of California Foundation, a California-based Task Force of high-level health care stakeholders from the hospital, physician, insurance, and consumer sectors recommend best practices to improve the value that the state gets for its healthcare spending. The Task Force found that successful implementation of its recommendations, which are grounded in shifting the focus of California’s health care systems from treating illnesses to promoting health, will likely save the state as much as $305 billion over the next ten years.

Health Care Have and Have Nots: A Crisis for California’s Retired Educators
The Teachers’ Retirement Board requested that the Public Education Health Benefits Task Force focus on three issues: compliance with Governmental Accounting Standards Board disclosure requirements, accessibility to health care, and affordability of health care in its efforts to improve the health security of CalSTRS (California State Teachers’ Retirement System) members. The Task Force recommended adopting monthly health allowances which retired members may use to cover certain medical expenses.