5 Things California: Healthcare consolidation, Scott Sukow, Health disparities

We are looking forward to hosting about 400 of you later this month at the 2018 Northern California State of Reform Health Policy Conference.  It’s coming up quick, so be sure to get registered before the opportunity slips your mind!

Now onto 5 Things We’re Watching in California health care in April.

DJ 5 Things Signature

1.  The implications of healthcare consolidation

Health care has seen an increase in both vertical and horizontal consolidation. But a recent study out of UC Berkeley reveals that greater consolidation among hospitals, physician groups and insurance companies results in people paying more for health care.

According to the report:  “In Northern California – which is considerably more concentrated than Southern California across all measures of health care market concentration that we analyzed – inpatient prices were 70% higher, outpatient prices were 17- 55% higher, and ACA premiums were 35% higher than they were in Southern California.”

Shortly after the study was released, AG Becerra filed a lawsuit against Sutter Health over anti-competitive practices that drive up costs. We have a panel dedicated to the implications of consolidation in California’s healthcare market at 11:30am during our 2018 State of Reform Health Policy Conference, which I expect will be a full room.

2.  Progress in addressing behavioral health

Addressing behavioral and mental health in California has proven challenging. While a recent audit of county MHSA funds revealed excessive reserves and a lack of oversight, another reportshows the positive impact MHSA funds have had in LA County. The report shows an increase in program enrollment and treatment utilization that have allowed “clients [to] experience improvements in their life circumstance and functioning.”

But the question remains: Is California making enough progress on behavioral health integration? Our panel on the topic later this month will review the progress, offer lessons learned, and point to future efforts for integration. We’ll hear from Laura Grossmann from Beacon Health Options, Margaret Kisliuk from Partnership Health Plan, and Brenda Goldstein from LifeLong Medical Care during this 10:30am panel.

3.  Executive Keynote Panel on April 26th

Our lunchtime Executive Keynote Panel will be a good one, the kind of multi-silo, honest conversation for which State of Reform is known.

We’ll host Carmela Coyle, the new CEO at the California Hospital Association; Don Crane, CEO of America’s Physician Groups; and Priscilla VanderVeer of PhRMA, who is flying out from DC.  We may add one more voice just to mix things up as we draw closer to the event.

If you haven’t registered to be with us on April 26th, now is the time to sign up to participate in one of the more dynamic, practical and diverse convenings of senior health care executives and health policy makers in Northern California!  We’d be honored to have you with us.

4.  Video: Scott Sukow, American Liver Foundation

Scott Sukow is the Executive Director of the American Liver Foundation, Pacific Coast Division – and is also one of my favorite people in San Diego health care. He joins us in this edition of “What They’re Watching” to talk about the need for transparency during enrollment.

“So, you’re really having these conversations with payers and providers about how to make more transparent their systems so that consumers can say, “I’m going to choose this plan because it has this network of providers that have outcomes about my particular health condition that are important to me, and I want to make a choice that aligns with my chronic health condition.” Well all these measurements and transparency measures have to be made public and that’s going to take some investment from payers or plans.”

5.  Health disparities among CA counties

recent report shows the significant health disparities that exist among  counties in California. For measurements of both health outcomes and health factors, California’s healthiest counties are concentrated in the Bay Area and along the Southern coast. Northern counties ranked lowest in terms of health outcomes, and Southern counties away from the coast ranked at the bottom for health factors.

Between counties, the poverty rate for children ranges from 8% in San Mateo to 37% in Fresno. Teen birth rates per 1,000 range from 8 in Marin to 50 in Del Norte and high school graduation rates range from 30% in Inyo to 94% in Calaveras. While multiple counties have an uninsured rate of 5-6%, Madera County’s rate is 13%. You can explore the data here.

Our panel, “Integrating the Social Determinants into the Medical Model” at our 2018 Health Policy Conference, will feature panelists who will discuss their experiences, successes, and setbacks in working to address these disparities through addressing social determinants of health. We’ll host Vitka Eisen, CEO of HealthRIGHT 360, and Brain Baker, Lead Government Strategist at Cerner.