5 Things California: Public option, Glenn Raup, What you missed

With the May budget revise now out, the legislature is moving towards finalizing the fiscal plan for the state by June 15. We’ll have more on that in our next issue of 5 Things. For this issue, we’re tracking a few “whoa” moments out in California health care in the last few weeks.


With help from Emily Boerger




1. Kent: BH integration needs constitutional amendment

Jennifer Kent is the Director of DHCS.  She recently said that any behavioral health integration effort at the state level would require a constitutional amendment. “I always like to make sure people understand that.”

That was apparently news to Asm. Jim Wood, one of the state’s most important health policy leaders. I asked him about it during our Sacramento conference on May 9th. He said “Wow, well that’s kind of shocking… I haven’t heard that but I think I’m going to need to have coffee with Jennifer and talk about that a little bit more.”


2. 2019 NorCal State of Reform: What You Missed

Earlier this month, we hosted our 2019 Northern California State of Reform Health Policy Conference with about 300 attendees from across the spectrum of California’s health care sector. We captured some of the energy, some of the sights, and some of the sounds from the event in this highlight video.

For a review of some of the conversations at State of Reform, check out our Morning Keynote with Asm. Jim Wood, Chair of the Assembly Committee on Health. Our Lunch Keynote featured one-on-one conversations with three of California’s most important and influential voices in health care: Dustin Corcoran, CEO of the California Medical Association, Elizabeth Mitchell, President & CEO of the Pacific Business Group on Health, and Sacramento Mayor Darrell Steinberg. Finally, we rounded out the day with a conversation on measuring the impact of consolidation vs. integration with an impressive group of health care leaders.

3. Is LA Care California’s “public option”?

John Baackes is the CEO of LA Care, and one of the most thoughtful – and disruptive – leaders in California health care. In a recent op-ed, Baackes argues: “I am concerned about single player or ‘Medicare for all’ proposals because they imply a single public utility solution without the benefits of healthy innovative competition.”

“I welcome the competitive environment. I appreciated that I have to look over my shoulder to see what the commercial plans are doing so we can remain competitive. And I am sure my commercial counterparts are looking at L.A. Care with a wary eye now that we have moved up in market share.”

Perhaps the best way to bring a low-cost, public option model to California health care is to have the LA County supervisors vote to allow LA Care to expand throughout the state in the commercial market. It could have a significant impact on the market, and would be one that could side-step the politics of Sacramento to deliver it.

4. Video: Glenn Raup, RN, Providence St. Joseph Hospital

Glenn Raup, RN, is the Executive Director of Emergency Nursing and Behavioral Health Services at Providence St. Joseph Hospital. He joins us in this edition of “What They’re Watching” to discuss the social determinants of health and the sustainability of pilot projects.

“It’s about sustainability. A lot of monies are released from time to time from lawmakers and they are what we call “one-and-done” type of demonstration grants and pilot projects. And the problem is these pilot projects prove to be very fruitful, demonstrate some wonderful changes, and then there’s no more funding.”


5. Becerra on monitoring consolidation in CA

In a recent POLITICO California Pro Q&A with Attorney General Xavier Becerra, the California AG commented on a broad range of topics, including consolidation in health care. In the Q&A, Becerra points to his lawsuit against Sutter Health as an example of consolidation and noncompetitive activities that drive up costs, and says he anticipates the trial will serve as a lesson for others.

“Once we prove that these anti-competitive activities are not only harming consumers and patients, but that we could put them to the test in front of a court and win, the price that these providers — these health systems — will pay will dissuade them from engaging in some of these practices. It will become more expensive to try to become anti-competitive [rather] than trying to be collaborative with your health care partners and sister organizations,” says Becerra.