California

The Petris Center has analyzes changes and initiatives in California’s healthcare system relating to mental health, insurance premiums, marketplace plans, and regulation.

Accountable Care Organizations and Antitrust Conference Briefing Document

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by Liora Bowers, Benjamin Handel, Emilio Varanini, Richard Scheffler | Published November 2011 by the Petris Center | Link to Full Briefing Document

This briefing paper serves as a background for the discussion that took place during the “Accountable Care Organizations and Antitrust Conference” held on November 11, 2011 at UC Berkeley. With the October 20, 2011 release of the final rule creating the Medicare Shared Savings Program (MSSP), the Center for Medicare & Medicaid Services has paved the way for a national move towards coordinated delivery systems known as Accountable Care Organizations (ACOs). This paper provides background on government policy towards an accountable care delivery system, the balance between integration efficiencies and market power, and the goals and methods of antitrust analysis within healthcare delivery. It provides context for the issues of market definition, anticompetitive effects, antitrust evaluations, and contracting practices among healthcare providers. The paper concludes with a brief discussion of the California ban on the corporate practice of medicine.

California on the Eve of Mental Health Reform

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By Tracy L. Finlayson and the Nicholas C. Petris Center | Published November 2007 by the Petris Center | Link to Full Report

This report summarizes baseline information derived from a survey of county mental health directors about key organizational and budgetary characteristics in California’s county mental health departments. These findings are intended to provide stakeholders, policymakers, researchers and others with a snapshot of county and system characteristics prior to the implementation of the Mental Health Services Act (MHSA) of 2004, which was created by the passage of Proposition 63. Much of the report’s findings, on topics such as financing, organizational structure, staffing patterns, information technology and mental health boards, cannot be found elsewhere. Key findings indicate that California’s counties, while highly diverse, share some common features and strengths. These include: 1) high participation in innovative demonstration programs, 2) minimal spending on institutional care, 3) low administrative overhead, and 4) provision of care in languages beyond the state requirements. This report can provide information on where counties are beginning their transformation process. While each county is different, the similarities between counties may be useful in providing lessons for improving the system as a whole.

Hospital Service Changes in California: Trends, Community Impacts and Implications for Policy

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By the Staff of the Nicholas C. Petris Center | Published April 2005 by the Petris Center | Link to Full Report

While hospital closures have generated a great deal of media attention and community concern, hospitals have other possible responses to the difficult financial environment. This report focuses on one such response. Are hospitals changing their inpatient service offerings in order to improve their financial health? This study is a systematic look at the changes in services offered by California hospitals from 1995 to the 2002. It shows that over the study period there were several significant shifts in service patterns.  This report documents these changes and provides a systematic exploration of the possible explanations for what has happened in California’s hospital system.

Measuring Mental Health in California’s Counties: What Can We Learn?

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By Daniel Eisenberg, Nicole Bellows, Timmothy T. Brown, Richard M. Scheffler | Published in January 2005 by the Petris Center | Link to Full Report

This report provides the first county-level comparison of a detailed set of mental health-related measures in the general California population utilizing the first California Health Interview Survey (CHIS), which took place in 2001. The main questions are how do counties differ in terms of their population’s mental health status, service utilization, insurance coverage, availability of providers, and government financial resources? This report provides data and information on a series of mental health indicators that enable us to draw a picture of the mental health status throughout Califomia. These mental health indicators include the following: ‘doing less overall due to emotional problems,’ ‘doing one’s work less effectively due to depression or anxiety,’ ‘feeling downhearted and sad,’ ‘not feeling calm and peaceful,’ and ‘lacking energy.’

Is There A Doctor in the House? An Examination of the Physician Workforce in California

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By Janet Coffman, Brian Quinn, Timothy Brown, and Richard Scheffler | Published June 2004 by the Petris Center | Link to Full Report

This report presents important new findings about long-range trends in physician supply in California, as well as a snapshot of the state’s current physician workforce.

California’s Closed Hospitals, 1995-2000

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By the Nicholas C. Petris Center | Published in April 2001 by the Petris Center | Link to Full Report

In October 2000, The Petris Center on Health Care Markets and Consumer Welfare, a research organization at the University of California, Berkeley, School of Public Health, took on the job of creating a taxonomical list of all general acute care hospitals in California that closed between 1995 and 2000. Thus, we have put together the only effort that we know of to collect and synthesize standardized information about the California hospitals that closed in the second half of the 1990s. For the first time, we can now document and describe the 23 general acute care (GAC) hospitals that closed, 11 of which took place at for-profit facilities. The vast majority took place in urban areas, and they were most often in southern California. More than half of the closed hospitals had fewer than 100 licensed beds. Ten of the closed hospitals had changed ownership within three years prior to their closure. All the closed hospitals claimed, and demonstrated, financial distress prior to closing.