Healthcare Utilization

We study the effects of healthcare utilization rates in reviewing government initiatives and current spending patterns. In modeling spending, we provide information on both future spending increases and measures to avoid  unnecessary spending.

What are the Health Care Costs of COVID-19 in California?: State and County Estimates

By Richard M. Scheffler, Daniel R. Arnold, Brent D. Fulton, Alexandra Peltz, Taylor L. Wang, and John Swartzberg | Published June 25, 2020 | Link to Report

Based on recent antibody studies that report about a 5% prevalence in California, we estimate the health care costs of treating coronavirus disease 2019 (COVID-19) to be $2.4 billion in California — six times the annual cost of influenza in the state. Costs vary dramatically across counties due to significant differences in population size, health care prices, and payer mix. Estimated costs are $617 million in Los Angeles, $64 million in San Francisco, and $204 million in San Diego. The cost per infected person is $1,326, $1,774, $289, and $629 for commercial, Medicare, Medi-Cal/CHIP, and uninsured enrollees, respectively. We also calculate the costs under scenarios of 15%, 30% and 60% prevalence — the latter being a lower threshold of the prevalence generally assumed to be needed before herd immunity is achieved. Our costing model will be updated as new information about the prevalence and health care utilization and costs are reported for California.

Avoiding Spending While Meeting Patients’ Wishes: A Model of Community-Based Palliative Care Uptake in California from 2014-2022

By Eric R. Kessell, Richard M. Scheffler, and Stephen M. Shortell | Pubished in November 2015 in the Journal of Palliative Medicine | Link to Full Article

Community-based palliative care can improve outcomes and avoid unnecessary spending, but the effects of its widespread adoption on health care spending in California is unknown. To estimate the spending avoided if, by 2022, more than 100,000 Californians received community-based palliative care (CBPC) per year. We estimated the 6-month per-patient spending avoided through three mature CBPC programs in California and extrapolated data to predict the total avoided spending statewide over 8 years if enrollment in the three programs proceeded according to our model. If Californians participated in CBPC in the numbers envisioned, in 2014 there would have been a $72 million reduction in intensive hospital-based care, while still respecting patients’ wishes, and nearly $1.1 billion in spending could be avoided in 2022. Overall hospital spending would be reduced by more than $5.5 billion through 2022. The paper concludes that existing CBPC programs have the potential to provide care that is both in alignment with patients’ wishes and avoids substantial amounts of unnecessary hospital-based spending.

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

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.’