Health Care & Social Services

Health care and social service programs are as diverse as they are essential, and the Blue Sky Consulting Group takes great pride in providing clients with the careful analysis they need on these issues. From a 58-county analysis of local program rules to a statewide projection of increased service need, our clients rely on our in-depth knowledge and thorough approach to tackle a myriad of challenges.

Featured Projects

Improving Mental Health Services Integration in Medi-Cal: Strategies for Consideration

This paper, commissioned by the Blue Shield of California Foundation, describes some of the current challenges facing California’s system of mental health services, explores strategies for improving mental health integration, and proposes scenarios for changing aspects of law, policy and organizational practices that could promote improved integration.

Accountable Communities for Health: An Evaluation Framework and Users’ Guide

Accountable Communities for Health (ACHs) are place-based initiatives in which community, clinical, and policy strategies are coordinated with the aim of improving health outcomes and controlling health care costs. The multi-sector nature of ACHs combines strategies addressing specific chronic diseases or other health conditions in a mutually reinforcing way. The framework provides a methodology or “road map” for communities, funders, or government agencies interested in conducting an evaluation of local ACH initiatives or understanding and interpreting the results of such an evaluation.

Dental Loss Ratios

The Affordable Care Act contains an important but little discussed consumer protection: insurers are now required to spend a minimum amount of the premiums collected on health care services, as opposed to administration, marketing, and profits. This consumer protection has already resulted in billions of dollars in consumer benefits. Nevertheless, it applies only to health plans and not to dental plans. This report examines the arguments for and against a minimum “Medical Loss Ratio” and evaluates issues California policymakers and stakeholders will confront as they consider whether to adopt a minimum loss ratio for dental plans.

California's Rural Health Clinics: Obstacles and Opportunities

The California HealthCare Foundation published our research highlighting the obstacles and opportunities facing California's Rural Health Clinics. This report provides a rare glimpse into an integral health care resource for rural Californians by analyzing administrative data and responses to our project-specific survey.

Expanding Access to Dental Care

The Virtual Dental Home Project offers the potential for an innovative, low cost method to improve access to dental care for vulnerable populations in California by providing prevention-focused oral health services in community sites such as Head Start Centers, schools, residential living facilities for people with disabilities, and long-term care institutions for dependent or elderly adults. Although this project has been shown to be effective in expanding access to care and in improving oral health, the cost-effectiveness of the program’s interventions had not previously been measured. We developed an analysis centered around a simulation model that estimates the potential cost impact of the Virtual Dental Home project on the state’s Medi-Cal program.

Health Care Safety Net Facts & Figures

The California HealthCare Foundation uses our research to inform health care advocates, analysts, and patients on the current state of the Health Care Safety Net. The Facts and Figures publication provides a quantitative look at the providers and public programs that serve the neediest Californians.

Impact of Expanded Use of Telemedicine

The use of information and communication technologies to deliver health care remotely, referred to as telehealth, has been reimbursable under California law since 1996. However, telehealth technologies and applications have advanced over the last decade and a half, leaving the current reimbursement laws outdated. The recent passage of Assembly Bill 415 will serve to modernize reimbursement law, and to help clear the path for the increased use of telehealth in California. Our analysis identified the potential fiscal impact of AB 415 on the State of California, primarily focusing on the Medi-Cal program. In addition, we described the fiscal effects that expanded use of telehealth (as envisioned by AB 415) could bring to other health services payers in California.

Assessing the Budget's Impacts on Local Communities

In both 2008 and 2009, the California Endowment enlisted our help in identifying the impact of health and social services program budget cuts on local communities. We examined how proposed changes to CalWORKs, Medi-Cal, IHSS, SSI/SSP, and state-supported child care would affect local communities and program recipients. The qualitative and quantitative impacts we unearthed were then used to help educate community stakeholders on the impact of the proposed reductions.

Growth Projections for Healthy Families

In 2010, with state budget cuts and federal health reform on the horizon, we estimated how the policy options on the table for Healthy Families would interact with future program growth. We developed a projection and simulation model of caseload, funding, and program cost changes for the state's Healthy Families program that responded to policy choices selected by the user.

The Cost of Universal Health Care Expansion

In 2007, before the recent federal health care expansion, the Schwarzenegger Administration proposed an expansion of access to care in California. The California HealthCare Foundation engaged the Blue Sky Consulting Group to estimate the likely fiscal impact of this proposal on California counties. By constructing a model of the likely response of consumers to the incentives embodied in the bill and identifying and analyzing the characteristics of the affected populations, we were able to accurately estimate the fiscal effects of the proposal. We presented the results of our work in a public meeting held at the state capitol and attended by key legislative and administration staff involved in the health care expansion effort.