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Healthy SF: Who Pays?

Some employers drop private health plans for San Francisco’s subsidized public option

Barbara Grady, SF Public Press — Nov 16 2011 - 9:08am

Unintended consequences of city’s effort at universal health care

A San Francisco requirement that businesses pay for their employees’ health needs has led to more workers having some form of health care. But after businesses initially stepped up to buy private health insurance for more of their workers, there has been a steady retreat. Since 2008, a growing percentage of employers have ditched private insurance for a cheaper way of meeting the law’s requirements: city-engineered reimbursement accounts, which cost companies half or less what they previously paid for traditional insurance.

Participants appreciate safety-net health access program, but note gaps

Kyung Jin Lee, SF Public Press — Nov 16 2011 - 9:02am

Customer service is a problem as patient load continues to grow

Most participants in Healthy San Francisco, the city’s 2007 initiative to expand care to more than 50,000 uninsured patients, appreciate the overall access to preventative care and treatment for chronic health conditions. A 2009 survey showed that more than nine in 10 are “very” or “somewhat” satisfied with the program. Patients cite the affordability of the program and the quality of care they receive from the health care practitioners. But program participants and medical care providers also note the inconsistency in the services they receive under Healthy San Francisco.

Medical records supporting San Francisco’s universal care add millions to official cost

Angela Hart, SF Public Press — Nov 16 2011 - 6:25am

Clinics scramble for money to switch to electronic health records

The San Francisco Department of Public Health says it is ahead of the curve in rolling out databases that keep tabs on tens of thousands of patients across a citywide network of clinics and hospitals. The rollout is needed not just to make a local form of “universal health care” work, but also to meet a 2014 deadline under national health reform. And the city says it spent just $3.4 million on new patient-tracking technology. Not bad for an unprecedented charity care initiative whose total budget has grown to $177 million just this past year. But while clinics and hospitals across the city are now linked up to a common intake tool that eliminates overbilling and duplicated medical appointments, that is only the first step in making the Healthy San Francisco program successful, directors of local health centers and technology experts say. A separate and much more complex piece of technology — electronic health records — is proving difficult and expensive.

San Francisco’s universal health plan reaches tens of thousands, but rests on unstable funding

Barbara Grady, SF Public Press — Nov 16 2011 - 6:04am

Coordination and prevention improve care, but as businesses resist, some costs are borne by one-time grants and struggling clinics

Four years ago, San Francisco launched a grand experiment, becoming the first city in the nation to offer comprehensive health care to its growing ranks of uninsured. Stitching together two-dozen neighborhood health clinics and an array of hospitals, the city bet that two reforms — emphasis on primary care and a common electronic enrollment system — could improve outcomes and buffer the city against soaring health care costs. By many measures, San Francisco’s effort to provide universal health care has been a huge success. The initiative, Healthy San Francisco, has over time treated more than 100,000 city residents. But the city’s grand plan has not solved the central problem dogging health care across the country: figuring out who pays for it.

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