In California, high health care costs have created widespread access and health problems for millions of Californians, particularly those with low incomes. 36% of Californians report having medical debt, and 1 in 10 Californians report having trouble paying medical bills.

Blue Shield of California is a non-profit health plan serving approximately 4.8 million members and with approximately $24 billion dollars in annual revenue. The organization’s core mission is to ensure all Californians have access to high-quality health care at an affordable price.

Medicaid patients remain in acute care settings (acute hospitals, long term acute care hospitals, skilled nursing facilities) because there are no safe, clinically appropriate discharge options. This results in an increased number of administrative or denied days because the patients are no longer clinically acute and are just awaiting placement. Patients who could be in an inpatient bed or in a skilled nursing facility are instead stuck boarding in the emergency department or an inpatient bed.

Healthcare prices are hard to understand and navigate for patients and healthcare teams. Health care affordability (out-of-pocket patient costs) is a leading health care concern for Americans and a key voting issue. More than half of Americans worry about the availability and affordability of health care, and more than a quarter have delayed care because of high costs. I am passionate about this work after having a friend lose her life savings due to healthcare costs and my own family has faced large medical bills without guidance to navigate our healthcare system.

Permanent vision loss is prevalent among the aging and will continue to rise. There are gaps and barriers resulting from fragmented care locally and globally. The health inequity among the aging, visually impaired population is also a public health issue with an economic burden on state and federal resources. The CDC reports that 4.5M over age 40 report that they are blind. This number is expected double to 9M by 2050. There are 21M more who reports having “vision problems” not correctable with conventional glasses, contact lenses, or refractive laser surgery.

After issuing statements on racial justice during Summer 2020, health care institutions’ attention towards health justice has decreased substantially. Meanwhile, health equity work is often (1) uncompensated and (2) undertaken by people from under-represented communities. This combination results in a “minority tax” on these colleagues, causing ongoing professional and psychological harm.

Applied Behavior Analysis (ABA) is a type of behavioral therapy commonly used to treat children diagnosed with Autism Spectrum Disorder (ASD). The treatment is long-term, intensive, and highly individualized. If the service is poorly designed or implemented, it may lead to behavioral regression and the need to restart treatment. The goal of my CHIP is to improve the quality of ABA service with a PayFor-Value (P4V) program. Two metrics were used as lead indicators: 1) percentage of supervision conducted by board certified clinicians and 2) utilization rate of approved treatment hours.

Project Goal: To demonstrate a cost-effective clinical model in the community pharmacy setting which promotes pharmacy quality and achieves measurable outcomes.

Project Goal: To improve receipt of whole person wrap-around services and therefore the quality of life of people with epilepsy in western Los Angeles county by increasing knowledge of epilepsy, referrals to Westside Regional Center, and offer of epilepsy-specific services.

Project Goal: To improve the value of care provided for hip and knee joint replacements through increased coordination of care, preoperative planning, and reduced use of unnecessary post-acute care.

Project Goal: To ensure that Multiple Sclerosis patients receive the most effective medication with in a month of diagnosis to reduce relapses and disease progression leading to inpatient utilization.