The Blue Sky Consulting Group researched and wrote this report for the California HealthCare Foundation. Medi-Cal is the state’s health insurance program for Californians with low income, including three in seven children, two in nine nonelderly adults, and two in five people with disabilities. It also paid for 39% of all births in the state. In total, over 15 million Californians rely on the program for health coverage. 

Wildfires have been increasing in intensity and destructiveness in recent years. This report draws on recent empirical research to estimate wildfires’ economic impacts within the State of California and is the first to provide a comprehensive estimate of their fiscal impact on the State’s General Fund. 

Working with a team from Arnold Ventures, the Blue Sky Consulting Group analyzed the potential for automatic savings programs for workers without access to a retirement plan through their employer. We explored the feasibility of these “Auto IRA” programs and identified strategies to help them work better and spread more widely. We also developed a 50 state feasibility model to help states without such a program quickly assess whether and how such a program would work in their region. Project lead Matthew Newman recently wrote a Commentary published in CalMatters discussing the potential for these programs.

California’s Health Care Safety Net: Essential Access for Millions presents data on the providers and programs that compose California’s safety-net system.

FQHCs are as diverse as they are widespread and are integral to the state’s safety-net provider landscape. This report, part of the California Health Care Foundation’s Regional Markets Study series, examines the changing FQHC landscape, focusing on emerging trends and regional differences in FQHCs across the state.

The California Health Care Foundation commissioned the Blue Sky Consulting Group to undertake seven studies of large and diverse regional health care markets in California. The studies of Humboldt/Del Norte, Inland Empire, Los Angeles, Sacramento, San Diego, San Francisco Bay Area, and the San Joaquin Valley provide details of local health care systems and identify common themes and emerging issues that influence how Californians receive their health care. 

Working closely with the City of Oakland staff, the Blue Sky Consulting Group developed a 5 year forecast for the City’s economy and accompanying expenditures and revenues. These projections formed the foundation for development of the City’s two year budget. 

Working closely with the City of Oakland staff, the Blue Sky Consulting Group developed a 5 year forecast for the City’s economy and accompanying expenditures and revenues. These projections formed the foundation for development of the City’s two year budget. 

The COVID 19 pandemic brought about nearly unprecedented economic and fiscal challenges. To help the State of California ensure that it could meet its financial obligations over the spring and summer, we worked with the State Controller to develop projections that accounted for the impact of the pandemic-induced economic effects and the delayed filing dates for income and sales tax payments. The model we developed projected daily cashflows and allowed the Controller to simulate a range of alternative scenarios, including a deeper or more prolonged recession, continued reductions in taxable sales, and ongoing high unemployment rates. Our work helped the Controller determine that the state’s reserves were sufficient to allow the state to meet all of its financial obligations without the need for external borrowing.

Providing enough affordable housing is a significant challenge across the country. For low-income households, high housing costs can lead to frequent moves that interfere with children’s school performance or force families to live in unhealthy or substandard housing. In order to identify the factors that are contributing to increased costs in Oregon, the legislature engaged the Blue Sky Consulting Group to study tax credit financed affordable housing projects developed in the state over the past two decades. The resulting analysis identified the important benefits of affordable housing while also shedding light on the factors that can influence costs, such as larger projects that benefit from economies of scale or local factors such as labor costs, system development charges, or community opposition that may add to costs. 

The San Diego health care market has long been dominated by four health systems: Kaiser Permanente, Sharp HealthCare, Scripps Health, and University of California San Diego Health. Despite significant gains in health coverage, access to care for people with lower incomes, especially for behavioral health services, remains a challenge.

The City of Los Angeles Office of Economic Analysis (OEA) sought assistance in addressing one of the most important questions facing any governmental entity: to what extent will a change in tax policy result in increases in economic activity? Working closely with the OEA, we utilized an econometric model of the city’s multi-billion dollar economy to estimate the likely fiscal and economic implications of phasing out the city’s gross receipts tax.

Blue Sky co-founder Tim Gage served as fiscal adviser to California Forward, which sought expertise on how to reform California's budget process. The effort included analyzing various proposals to mitigate the impact of volatile state revenues on budget planning. With this assistance, California Forward created a 6-point platform for fiscal reform. This effort was just one of numerous fiscal advisory projects undertaken by the Blue Sky Consulting Group, which range from delineating higher education funding challenges to modeling changes to the state's "rainy-day" fund mechanisms.

The sorry state of California's infrastructure is a common refrain, but how much additional infrastructure investment can the state afford? In order to address this question, we examined California's ability to take on additional debt  to fund infrastructure projects, constructing a simulation and forecasting model to project debt service payments and state General Fund costs and revenues under a variety of scenarios. This interactive simulation tool allowed our client to project the effects of various interest rate assumptions, program caseload and cost increase scenarios, and new debt approval schedules. The resulting insights were used to guide strategic decision-making with respect to new infrastructure initiatives.

The Blue Sky Consulting Group developed a long-term business planning model for the Board of Regents and Office of the President of the University of California, which sought to improve the ability of the system's leaders to manage the organization's $20 billion annual budget. The model can adapt over time as enrollment, state budget, and cost structures change, making it more than just a one-time planning solution.

The Think Long Committee for California and California Forward engaged Blue Sky Consulting Group to develop a microsimualtion model capable of estimating the economic incidence of a series of tax policy changes. These policy changes include proposed changes to the Personal Income Tax, Corporation Tax, and the Sales Tax. The model we developed shows how Californians across the income spectrum would be affected by proposed tax policy changes. This work was also supported by The James Irvine Foundation.

In 2011, we conducted an analysis of the fiscal and economic effects of legalizing online poker in California. Although playing poker online is not currently legal in California, pending legislation (as of January 2012) would authorize this activity. Previous research that sought to estimate the impact of online poker relied upon “black box” methodologies or a simplistic allocation of a share of the global market to California. Our analysis is based on a California-specific impact model, which drew from two surveys of Californians’ online poker behavior and preferences that were conducted as part of the project. Our analysis has been utilized by the client to educate members of the legislature and the media about the potential effects of the pending legislation.

In 2008, BSCG conducted an economic analysis of Proposition 2 for the Humane Society of the United States. The successful ballot measure created standards for confined animals, most notably egg-laying hens. After a detailed examination of the economics of the egg industry, we found that production price increases likely would be minimal, that cage-free production likely would expand, and that cage-free egg prices likely would decrease. Our analysis was utilized by the client to educate voters and the media about the potential effects of the measure.

In 2014, BSCG estimated the amount of revenues that would be generated by SB 270 (Padilla). As amended March 27, 2014, the bill would ban the use of disposable plastic bags and require a minimum price of $0.10 for disposable paper bags and reusable bags issued at grocery, pharmacy, and convenience store checkouts in California. Using data from the Department of Resources, Recycling, and Recovery (CalRecycle) on the number of plastic carryout bags used each year and before-and-after data from jurisdictions that have implemented policies similar to SB 270, we estimated statewide disposable bag revenues. Actual revenues will depend on how many times reusable bags are reused, the price differential between reusable and paper bags, and on consumers’ propensity to choose a reusable bag, paper bag, or no bag.

Payday loans - short-term, often high interest rate loans - have been the subject of much attention in the media and among policy-makers at all levels of government, but the practice has been the subject of much less attention from researchers and analysts. Blue Sky Consulting Group analyzed the consumer welfare impacts of payday lending in order to shed more light on the topic. Through a novel approach to analyzing previously unutilized national data, we conducted an advanced econometric analysis of the consumer welfare effects of payday lending. This objective, analytically rigorous study injected new insights into this often emotion-laden debate. The groundbreaking results have been submitted for publication to an academic journal.

In 2008, Blue Sky Consulting Group prepared an analysis of the impact of state budget reductions to higher education for the California Faculty Association. We examined the impact of the budget on the California State University system by analyzing the economic and social impacts of higher education and the potential costs associated with state funding reductions. The client used this information to make the case to policy-makers that these funding reductions were not in the state's best interest.

The Campaign for College Opportunity engaged us in 2006 to develop a higher education and General Fund budget projection and simulation model. This model projected the budget for both the State of California and the state's university systems under a variety of scenarios and assumptions regarding state support, enrollment, and tuition. The model was used by the client to develop policy proposals and to inform policy-makers of the challenges facing higher education in the state.

In 2010, Blue Sky Consulting Group estimated the potential impact of the federal Race to the Top education reform program on California's K-12 curriculum standards and instructional materials costs. For this study, we developed an inventory of state programs and expenditures from 1996-2009 related to curriculum reform and instructional standards. We then assessed how participation in the program could affect the state's curriculum and budget flexibility and instructional material adoption schedules as well as costs for instructional materials, staff development, and student assessment.

Blue Sky Consulting Group assisted the State Treasurer’s Office with an analysis of affordability and financing issues related to the Bay Delta Conservation Plan Conveyance Facility (aka the Delta tunnels). The BDCP is an ambitious and controversial habitat conservation plan proposed by the governor involving the construction of two large, underground tunnels intended to transport water from the Sacramento River around the Sacramento-San Joaquin Delta. Our report was intended to provide a context for better public understanding of the potential costs of the project and an assessment of whether those costs are affordable for the water contractors and their customers who are expected to pay for the project. In addition the report explores a number of critical issues related to financing the cost of construction through revenue bonds and risks associated with that financing.

Next 10's Carbon Challenge engages Californians in the process of meeting the state's greenhouse gas reduction goals. The nonpartisan internet tool allows users to call the shots on which carbon reduction strategies to pursue. Based on research and modeling by Blue Sky, the Carbon Challenge lets users evaluate policy options, balance tradeoffs and make choices about how to meet the state's AB32 greenhouse gas reduction targets.

Carbon Label California was founded by Blue Sky Consulting Group founders Matt Newman and Tim Gage with the support of Silicon Valley philanthropist Noel Perry to help bring academics, environmentalists, business leaders, and policy-makers together to design a Greenhouse Gas Content Label for consumer products in California. The effort led to the development of draft legislation and a simple, implementable approach for measuring the carbon content of most products produced or sold in California.

In 2010, we assisted the State Treasurer's Office with the development and implementation of a sales tax exclusion program for green manufacturing equipment that was created by SB 71 of 2010. Specifically, we designed project evaluation criteria, drafted regulations, and assisted with the scoring of applications for the exemption, which is aimed at assisting manufacturers of solar panels, bio fuels, electric cars, and other alternative energy and advanced transportation technologies. The framework we developed has been instrumental to the successful implementation of this program.

Blue Sky Consulting Group researched and wrote this for the California HealthCare Foundation. Medi-Cal, California’s Medicaid program, is the state’s health insurance program for low-income Californians, including 40% of all children, half of all people with disabilities, over a million seniors, and nearly 4 million adults. It also pays for more than 50% of all births in the state and 58% of all patient days in long-term care facilities. In total, 13 million, or one in three, Californians rely on the program for health coverage. Medi-Cal pays for essential primary, specialty, acute, behavioral health, and long-term care services.

This research identified additional funding strategies that could provide a more solid foundation for support of CHIS. Funded by the California Health Care Foundation.

The Blue Sky Consulting Group assessed the access to ambulatory care medical services for Medi-Cal and indigent care patients and explored issues about the safety net “ecosystem” in Santa Cruz County. This report is intended as a resource to inform discussions about an evolving safety net. Funded by the Santa Cruz County Health Services Agency.

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 (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.

This peer-reviewed paper in the September 2018 issue of Health Affairs analyzes California dental plans’ medical loss ratios [MLR] reported in California for 2014 and 2015. California passed a law in 2014 requiring dental plans to report MLRs but stopped short of setting minimum thresholds. Len Finocchio and Katrina Connolly found that while millions of Californians were in large-group plans that achieved high MLRs, millions more were in other plans with relatively low MLRs. A legislatively mandated MLR would provide a standardized financial tool and potentially ensure value for dental products. Given the multiplicity of dental products and the varying numbers of covered lives in those products, setting MLR thresholds poses a challenge for stakeholders.

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.

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.

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.

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.

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.

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.

State budget cuts and federal health reform prompted the need for accurate estimates of how 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.

In 2007, before the Affordable Care Act expansion of health care coverage, 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.

Addressing poverty is one of the most important and most challenging issues counties confront. This report identifies several promising, research based strategies that can be employed at the county level to reduce poverty. This report further examines the impact of a county-level living wage policy, including information about the number and types of workers affected and the likely cost to the county to implement such a policy.

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.

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.

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.

The Blue Sky Consulting Group assessed the access to ambulatory care medical services for Medi-Cal and indigent care patients and explored issues about the safety net “ecosystem” in Santa Cruz County. This report is intended as a resource to inform discussions about an evolving safety net. Funded by the Santa Cruz County Health Services Agency.

Working in partnership with the City’s Controller and Chief Economist, the Blue Sky Consulting Group analyzed the effects of alternative inclusionary housing policies on production of market rate and below market rate housing in San Francisco. The foundation for this work was a regression model that predicts a change in housing production based on changes in prices, production costs, zoning changes and other factors, while taking into account parcel specific data such as maximum building size, setback requirements, and parcel size. Our work was used to inform the decisions of a Technical Advisory Committee that advised the City’s Board of Supervisors about the optimal inclusionary policy.

In 2014, the Blue Sky Consulting Group completed an affordable housing cost study for the state of California’s housing agencies (The California Department of Housing and Community Development, the California Tax Credit Allocation Committee, the California Housing Finance Agency, and the California Debt Limit Allocation Committee). The study measured the factors that influence the cost of building affordable rental housing in California, analyzing data from hundreds of multi-family projects. The study utilized a regression analysis model to identify factors that are correlated with raising or lowering the costs of developing affordable housing in California. The analysis evaluated how factors such as parking requirements, economies of scale, community opposition, local design-review requirements, developer characteristics, and many others influenced the cost of developing affordable housing. In addition to the empirical analysis of multi-family housing development costs in California, this study also examined the social and economic impact of affordable housing to better understand the indirect benefits from the investment in subsidized affordable housing.

In 2007, Blue Sky Consulting Group was chosen by the California Building Industry Foundation to analyze the fiscal impact of residential housing in California. Specifically, we addressed the question of whether new residential housing "pays its own way" at the state and local levels. We conducted the first of its kind analysis of every local jurisdiction in the state to determine whether revenues generated by new housing were sufficient to cover the costs of increased service demands from new residents.

In 2010, the Yokohl Ranch Company, LLC hired Blue Sky to analyze the economic impact of a proposed large-scale residential housing development in Tulare County. Given the county's emphasis on sustaining a balanced resident-to-employment ratio, the client needed our help in identifying and articulating the likely economic effects of this proposed development in the context of the county's projected rapid future growth.

The "great recession" has caused governments at all levels to reevaluate their budgets in an effort to do more with less. In 2010, the City and County of San Francisco sought help in evaluating a series of changes to the city's business tax system. We aided the city in evaluating both the fiscal and economic effects of proposed changes to the city's business tax. Our analysis helped point the way toward a tax system that could raise additional revenue with a minimal impact on the city's economy.

Tribal Casinos have the potential to increase local economic activity, but they can also increase costs for local governments. We have analyzed the fiscal and economic effects of several casino  projects. By employing a custom fiscal and economic impact model that we developed, we were able to provide strategic advice to our local government clients as they negotiated financial agreements with casino developers.

The Blue Sky Consulting Group analyzed the revenue impact of split roll property tax proposals for the California Tax Reform Association. To do so, we developed a simulation model to estimate the impact of these proposals - on a jurisdiction-by-jurisdiction basis - under a variety of scenarios and assumptions. The analysis required the construction of a property database with more than 5 million records.

The managers of the state’s 529 college savings program, known as Scholarshare, sought assistance in estimating the fiscal and economic effects of adopting a tax credit to encourage additional saving for college. Our analysis showed how many additional Californians would open accounts in response to the tax credit and how much more existing participants would save. We also estimated the economic effects of such a program, and determined the cost to the state’s general fund.

Next 10's Budget Challenge engages Californians in the state's crisis-plagued budgeting process. The nonpartisan internet tool allows users to call the shots on how much to spend on schools, prisons and other state programs - and how to pay for them. We have provided up-to-date policy options and budget figures for the project since 2007.

This report, prepared on behalf of the Los Angeles Revenue Commission, presents estimates of the potential revenue that could be generated from a tax on vacant or unoccupied property in the City of Los Angeles (the City) and identifies the design features the City may want to consider should it proceed with implementation of a such a tax.