CHCF is updating a series of market studies in six areas: Fresno, Los Angeles, Riverside/San Bernardino, Sacramento, San Diego, and the San Francisco Bay Area. These regional market reports highlight variations in health care affordability, access, and quality of care across the state. The reports are published as part of the CHCF California Health Care Almanac, an online clearinghouse for key data and analysis examining California's medical system.

Key findings from the Fresno issue brief include:

• Five providers give the majority of hospital care across the region, with one playing a pivotal safety-net role. Health maintenance organizations (HMOs) continue to have a weak presence, with preferred provider organizations (PPOs) as the dominant model. Fresno trails other areas in preparing for coverage expansions under health reform.
• Most of the region's hospitals survived the poor economy, maintaining or improving operating margins. Still, they face mounting financial pressures from rising Medi-Cal enrollment and high rates of uninsured, which have strained provider capacity. Hospitals are increasing capacity of inpatient beds and services to compete aggressively for commercially insured patients.
• Fresno hospitals face strong competition with federally qualified health centers (FQHCs) and hospital-operated rural health clinics (RHCs) for physicians, who remain rooted in independent practices and show little interest in alignment.

The complete 2012 issue brief, as well as the 2009 edition, is available under Document Downloads.