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 San Francisco Bay Area issue brief include:

• Although two hospital systems account for half of inpatient discharges, as a result of geographic barriers, much of health care delivery occurs within local submarkets.
• Health care providers weathered the economic downturn comparatively well, with hospital systems showing strong financial performance. However, county hospitals and smaller safety-net hospitals continued to struggle. Health reform and other developing trends are expected to tamp down revenues in coming years. Substantial seismic construction projects underway raise concerns that hospitals may not be able to pay debt obligations in the face of declining income.
• Bay Area providers and health plans are aggressively aligning. Health plans and providers formed narrow-network accountable care organizations (ACOs) in 2011. Safety-net providers are working to coordinate care through the medical home model, while a surge of physicians and hospitals have collaborated to expand geographic reach.

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