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Orange County: Changing Market Fuels New Models of Provider Collaboration

Since 2010, Orange County has largely recovered from the economic downturn and remains a relatively well-educated community with high rates of private insurance coverage overall. Still, socioeconomic variation persists in this county, with the number of residents with low incomes growing and a large jump in the proportion of the population that gained Medi-Cal coverage under the Affordable Care Act (ACA).

Other key findings include:

  • The region’s major hospital systems are expanding ambulatory services and geographic reach.
  • Orange County physicians are increasingly giving up independence to varying degrees and joining larger physician organizations or hospital-affiliated groups to gain shelter from mounting financial pressures and administrative burdens.
  • Providers are collaborating on new payment arrangements, with some Orange County physician organizations and hospitals working toward assuming more risk for more patients, particularly the growing numbers in preferred-provider organizations (PPOs).
  • The proportion of Orange County residents covered by Medi-Cal has jumped, with a greater proportional increase in Medi-Cal enrollment than other California regions studied.
  • Safety-net provider capacity is tight; private providers are playing a significant role in serving the Medi-Cal expansion population.

Since 2009, CHCF has published a series of regional market studies that examine the health care markets in specific regions across California. These studies highlight the range of economic, demographic, and health care delivery and financing conditions in California. They are published as part of the CHCF California Health Care Almanac, an online clearinghouse for key data and analyses examining California’s health care system.


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