San Francisco Bay Area: Major Players Drive Regional Network Development

Ha Tu, Mathematica Policy Research
Len Finocchio
Annie Doubleday
Kristie Liao


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Since the last round of this regional study four years ago, the Bay Area’s economy has continued to thrive, although there remain stark economic contrasts between the haves and have-nots. The analysis of the Bay Area health care marketplace reveals these developments:

  • In a region historically characterized by many segmented submarkets, major providers are expanding in efforts to manage care efficiently, serve more patients, and compete with Kaiser Permanente.
  • The number of independent hospitals is shrinking as financial problems mount. Though none of the region’s remaining private safety-net hospitals appear threatened by imminent closure, several face an uncertain future.
  • Independent practice associations (IPAs) are seeking to diversify, raise capital, and keep private practice viable, especially for primary care physicians.
  • The region’s safety net is strong, but is facing serious capacity and access challenges resulting from the Affordable Care Act (ACA) Medi-Cal expansion. They are particularly hampered by their limited ability to recruit and retain clinicians.

An accompanying interactive infographic showcases how industry consolidation is changing the competitive diversity of the health care marketplace in the counties that make up the Bay Area.

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.