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California Health Care Almanac

Regional Markets

California’s large size means that health care is organized, delivered, and financed differently throughout the state. CHCF commissioned studies of seven large and diverse regional markets that provide details of local health care systems and identify common themes and emerging issues that influence how Californians receive their health care.
    • Cost & Quality
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    • Regional Markets
Publication

San Francisco Bay Area: Regional Health Systems Vie for Market Share

April 2021
Caroline Davis, Katrina Connolly
Over the last 20 years, the Bay Area health care market has consolidated, leaving four dominant systems — Kaiser, Sutter Health, UCSF Health, and Stanford Health Care. At the same time, smaller systems, such as John Muir Health and El Camino Health, play key roles in geographic submarkets, making them attractive partners for the larger systems seeking to expand market share.
Publication

Sacramento Area: Large Health Systems Grow in a Pricey and Tumultuous Market

February 2021
Len Finocchio, James Paci
The Sacramento area — a region spanning El Dorado, Placer, Sacramento, and Yolo Counties — stands out among other inland California localities in boasting relatively high household incomes and a stable economy. Yet the region's hospital market continues to be dominated by four large health systems, a trend that likely contributes to the area’s high private health insurance premiums.
Publication

San Diego: Competing, Collaborating, and Forging Ahead with Population Health

February 2021
Caroline Davis, Katrina Connolly
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.
Publication

Los Angeles: Vast and Varied Health Care Market Inches Toward Consolidation

January 2021
Jill Yegian, Katrina Connolly
The Los Angeles health care market juggles the needs of more than 10 million people. The vast county includes 88 cities, and the historically fragmented health care sector tends to serve distinct geographic areas where people live and work.
Publication

San Joaquin Valley: Despite Poverty and Capacity Constraints, Health Care Access Improves

December 2020
Len Finocchio, James Paci
Federally Qualified Health Centers and Rural Health Clinics continue to expand across the region. They are also working with hospitals to improve care integration and access to specialty services for Medi-Cal patients.
Publication

Inland Empire: Increasing Medi-Cal Coverage Spurs Safety-Net Growth

December 2020
Matthew Newman, James Paci
Following the implementation of the Affordable Care Act, this region, comprising Riverside and San Bernardino Counties, has seen a decrease in people who are uninsured and an increase in people with Medi-Cal coverage. In turn, the number of Federally Qualified Health Centers has grown, and patient visits more than doubled in just a few years.
Publication

Humboldt and Del Norte Counties: Community Collaboration in the Face of Health Adversity

October 2020
Jill Yegian, Katrina Connolly
The rural North Coast California counties of Humboldt and Del Norte face multiple health and health care challenges, including high death rates from preventable causes and shortages of health care providers. The region is addressing these challenges through strong collaborative efforts.
Publication

The Changing Landscape of California’s Federally Qualified Health Centers

June 2021
Blue Sky Consulting Group
This paper is one of two cross-site analyses drawn on insights from the seven publications in the 2020 Regional Market Report series. In the post-ACA period, FQHCs have added patients and clinic sites at a rapid pace, and many health centers have increased offerings of specialty services and of care for elderly patients. This paper examines the changing FQHC landscape, focusing on emerging trends and regional differences in FQHCs across the state.
Publication

Medi-Cal Behavioral Health Services: Demand Exceeds Supply Despite Expansions

September 2021
Blue Sky Consulting Group
Behavioral Health, Medi-Cal
This paper is the second of two cross-site analyses drawn on insights from the seven publications in the 2020 Regional Market Report series. It explores factors contributing to behavioral health access issues, including workforce shortages and the complexity of the Medi-Cal system for behavioral health services. It also highlights efforts to improve and integrate services to Medi-Cal enrollees.
Collection

Webinars — 2020 CHCF Regional Market Reports

For the fourth time since 2009, CHCF commissioned reports of seven health care markets in California. The markets in the 2020 release — Humboldt/Del Norte, Inland Empire, Los Angeles, Sacramento, San Diego, San Francisco Bay Area, and the San Joaquin Valley — reflect a diverse range of conditions in California. Each report was accompanied by a webinar featuring the report's author and local health care experts.
Collection

2016 Edition — Health Care Almanac Regional Markets Study

This is the third round in CHCF’s Regional Market Series; CHCF published the first set of regional reports in 2009. Seven markets are included in the 2016 release — Fresno, Los Angeles, Orange County, Riverside/San Bernardino, Sacramento, San Diego, and the San Francisco Bay Area. These reports are part of the CHCF California Health Care Almanac.
Collection

2012 Edition — Health Care Almanac Regional Markets Study

This is the second round in CHCF’s Regional Market Series; CHCF published the first set of regional reports in 2009. Six markets are included in the 2012 release — Fresno, Los Angeles, Riverside/San Bernardino, Sacramento, San Diego, and the San Francisco Bay Area. These reports are part of the CHCF California Health Care Almanac.
Collection

2009 Edition — Health Care Almanac Regional Markets Study

This is the first round in CHCF’s Regional Market Series. Six markets are included in the 2009 release — Fresno, Los Angeles, Oakland/San Francisco, Riverside/San Bernardino, Sacramento, and San Diego. These reports are part of the CHCF California Health Care Almanac.
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