Los Angeles — Regional Market Report 2026

Introduction

The Los Angeles County health care market is vast, complex, and fragmented — balancing the needs of nearly 9.8 million residents, almost half of whom are covered by Medi-Cal. At its center is a resilient safety net anchored by the Los Angeles County Department of Health Services (LA Health Services), which operates four public hospitals and a countywide network of 23 clinics that delivered 2.9 million patient visits in 2025.

A strong network of community health centers (CHCs) extends this safety net further, providing care — mostly to people with low incomes — at nearly 300 sites across the county. Recent state-funded Medi-Cal expansions have extended coverage to hundreds of thousands of Los Angeles residents. But federal Medicaid cuts and state budget shortfalls now threaten those coverage gains — not only for undocumented residents and other immigrants, but also for many low- and middle-income Angelenos.

Los Angeles Health Care Market: Key Takeaways

Since CHCF’s last Regional Market Study in 2020–21, the Los Angeles health care landscape has shifted significantly. Coverage gains are under threat, hospital finances are diverging between affluent and underserved areas, and corporate consolidation of physician organizations continues — even as the safety net adapts to growing demand.

Six Key Developments in the Los Angeles Health Care Market

1. Federal and State Cutbacks Threaten Recent Coverage Gains

Federal House Resolution 1 (H.R. 1), often referred to as the “One Big Beautiful Bill Act,” is expected to hit Los Angeles County hard — reducing Medi-Cal enrollment and increasing the number of uninsured residents. Reduced premium subsidies for people enrolled in Covered California, the state’s health insurance marketplace, compound the problem.

At the same time, state budget shortfalls have prompted a statewide Medi-Cal enrollment freeze for undocumented adults and others with unsatisfactory immigration status (UIS) — a change that will disproportionately affect Los Angeles County.

2. The Hospital Market Remains Fragmented Despite Some Acquisitions

The Los Angeles hospital market is significantly less concentrated than the Bay Area’s. Only two health systems — Kaiser Permanente and Cedars-Sinai — account for more than 10% of inpatient discharges from acute care hospitals in Los Angeles County. The eight largest health systems by number of beds collectively account for less than 60% of discharges.

Recent hospital acquisitions in Los Angeles — including those by UCLA Health and Adventist Health — have typically involved one or two independent hospitals rather than entire systems.

3. Hospital Financial Health Varies by Community

Hospitals in more affluent areas of Los Angeles County have posted healthy financial margins in recent years, while those serving lower-income, underserved communities face intensifying financial pressure. In 2023, Kaiser, Prime Healthcare, and Cedars-Sinai all reported net income margins at or above 5%. Meanwhile, Martin Luther King Jr. Community Hospital received assistance from the state’s Distressed Hospital Loan Fund, and Beverly Hospital filed for bankruptcy.

Some hospitals are now examining their service lines with an eye toward cutting unprofitable services — including emergency departments — raising serious questions about access to care in already-underserved communities.

4. Risk-Bearing Physician Organizations Continue to Consolidate

Risk-bearing physician organizations remain a defining feature of the Los Angeles health care market, with ongoing consolidation and growth in corporate ownership:

• Optum Health, a subsidiary of UnitedHealth Group, has shifted from acquiring to integrating physician practices across Southern California
• Astrana, also publicly traded, has grown significantly through the acquisition of Community Family Care Medical Group and Prospect Medical Group
• Altais, a for-profit offshoot of Blue Shield of California, has entered the Los Angeles market

Safety-net organizations are also taking on risk. Health Care LA IPA — a nonprofit independent practice association anchored by more than 30 CHCs — accepts professional risk for approximately 730,000 patients, almost all covered by Medi-Cal. AltaMed, the largest CHC in Los Angeles, launched AltaMed Health Network in 2020 to accept financial risk for professional and facility services in the Medi-Cal market, and has grown enrollment significantly.

5. CHCs Are Central to Care for the Uninsured and Homeless Populations

CHCs — most designated as Federally Qualified Health Centers (FQHCs) — have long been central to ensuring access to care for Medi-Cal members and uninsured residents. Their role has expanded significantly in recent years.

Several large CHCs in Los Angeles have created street medicine teams that visit homeless encampments and set up clinics at homeless services hubs. Others operate recuperative care sites with temporary housing, enabling safe hospital discharge for patients who need a place to recover.

6. County Government Plays a Critical Safety-Net Role Across Physical Health, Mental Health, and Substance Use Treatment

Los Angeles County government carries significant responsibility for the safety net, with physical health, mental health, and substance use treatment divided across three departments:

• LA Health Services operates an integrated delivery system of hospitals and clinics serving Medi-Cal and uninsured patients
• The Department of Mental Health runs the County Mental Health Plan, providing specialty mental health services
• The Department of Public Health’s Bureau of Substance Abuse Prevention and Control provides a continuum of specialty substance use disorder services.

Together, these three county entities serve hundreds of thousands of Angelenos. Coordination across them, however, remains an ongoing challenge.

Key Data on Los Angeles

Health Insurance Coverage

Where do Los Angeles residents get their health coverage?

The uninsured rate in Los Angeles County dropped from 9.9% in 2019 to 7.6% in 2023, narrowing the gap with the statewide uninsured rate of 6.4%. Almost all of this improvement was driven by increased Medi-Cal coverage, which grew from 37.8% of the population in 2019 to 46.1% in 2023 (including those dually eligible for Medicare and Medi-Cal).

While statewide Medi-Cal coverage grew at a similar pace, the share of Los Angeles residents covered by Medi-Cal remained about five percentage points higher than the statewide average in 2023.

Sources: MA State/County Penetration (July 2019 and July 2023), US Centers for Medicare & Medicaid Services, “Selected Characteristics of Health Insurance Coverage in the United States, American Community Survey, 1-Year and 5 Year Estimates,” US Census Bureau, “By Medicare Dual Status, Certified Eligibles,” California Department of Health Care Services, Katherine Wilson, California Health Insurers, Enrollment Almanac — 2025 Edition, California Health Care Foundation, February 2025

Population and Economic Context

How does Los Angeles County compare to California overall?

Between 2019 and 2024, the Los Angeles County population declined by 2.8% — a steeper drop than the statewide decline of 0.2%. County residents generally have lower incomes and less formal education than Californians overall. About 1 in 7 Los Angeles County residents live in households earning below 100% of the federal poverty level ($30,000 for a family of four in 2023), compared to 1 in 8 statewide.

Even so, Los Angeles performs notably well on several public health indicators. Among CHCF’s seven regional study sites, Los Angeles has the lowest rate of drug-related emergency department visits (109.4 per 100,000 residents) and the lowest suicide rate (8.0 per 100,000). The county’s drug overdose death rate is also lower than the statewide average.

Sources: Annual Estimates of the Resident Population for Counties in the United States: April 1, 2020 to July 1, 2024 (CO-EST2024-POP) Annual Estimates of the Resident Population for Counties in the United States: April 1, 2010 to July 1, 2019 (CO-EST2019-ANNRES-06) “American Community Survey 5-Year Estimates Subject Tables, S1901, Income in the Past 12 Months (in 2023 Inflation-Adjusted Dollars), 2023,” US Census Bureau “Current Industry Employment and Unemployment Rates for Counties,” California Employment Development Department “California Employment Development Department; and “Housing Affordability Index – Traditional – Historical Data Series (Q2 2024),” California Association of Realtors “Healthcare Payments Data Measures Data (2018–2023)”, California Department of Health Care Access and Information “Infant Mortality,” California Department of Public Health (CDPH) “California Overdose Surveillance Dashboard,” CDPH, last updated May 19, 2025. “American Community Survey, 2023 5-Year Estimates, S1810, Disability Characteristics,” US Census Bureau

Hospital Landscape

What are the largest hospital systems in Los Angeles?

While some hospital consolidation has occurred in Los Angeles in recent years, the sector remains relatively fragmented. Only two health systems — Kaiser and Cedars-Sinai — accounted for more than 10% of acute care hospital discharges. In the more concentrated Bay Area hospital market, the four largest health systems accounted for 73% of discharges in 2023, compared to 39% for the four largest Los Angeles systems.

Source: 2023 Pivot Table – Hospital Annual Selected File, California Department of Health Care Access and Information.

Community Health Centers

What are the largest CHC systems in Los Angeles?

CHCs provided nearly seven million patient encounters across Los Angeles County in 2023. The two largest CHCs are AltaMed Health Services Corp. and St. John’s Community Health. A higher percentage of Los Angeles CHC patients earn less than 100% FPL compared to CHC patients statewide (74% versus 70%). Los Angeles CHCs rely on Medi-Cal for a higher percentage of their net patient revenue (84%) compared to CHCs statewide (78%).

Source: 2023 Primary Care Clinic Annual Utilization Data (November 2024), California Department of Health Care Access and Information, last updated October 31, 2024.

Health Care Workforce

How does Los Angeles compare to California?

Los Angeles is home to many physician residency training programs and practice opportunities, including academic medical centers, health systems, and CHCs. Unsurprisingly, the supply of physicians and other clinicians in Los Angeles County matches or modestly exceeds statewide figures.

However, this does not indicate adequate workforce or patient access; statewide figures are not a recommended benchmark.

Source: “2024 License Renewal Survey Data, Representing Active Licenses as of December 3, 2024,” custom data request, HCAI, received April 14, 2025.