Health care systems in the San Francisco Bay Area — which is healthier, wealthier, and has higher rates of insurance, on average, than the rest of California — continue to focus on building regional networks to support population health strategies and compete with market leader Kaiser Permanente. Over the past 20 years, the Bay Area health care market has consolidated and, as a result, is dominated by four systems: Kaiser; Sutter Health; University of California, San Francisco (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. In response to the region’s high health care costs and employer requests for affordable, high-value options, new models and contracting structures are emerging in the Bay Area, including providers contracting directly with employers. Despite the region’s relative affluence, more than one in five residents are covered by Medi-Cal or uninsured, and county-based safety-net health systems and Federally Qualified Health Centers (FQHCs) play critical roles in providing access to care for vulnerable populations, including the growing number of people experiencing homelessness.
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