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 has also experienced troubling developments in recent years, including higher health costs and more people experiencing homelessness. Four large health systems — Dignity Health, Kaiser Permanente, Sutter Health, and UC Davis Health — continue to dominate the Sacramento area hospital market, a trend that likely contributes to the region’s high private health insurance premiums. The region’s hospitals post the highest average operating margins of the seven regional markets studied and negotiate among the highest commercial payment rates in the state. All four systems continue to expand their footprints, building new office and hospital space while affiliating with a growing number of medical groups.
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