San Francisco Bay Area: Major Players Drive Regional Network Development

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 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 ACA Medi-Cal expansion. They are particularly hampered by their limited ability to recruit and retain clinicians.