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.