  
	
  
Riverside/San Bernardino: Vast Region, Market Fragmentation Add to Access Woes
CHCF Regional Markets Issue Brief 
September 2012 
 Laurie E. Felland, Ann S. O'Malley, Dori A. Cross, Isabel  Perera 
As part of the California Health Care Almanac project, the California HealthCare   Foundation (CHCF) funded HSC to conduct interviews in six California communities   in 2011-12 to assess how the organization, financing and delivery of health care   are changing, including preparations for health reform. 
The vast Riverside/San Bernardino region is  recovering slowly from the economic downturn, and access to care continues to  be a challenge. Key findings of the market report include: 
  - Improved  overall hospital financial performance. Many hospitals maintain bargaining  clout on payment rates because health plans must ensure access in each of the  region’s many submarkets, some of which are underserved. This has helped  maintain and even improve financial performance at the same time that hospitals  have struggled with a declining payer mix as people lost private health  coverage. 
 
  - Increased  presence of Kaiser. Kaiser Permanente’s presence has expanded, with other  providersboth hospitals and physiciansviewing the integrated delivery system  as their biggest competitive threat.
 
  - Growing  concerns about physician supply. The per capita physician supply in the  region is low compared with other California markets, and some observers  reported that demand for physicians continues to outpace supply.
 
  - Growing  efforts by hospitals to align with physicians. Physicians remain largely  independent in solo or small practices, although some are joining larger physician-owned  organizations. Hospitals are seeking to align more closely with physiciansboth  to gain patient referrals and inpatient admissions and to prepare for new  payment arrangements under national health reform. 
 
- Increased  pressures on safety nets. County-run safety  net organizations face capacity and financial pressures to care for growing  numbers of Medi-Cal and uninsured patients. Both counties are trying to work  more with federally qualified health centers (FQHCs) and other private  community clinics and health centers, especially as they prepare for reform.
  
Click here to access the Riverside/San Bernardino report at the CHCF Web site. 
  
  
  
 
 
 |