Orange County, CA Market Overview
HealthLeaders Interstudy, January 2011, Pages: 37
Physician consolidation is on the rise in Orange County, including HealthCare Partners’ 2010 acquisition of Talbert Medical Group. Watch for physicians to partner with fewer independent practice associations as they turn to more integrated models of care, and expect physicians in this market to gradually take on more of the medical risk for treating patients as health plans attempt to comply with new federal regulations concerning medical loss ratios. Hospitals known for their tertiary care and high-end medical service lines in Orange County will have to make adjustments as healthcare reform begins placing more of an emphasis on patient population management. At the same time, hospitals are experiencing a decline in patient volume and a more difficult payor mix, although Medicaid funding has increased for many acute-care facilities because of a provider fee that draws federal matching funds to California. Meanwhile, volatility continues in California’s individual insurance market as child only coverage is restored by several carriers, and insurance premiums rise dramatically with regulators looking to intervene.
Questions Answered in This Report
Health systems in Orange County are creating medical foundations partnered with hospitals. Which health systems are doing this? How do medical foundations fit within health system strategies? What health systems are participating in a bundled payment pilot project? What health plans are involved in the pilot? What hospital construction projects have been undertaken? What are health systems doing to install electronic medical records in the inpatient and outpatient setting?
Physician consolidation is changing the arrangement of providers in Orange County. What recent mergers or acquisitions have taken place among physician organizations? What is the county’s largest independent practice association, and where is this IPA in the process of setting up an accountable care organization? What is the physician supply like in Orange County? How is pay-for-performance changing for physicians?
The cost of individual insurance policies in California is rapidly rising. What impact might this have on enrollment and government regulation? Are more businesses in Orange County interested in switching to self-insured plans? Why is it difficult for health plans to offer narrow provider networks in this market? What might California’s newly elected governor do to Medicaid funding in response to a massive state budget deficit?
Metrics
- Key market indicators and leading organizations among health systems, physicians and health plans
- Health systems’ market share
- Income, revenue, enrollment and pharmacy spend for leading health plans
- Demographics
Scope: Orange County
Primary Research: Analysis of HealthLeaders-InterStudy data, Billian’s HealthDATA, local and state news and industry reports and interviews with local healthcare executives
Orange County Market
Market Indicators
Leading Organizations
Market Stage
Management Summary
Outlook
Health Systems and Hospitals
Physicians
Health Plans
Medicaid/Medicare/Uninsured
Pharmacy
Legislation
Employers
Health Systems & Hospitals
St. Joseph Health System-Southern California
Description
News and Analysis
Hoag Memorial Hospital Presbyterian
Description
News and Analysis
MemorialCare
Description
News and Analysis
Integrated Healthcare Holdings Inc.
Description
News and Analysis
Tenet Healthcare
Description
News and Analysis
Other Health Systems and Hospitals
Physicians
Monarch HealthCare
St. Joseph Heritage Healthcare
Affiliated Doctors of Orange County
Additional Physician Organizations
Health Plans
WellPoint (Anthem Blue Cross)
Kaiser Foundation Health Plan
CalOptima
Medicaid/Medicare/Uninsured
Medicaid
Medicare
Uninsured
Pharmacy
Legislation
Employers
Business Coalitions
Demographics & Statistics
- California Health Care Coalition
- California Public Employees’ Retirement System
- CalOptima
- Integrated Healthcare Holdings Inc.
- Kaiser Foundation Health Plan
- MemorialCare
- Monarch HealthCare
- Pacific Business Group on Health
- Southern California Permanente Medical Group
- St. Joseph Health System
- St. Joseph Heritage Healthcare
- WellPoint
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