San Diego’s 14 FQHCs provide critical access to safety-net services across more than 100 sites in the region. Federally Qualified Health Centers (FQHCs) thrive.Medical groups also have grown as new physicians and independent physicians nearing retirement opt for employment instead of running their own practices. As health systems expand population health strategies, they have increased affiliations with medical groups and independent practice associations. Both UCSD Health and Kaiser opened new hospitals in 20, respectively, and Kaiser announced plans in early 2020 to build a third hospital in the northern part of the county. Overall, the region’s hospital sector remains stable, with no changes in ownership in recent years. Hospital sector remains stable and consolidated.Kaiser remains the dominant insurer in the region, reportedly covering 20% of the population. More than half of residents have private insurance coverage, and Medi-Cal now covers almost a quarter of the population. The 2014 Medi-Cal expansion under the federal Affordable Care Act and the strong (prepandemic) economy helped increase the share of San Diegans with health insurance. Health care coverage expansion continues.Key factors affecting the local health care market include: Despite significant gains in health coverage, access to care for people with lower incomes, especially for behavioral health services, remains a challenge. While they compete for patients and market share, providers in the region also collaborate on community-wide issues, including access to care and more recently, the COVID-19 pandemic. Both Kaiser and Sharp historically have embraced capitated (fixed per-member per-month) payments when they assume financial risk for patient care, a trend now taking hold at Scripps and UCSD.

The San Diego health care market has long been dominated by four health systems: Kaiser Permanente, Sharp HealthCare, Scripps Health, and University of California San Diego (UCSD) Health.

The markets included in the 2020 release - Humboldt/Del Norte, Inland Empire, Los Angeles, Sacramento, San Diego, San Francisco Bay Area, and the San Joaquin Valley - reflect a range of economic, demographic, care delivery, and financing conditions in California. This is the fourth round of the study CHCF published the first set of regional reports in 2009.

San Diego County is one of seven markets included in the 2020 Regional Markets Study.

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