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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.
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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.