The Los Angeles health care market — as varied as it is vast — juggles the needs of more than 10 million people across a geographically diverse landscape.

• More than 80 general acute care hospitals are scattered throughout Los Angeles County, an area twice the size of Delaware with 10 times the population.
• The county includes 88 cities, and the historically fragmented health care sector tends to serve distinct geographic areas where residents live and work.
• Only two health systems operate on a countywide scale: Kaiser Permanente, an integrated delivery system with a health plan, owned hospitals, and tightly aligned employed physicians serving primarily commercial and Medicare patients across the market;  and the Los Angeles County Department of Health Services (LACDHS), which operates the countywide safety-net system.
• Over the past several years, the Los Angeles market has inched toward greater consolidation as two major health systems — Cedars-Sinai and Providence — have expanded: Cedars by affiliating with community hospitals both north and south of its flagship medical center, and Providence through a merger with St. Joseph Health to strengthen its regional presence.

Key developments include:

• Medi-Cal coverage expansion continues to fuel growth of the L.A. Care Health Plan, the local public plan.
• Enrollment in Medicare managed care continues to grow, while commercial health maintenance organization (HMO) enrollment stagnates.
• The Los Angeles hospital market has consolidated slightly in recent years — primarily through closures and new affiliations and partnerships
• Los Angeles continues as a stronghold for large capitated, delegated physician organizations.
• Los Angeles County government, which plays a critical safety-net role, divides responsibility for physical and behavioral health services across three departments. LACDHS, with a $6.2 billion operating budget, runs an integrated delivery system of hospitals and clinics serving Medi-Cal enrollees and the uninsured.
• The 131-bed Martin Luther King Jr. Community Hospital (MLKCH), which opened in 2015, provides much-needed services to one of the county’s most disadvantaged areas.
• Collectively caring for about 1.7 million patients, more than 60 Federally Qualified Health Centers (FQHCs) continue to play an essential and growing safety-net role for Medi-Cal enrollees and uninsured people in the county.
• The COVID-19 pandemic hit Los Angeles hard in 2020.

REGIONAL MARKET STUDIES

Los Angeles County is one of seven markets included in the Regional Markets Series. This is the fourth round of the study; CHCF published the first set of regional reports in 2009. 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.

Since 2009, CHCF has published a series of regional market studies that examine the health care markets in specific regions across California. These studies highlight the range of economic, demographic, and health care delivery and financing conditions in California.

They are published as part of the CHCF California Health Care Almanac, an online clearinghouse for key data and analyses examining California’s health care system.