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Research & Reports

Searching in Market Access (2102)

Sacramento | California | 2017 | Market Overview (Event Driven)

Consolidation has reached a zenith in Sacramento. Competition among health systems is fairly evenly distributed among the three leaders, but Dignity Health, which is working on alignment with Denver-based Catholic Health Initiatives, is readying to pull ahead of the pack. A Dignity-CHI marriage will, of course, first have to clear regulatory hurdles. In integrated market, pharmaceutical acquisition is on the verge of changing as the providers are taking capitated risks and becoming payers themselves. To that end, we expect drug acquisition discussions will shift from “what do the traditional payers want?” to “what do the providers want?” As these consolidated health systems become more sophisticated and able to make drug purchasing decisions, watch for them to begin asserting leverage over clinical decisions that impact formularies and plan design.

Questions Answered in This Report:

  • Health systems are highly consolidated but still looking to grow. What innovations does Sutter Health have planned? How is Kaiser differentiating itself? Will Dignity stay the lead health system?

  • The Medicare Access and CHIP Reauthorization Act of 2015 took effect on Jan. 1, 2017. How is the law impacting Sacramento physicians? How are medical foundation physicians being impacted? Are any physicians exempted from reporting requirements?

  • The new HMO Sutter Health Plus continues to seek membership. Has it taken total enrollment market share from Kaiser, Anthem or Blue Shield of California? Has Sutter's HMO been profitable? Has Sutter had any problems running its own health plan?

  • Large groups insist on reasonably priced traditional HMOs in Sacramento. What do midsize employers want in a health plan? What do brokers say is obstructing small-group employers from getting their needs me? Is Sutter's new HMO doing well?


Market Includes: El Dorado, Placer, Sacramento, and Yolo counties

Primary Research: Analysis of Decision Resources Group data, local and state news and industry reports, and interviews with local healthcare executives