Orange County Market Overview

Analyst: Laura Beerman

Report Summary

Monarch HealthCare's acquisition by UnitedHealth Group subsidiary OptumHealth has ended Monarch’s accountable care organization with Anthem Blue Cross and its relationship with Blue Shield of California. While the result of this acquisition has been clear, the effect of the market's tighter integration and growing consolidation on reform initiatives remains to be seen, particularly as it develops alongside increasing health plan influence and the likely growth of narrow networks in the Orange County market.

Questions Answered in this Report

Grant funding for accountable care organizations has poured into Orange County. Which health systems and physicians groups received grants? What entity has provided the funding? What are the differing quality objectives of these ACOs?

The acquisition of Monarch HealthCare by UnitedHealth Group has made national headlines. What strategy are other IPAs considering in light of Monarch’s potential patient losses? What physician alignment model could continue to gather steam in Orange County?

Blue Shield is at the center of multiple developments in the Orange County market. With which large physician group is the insurer terminating its contract? What reimbursement reform pilot will likely fall victim to the Blue Shield termination? What initiatives is Blue Shield funding as part of its net-income refund pledge?

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

Select Companies Listed in the Report

• Anthem Blue Cross
• CalOPTIMA
• Kaiser Foundation Health Plan
• Monarch HealthCare
• St. Joseph Heritage Healthcare
• Southern California Permanente Medical Group
• St. Joseph Health System
• Hoag
• MemorialCare