Published: 28 February 2000
Analyst(s): Linda R. McManama
Management Summary Riverside and San Bernardino counties, often referred to as the Inland Empire, are part of the larger Los Angeles-Riverside-Orange County, California, consolidated metropolitan statistical area (CMSA). It is the second-largest CMSA in the United States, only behind New York's. With more than 3.1 million residents, the Inland Empire represents 20 percent of the 15.8 million people in the Los Angeles CMSA. Statewide and national healthcare companies operating in the Inland Empire strategically link the area to the larger southern California market. Inland Empire-area healthcare providers continue to experience cost pressures brought on by low reimbursement levels from area payers; the effects of the federal Balanced Budget Act of 1997, which will continue to reduce Medicare and Medicaid spending; the financing of extensive seismic safety upgrades to comply with Senate Bill 1953; and rising medical and pharmaceutical costs. Medicare reimbursements are crucial to many local hospitals, accounting for 20 percent to 40 percent of their total revenue. The California Office of Statewide Health Planning and Development expects seismic retrofit and rebuilding expenses for all California hospitals to total about $20 billion. Much like the consolidation experienced by California's health plans, the provider market is expected to shake out further with only large, financially strong systems surviving. The Inland Empire has no single dominant hospital system. Each of the geographically dispersed systems have no more than three hospitals. The area's major hospital systems are: Adventist Health System - Loma Linda (Loma Linda University Medical Center with 764 beds), Catholic Healthcare West (803 beds at two hospitals), Kaiser Permanente (644 beds at two hospitals), Tenet California HealthSystem (660 beds at one leased and two owned hospitals), Valley Health System (531 beds at three hospitals) and Columbia/HCA Healthcare (423 beds at two hospitals). The...
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