While physician supply in the Bay Area is strong, the share of independent physicians in private practice continues to decline. More physicians align with large health systems as the independent private practice model erodes.New contracting models and alliances that shift greater financial risk to providers also are emerging in the market. Bay Area health care costs remain among the highest statewide, creating interest in the adoption of population health strategies long used by Kaiser that stress prevention and care coordination to avoid costly hospital stays. High health care costs and competition among large systems prompt interest in population health management.The region, defined in this study as the five counties of Alameda, Contra Costa, San Francisco, San Mateo, and Santa Clara, has experienced a number of changes since the previous study in 2015–16. Despite the region’s relative affluence, more than one in five residents are covered by Medi-Cal or uninsured, and county-based safety-net health systems and Federally Qualified Health Centers (FQHCs) play critical roles in providing access to care for vulnerable populations, including the growing number of people experiencing homelessness. In response to the region’s high health care costs and employer requests for affordable, high-value options, new models and contracting structures are emerging in the Bay Area, including providers contracting directly with employers. At the same time, smaller systems, such as John Muir Health and El Camino Health, play key roles in geographic submarkets, making them attractive partners for the larger systems seeking to expand market share. Over the past 20 years, the Bay Area health care market has consolidated and, as a result, is dominated by four systems: Kaiser Sutter Health University of California, San Francisco (UCSF) Health and Stanford Health Care. Health care systems in the San Francisco Bay Area - which is healthier, wealthier, and has higher rates of insurance, on average, than the rest of California - continue to focus on building regional networks to support population health strategies and compete with market leader Kaiser Permanente. 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. This is the fourth round of the study CHCF published the first set of regional reports in 2009. Aidan Dodson and Dirk Nottelmann have made extensive use of archival material, particularly relating to the political and technical background to design and procurement and present a developmental history of this ship class which is unique in the English language.The San Francisco Bay Area is one of seven markets included in the 2020 Regional Markets Study. The ships’ technical details are itemized in the second half of the book which also includes sketches of ships’ internal layouts and armor and changes in appearance over time. This book includes both design and operational histories, the latter continuing down to the end of ships’ service after the fall of Imperial Germany, and it is accompanied by an extensive selection of many rare photographs. Arranged in a chronological narrative, these include corvettes, avisos, sloops, torpedo cruisers, III- and IV-class cruisers, and small cruisers. The Kaiser's Cruisers, 1871–1918 covers the full range of cruising vessels operated or ordered by the Imperial German Navy between 18, excluding the battlecruisers, previously covered by the author’s companion volume The Kaiser’s Battlefleet.
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