High Cost Hospitals in the Southern Bay Area

Problem: High Health Care Costs in the Southern Bay Area Exacerbate Already High Cost of Living, Pushing More Residents into Debt

Southern Bay Area Overview

The South Bay faces severe housing affordability challenges. These challenges mean that an unexpected medical bill can lead to financial insecurity for families. In Santa Clara County, 99,000 residents (6.8%) have problems paying medical bills for themselves or members of their households, with 27,000 (31.4%) of those residents reporting that they were unable to afford basic necessities due to medical debt. In Alameda County, 126,000 residents said they have problems paying medical bills, with more than 60,000 (47.4%) of those residents saying it would limit their ability to pay for basic necessities. Of the seven “high cost hospitals,” identified by the Office of Health Care Affordability (OHCA), two are in the Southern Bay Area: Stanford Hospital in Palo Alto and Washington Hospital in Fremont. These hospitals are very different: Stanford Hospital is a nationally recognized nonprofit academic medical center known for its quality of care, and is part of a health system that spends billions in investments while providing less than the state average in charity care as a percentage of revenue. , Washington Hospital is a district hospital, with a low 2-star rating from Medicare, which is expanding its clinical footprint while providing less than the state average in charity care as a percentage of revenue. , Washington Health System is spending more than 2.5 times as much on executive compensation as on charity care to help its patients afford their hospital bills. , Both are parts of health systems with clinical reach allowing them to exert their market power; both hospitals are paid more than 3 times what Medicare is paid for the same service in markets with more hospitals. These high prices are a significant driver of high health care costs in the area, which translates into higher health care premiums and cost-sharing for residents.

Figure 1. Commercial Rates for Hospital Services

Note: Data for Figure 1 are from the Department of Health Care Access and Information

Table 1. Comparing Days Cash on Hand by Health System

Note: Data for Table 1 are from Health System Financials from Fitch Rating and Washington Township Health Care District

Figure 2. Charity Care in Proportion to Net Patient Revenue by Hospital

Note: Data for Figure 2 are from 2024 Pivot Table – Hospital Annual Selected File from the Department of Health Care Access and Information

Santa Clara County

Key Points on Hospitals in Santa Clara County

• ”Stanford Hospital” refers to Stanford Hospital at 300 Pasteur Drive, Palo Alto, CA, 94305. Stanford Health System refers to the health system of Stanford Health Care whose financials referenced include hospital and clinic subsidiaries including Stanford Hospital, Stanford Health Care Tri-Valley, Stanford Medicine partners, and other subsidiaries, but not Lucile Packard Children’s Hospital at Stanford, which has separate financials, but is part of Stanford Medicine.
• Stanford Hospital sits in a county with seven general and acute hospitals offering care (not including Children’s hospitals identified above) that vary in ownership between private, nonprofit and city/county or district.
• Stanford Hospital is one of the high-cost hospitals across the state identified by OHCA. These hospitals get paid two, three or even four times as much as other hospitals for the same care.
• All the hospitals (including Lucile Packard) have the same Stanford Medicine brand, common corporate parent, and joint contract administration function. Thus, while Stanford Health System and Lucille Packard are separate entities, they operate together as an aligned system that can exert market power.
• The aligned relationship creates an environment where patients “age out” of pediatric care at the children’s hospital and transition into adult care at Stanford Hospital. This sets up a care relationship spanning the patients’ lifetime.
• In the immediate area around the hospital, Stanford Hospital by itself dominates the market (takes up majority market share) for inpatient care in Palo Alto (58.8%), Stanford (50.2%), Portola Valley (61.5%) and Atherton (61.4%).
• If you combine its inpatient market share in those areas with Lucile Packard Children’s Hospital, the system has even more of the market share in those cities: combined market share of nearly 90% in one Palo Alto zip code, 91% in Stanford, 80% for Portola Valley, 68% in Menlo Park and 82% in Atherton. Their combined market share also expands where they dominate or have the top market share to include cities and communities like Redwood City, Woodside and La Honda.
• For emergency care, Stanford Hospital dominates the market in Stanford (100%), Palo Alto (88.6%), Portola Valley (72.9%), Atherton (62%).
• Outside these areas, immediately around the hospital, Stanford Hospital competes with other hospitals like El Camino Health – Mountain View Hospital, Kaiser Permanente Redwood City Medical Center, and Dignity Health Sequoia Hospital.
• California is home to multiple academic medical centers, but Stanford Hospital is the only one on the high cost hospital list. California’s academic medical centers include University of California (UC) San Francisco, UC Davis, UCLA, UC Irvine, UC Riverside, UC San Diego, University of Southern California (USC) Keck School, Loma Linda University and Stanford Hospital.
• Stanford Hospital is paid 2.5–3.4 times as much by employers, working families and consumers with private insurance, as other California hospitals. The measure of how much Stanford Hospital is being paid compared to other hospitals already accounts for Palo Alto having a high cost of living.
• This means that where Stanford Hospital dominates the market, consumers are more likely to go to that hospital and in this case, a hospital that is paid 2.5 times more than other hospitals, impacting consumers’ bills and health care spending in the region and the state.
• Stanford Health System has extremely strong liquidity of assets, and is spending less than the state average on charity care as a percentage of net patient revenue.
• Stanford Hospital has significantly higher operating and net income margins than the state.
• Stanford Hospital also has vast nonoperating revenue—the hospital made $910 million in 2025. And Stanford Health System had $7.29 billion in cash and investments (including $3.81 billion in university managed investments), with 19% in returns year-over-year.
• For comparison, El Camino Health, the district hospital close to Stanford Hospital, was providing 0.7% of its net revenue in charity care (2024), but also had extremely strong liquidity but El Camino is not on the high cost hospital list and provides more charity care as a percentage of revenue. ,
• Stanford Hospital serves a smaller percentage of Medi-Cal and Medicare Managed Care patients than the state average, so that cannot be used to justify charging higher rates to consumers, workers, and purchasers. Economists also reject the argument that hospitals that serve more Medicaid and Medicare patients charge higher commercial rates. Research from the Congressional Budget Office shows that higher percentage of patients with Medicaid coverage is not related to higher prices paid by commercial insurers to the hospital, suggesting that providers do not raise commercial prices to offset lower reimbursement from government programs.
• This suggests that Stanford Hospital is not being paid very high rates because of financial need or because the system is spending more on charity care than other hospitals in California. And other academic medical centers in the state are not on the high cost hospital list. Stanford Hospital is paid these higher rates even when accounting for a high cost of living in the area.

Table 2. Hospitals in Santa Clara County

Note: Data for Table 2  are from the Department of Health Care Access and Information Hospital Annual Financial Data and Facility Finder

Santa Clara County High Cost Hospital Profile

Stanford Health System

• total $7.29 billion in cash and investments (including $3.81 billion in university managed investments), with 19% in returns year-over-year
• total $8.88 billion in total net assets with 12% returns year over year
• spent $15.2 million on executive compensation, with the system’s CEO making $5.9 million in 2024 (and getting a 26% raise between 2023 and 2024)
• spent $29.1 million on charity care in 2024 and $25.4 million charity care in 2025 (0.3% of net patient revenue or 2% of profits)
• made $9.2 billion (2025) and $8.7 billion (2024) in net patient service revenue
• made $1.2 billion (2025) and $1 billion (2024) in profits
• has extensive clinical reach in greater San Francisco and Central Valley regions, and is a nationwide and worldwide destination for very high acuity services
• had 282 days of cash on hand in 2024, $5.5 million in in total financial assets and liquidity resources available within one year in 2025

Figure 3. Charity Care is 0.4% of Stanford Health System Total Spending

Note: Data for Figure 3 are from Stanford Health Care Consolidated Financial Statements and Accompanying Consolidating Information

Stanford Hospital (part of Stanford Health System):

• is a nonprofit academic medical center in Palo Alto
• has 368 beds, general and acute care provided
• solely level 1 trauma center between San Francisco and San Jose CA and a nationally and internationally recognized brand
• is paid 340% of Medicare rates as their commercial hospital price for the same service (the average commercial price of hospital services in the Bay Area is 320% and the average commercial price of hospital services across the state is 287% of Medicare) ,
• is paid $51,500 for each inpatient stay adjusted for the care that the patient needed (if higher acuity care or not); the average hospital is paid $20,200 for inpatient stay with this adjustment
• had $8.2 billion in operating revenue in 2025
• had $910 million in nonoperating revenue in 2025 ,
• provided $24.6 million or 0.3% of $7.8 billion in net patient revenue, in charity care
  in 2024. This is below the state average of providing 0.8% of net revenue in charity care
• had $3.2 billion in net total in assets that are property, plants or equipment in 2024
• had $7.4 billion in total investments and other assets in 2024
• had total assets of $12.7 billion in 2024
• had 22.3 days cash on hand in Stanford Hospital in 2026
  o having lower days of cash on hand at the hospital level, while the system has strong liquidity suggests that Stanford Health System keeps their reserves at the system level rather than at this individual hospital
• had cash to debt ratio of 213% in 2024
• had 5-star Medicare quality rating
• sees less patients proportionately in the Emergency Department (ED) than the statewide average and El Camino Health, the district hospital that is 20 minutes away
• sees more patients in ambulatory surgery and inpatient from the ED than state and less people inpatient from the ED than El Camino
• 19% of patients served are Asian, 4% of patients served are Black, 38% of patients served are White, and 28% of patients served are Hispanic
• serves an older population (67% of their patients are over 35 years old) than the state average (61% of patients are over 35 years old)
• serves less patients with Medi-Cal and Medicare Managed Care for both inpatient and outpatient care than the state average, and more patients with commercial and Medicare fee for service coverage than the state average

Santa Clara County Overview

Santa Clara County is urban and suburban, with 99% of its population living in urban areas as the core of the Silicon Valley. The county has 15 cities—with San Jose being the largest. The county’s population is the sixth largest in the State and the largest in the nine Bay Area counties—constituting about one-fourth of the Bay Area’s total population. Residents of the county are very diverse in culture, nationality, race and languages and dialects spoken—with a large population of immigrants. Approximately 41% of the population is Asian or Pacific Islander, 29% of the population is White, 25% is Latino or Hispanic, 2.9% is Black.

While the County is home to numerous technology companies including Google, Apple, HP, Cisco Systems, Meta and Yahoo, the County is a significant employer making up a quarter of all the jobs in the Bay Area. The county is also home to 3 universities—Stanford, Santa Clara University and San Jose State University and community colleges. While the county is home to tech companies and workers making 6-figure salaries, residents in the county face a high cost of living and severe affordability challenges. San Jose is the most expensive large city in the country and has the second highest rent in the country. Fair market rent for a two-bedroom apartment is about $3,051. The mean wage is not enough for renters in San Jose to spend less than a third of their income on rent, which is the general definition of “affordable.” But many people in the city don’t earn the mean wage – people in the San Jose workforce earn more than minimum wage, but still can’t pay market-rate rent, including childcare administrators, food service managers, human resources specialists and others. Which means they may be paying much more than a third of their income on rent. The county leads the nation in percent of unsheltered homelessness and unsheltered, unaccompanied youth. The affordability crisis is causing 40 percent of county residents to say they are likely to leave the region in the next few years.

There is significant income inequality—nine households hold $110 billion in liquid wealth—12 times more than 50% of households in the region. That wealth doubled from 2023 to 2024, while household income, homelessness, food insecurity and quality of life for Black and Latino residents, as well as women, got worse.

Low incomes and high cost of living limit residents’ ability to pay unexpected medical bills. 99,000 or nearly 7% of county residents said they had problems paying their medical bills, and more than 31% said this meant they were unable to afford basic necessities. About 460,000 county residents were enrolled in Medi-Cal in 2025. Due to H.R. 1 and state budget actions, the U.C. Berkeley Labor Center projects that 129,000 people will lose this coverage in the county.

As Stanford Hospital only provided 0.3% of their revenue in charity care to consumers eligible for assistance on their hospital bills, they spent billions in investments and sit on extremely liquid reserves. As H.R. 1 policies are implemented, and health care prices rise, more residents will need financial assistance to prevent crushing medical debt.

Stanford Hospital can likely charge high prices due to both its market power in cities identified as the hospital alone, but also through its extensive clinical reach as a system. The hospital is a nationally recognized brand for their services. While the hospital provides high quality care to the region, other academic medical centers do so without being high cost hospitals.

Alameda County

Key Points on Hospitals in Alameda County

• Alameda County is home to 13 general and acute hospitals and no one hospital dominates a majority of a zip code’s market share. The majority of these hospitals are nonprofit with two city/county hospitals and one district hospital and only one for-profit hospital, Kindred Hospital – San Francisco Bay Area.
• Washington Hospital, a district hospital, is the only high cost hospital in Alameda County, but is one of two in the Southern Bay Area. There are three high cost hospitals in the Central Coast in Monterey and Santa Cruz Bay Areas.
  • Washington Hospital has the highest percentage of the market share for inpatient care in Fremont (41-46.7%), parts of Mission San Jose (41.7%), Newark (35.7%) and Union City (35%).
  • Washington Hospital takes up larger portions of the market share for emergency department services in those areas—Fremont (47-50%), parts of Mission San Jose (50%), Newark (44.7%), and Union City (36.9%).
  • Washington Hospital is also increasing its market share in ambulatory surgery but is not a significant part of the market.
  • Washington Hospital competes with the Kaiser Foundation hospitals in those cities.
  • Washington Hospital is part of a health system governed by the Washington Township Health Care District Board.
  • The system has 44 locations offering a wide range of services ranging from specialty services to primary care.
• Health systems with options for outpatient primary and specialty care increase access to primary care and preventive services, and are lower cost than going to a hospital. However, hospital outpatient facilities often charge higher prices than independent physician practices and may also charge facility fees—increasing access, but at a higher cost to the patient. ,
  • Washington Hospital is paid more than both the state and Bay Area average for services compared to Medicare.
  • While the system is operating at a loss, it is spending significantly on joint partnerships and service expansion—expanding its reach. While this would increase access to care, there could be cost concerns for patients. As the system expands its reach, it could use its market power to further increase costs at an already high cost hospital.
• Washington Health system is spending more than 2.5 times more on executive compensation than on charity care for its patients. ,
  • Both system and the individual hospital are below the state average for spending on charity care as a percentage of net revenue.
  • The hospital serves fewer people with Medi-Cal Managed Care coverage than the state average so that cannot be a reason why they are charging higher commercial rates to workers, consumers, and purchasers.
  • The hospital has a 2-star rating on quality from Medicare. Thus, higher prices are not resulting in better care for patients at Washington Hospital.
  • The hospital has adequate reserves that it is using to expand services, but provide only 0.1% of net revenue in charity care.
  • This suggests that Washington Hospital is not being paid higher prices due to financial need, providing higher quality care, or because they are providing charity care to their residents. They are one of seven high cost outliers in the state.

Table 3. Hospitals in Alameda County

Note: Data for Table 3 are from Department of Health Care Access and Information Hospital Annual Financial Data and Facility Finder

Alameda County High Cost Hospital Profile

Washington Health System

• spent $1.3 million on CEO salary in 2024
• spent $6.8 million total on executive compensation in 2024
• spent $2.7 million on charity care in 2024
• spent 2.5 times as much on executive compensation than charity care in 2024
• had $240.0 million in assets and $454.4 million in cash and investments in 2025
• has operated at a loss the last 3 years, though they have increased net patient revenue in recent years and invested in capital and service expansion during this time
  • according to system financial reports, the loss has been driven by high reliance on government payers, and increasing operating expenses including salaries and employee benefits according to their financials
  • the health system is increasing the number of patients they see, resulting in improvements in net patient revenue by 9.8 percent in 2025 (made $696 million) from 2024, and 6.2 percent from 2023 to 2024 (made $634 million); they expect further increases because of upcoming strategic and operational initiatives
  • while operating at a loss, the health system is spending significantly on capital and service expansion including:
    • partnering with USCF to open the Washington Cancer Center (opened in 2026), and Washington Hospital – UCSF Warm Springs (in development) for outpatient primary and specialty care
    • Washington Urgent Care (opened in 2025)
    • Morris Hyman Critical Care Pavilion Innovation Project (projected in summer 2026)
• total assets have remained stable since 2023, reaching $1.3 billion in 2025
• had adequate financial liquidity and financial flexibility, with 112 days of cash on hand

Figure 4. Washington Health System Spending—Charity Care v. Executive Compensation

Note: Data for Figure 4 are from Transparent California and Washington Township Health Care District

Washington Hospital (part of Washington Health System):

• is a district hospital in the City of Fremont
• has 415 beds, general and acute care provided
• is paid 359% of Medicare rates as their commercial hospital price for the same service (the average commercial price of hospital services across the state is 287% of Medicare)
• is paid $32,900 for each inpatient stay adjusted for the care that the patient needed (if higher acuity of care or not); all other comparable hospitals are paid $20,200 as a pooled average for inpatient stay with this adjustment
• is being paid 1.6 times that of the comparable hospitals by consumers, working families, employers and private insurance
• had $556.2 million in operating revenue in 2024
• had $455.3 million in current assets and $84.5 million in investments and other assets ($1.5 billion in total assets) and $53 million in nonoperating revenue in 2024 ,
• provided $640,171, or 0.1% of $544.6 million in net patient revenue on charity care
  in 2024
• had 129.4 days cash on hand in 2026
• had 2-star Medicare quality rating
• sees more patients proportionately in the Emergency Department than the statewide average
• sees less patients in ambulatory surgery and more patients inpatient from the emergency department than state
• 37% of patients served at the hospital are Asian, and 22% of patients served are White, 21% are Hispanic and 8% are Black
• serves similar percentage of older (27% patients ages 65 and older) and younger (34% patients ages 35–64) populations to both the state average and Alameda patients demographics
• serves less patients with Medi-Cal and Medicare Managed Care for both inpatient and outpatient care than the state average, and more patients with commercial and Medicare fee for service coverage than the state average

Alameda County Overview

The county is home to over 1.5 million people living in 14 incorporated areas, as well as six unincorporated areas communities and rural areas throughout the county. Alameda is the seventh most populous county in California and Oakland is the largest city. The county is one of the most ethnically diverse regions in the Bay Area and the nation. There is no majority racial group in the county—36.3% of the population is Asian, 25.9% is White, 23.8% is Hispanic or Latino, and 9.8% is Black.

Major employers in the county include hospitals, universities, state and local government, technology companies and retail. Alameda is facing a housing affordability crisis where renters need to make 2.9 times the City of Oakland minimum wage to afford the average rent of $2,647. Three-quarters of extremely low-income households in Alameda County are paying more than half their incomes on housing costs and housing costs are above the affordability threshold for 40% of all households in the county. A large portion of residents (36.5%) live in the county but commute for work to other parts of the Bay Area.

Low incomes and high cost of living limit residents’ ability to pay unexpected medical bills. 126,000 or 10.1% of county residents said they had problems paying their medical bills, and more than 47.4% said this meant they were unable to afford basic necessities. Due to H.R. 1 and state budget actions, the U.C. Berkeley Labor Center projects that 127,000 people will lose this coverage in the county.
Washington Hospital only provided 0.1% of their revenue in charity care to consumers eligible for assistance on their hospital bills. This is while being a high cost hospital and a only having 2-stars from Medicare.As H.R. 1 policies are implemented, and health care prices rise, more residents will need financial assistance to prevent crushing medical debt.

Washington Hospital can likely charge high prices due to both its market power in cities identified as the hospital alone, but also through its clinical reach as a system.

Solution: Consumer Advocacy for Affordability

Real Californians, Real Stories

What is the Office of Health Care Affordability?

The state established the Office of Health Care Affordability to respond to state’s health care affordability crisis causing nearly 6 in 10 Californians to skip or delay care due to the cost. Health care costs have risen fast than wages and inflation, making it harder and harder to afford care, and stagnating wages for workers. One of OHCA’s first and paramount tasks in its first years was establishing its state cost growth target which has its first enforceable year in 2026. The OHCA Health Care Affordability Board did so after two years of deliberations, including hearing from a broad range of stakeholders. Consumers, labor organizations and businesses purchasing health care for their employees showed up to support a cost growth target of 3% aligned with median income growth over the last 20 years. This was under the premise that health care spending can no longer outpace workers’ wages, and limiting this growth from 6% (spending without limits) to 3% will lead to less of workers’ wages going to health care over time. Consumer advocates, groups representing communities of color, business organizations of large employers; groups such as the National MS Society and Blood Cancer United; as well as labor unions supported this historic first limit on spending growth in California. Nearly 400 comment letters were submitted to the Board from stakeholders, the majority supporting the target based on consumer affordability measures. The state approved a phased cost growth target starting at 3.5% growth in 2026. Responding to stakeholder concerns about persistently high hospitals costs in some parts of the state, the Board voted to establish a specific cost growth target for “high cost” hospitals after eight months of monthly public meetings, including 100 comments from consumers sharing their challenges affording care in their region. Only seven (out of more than 400 hospitals in the state) high cost outlier hospitals were adopted—those with higher commercial prices and commercial revenue than 85% of other comparable hospitals. Research shows that higher prices are not attributed to higher quality care or better-quality outcomes, reinforcing the logic of lowering cost growth at these hospitals, to increase access, and without a detriment to quality.

What OHCA is Doing About the High Price of Health Care in the Southern Bay Area

In 2025, the OHCA Health Care Affordability Board set a lower cost growth target for the seven high-cost hospitals including Stanford Hospital and Washington Hospital. While the rest of the state’s hospitals are required to meet a target of 3.5% in 2026, the seven high cost hospitals will have to meet a target for 1.8% cost growth in 2026 decreasing to 1.7% in 2027 and 2028, and 1.6% in 2029. Because these hospitals have prices sometimes double that of other hospitals, even after accounting for cost of living, OHCA determined a target half that of statewide was necessary to ensure that communities with high hospital prices experience relief. Without this lower target, hospital prices in the Southern Bay Area and other high cost hospital communities would start at a higher baseline and continue to rise higher than other parts of the state.

Endnotes

1. Paying the Price: Californians Struggle with the High Cost of Care (California Pan-Ethnic Health Network, 2026)
2. For purposes of this case study, ”Stanford Hospital” refers to Stanford Hospital at 300 Pasteur Drive, Palo Alto, CA, 94305. Stanford Health System refers to the health system of Stanford Health Care whose financials referenced include hospital and clinic subsidiaries including Stanford Hospital, Stanford Health Care – Tri-Valley, Stanford Medicine partners, and other subsidiaries, but not Lucille Packard Children’s Hospital at Stanford, which has separate financials, but is part of Stanford Medicine. All have the same Stanford Medicine brand, common corporate parent ad joint contract administration function.
3. This refers Washington Hospital located at 2000 Mowry Avenue, Fremont, CA 94538
4. Hospital Financial Data Interactive Series: Hospital Financials (Department of Health Care Access and Information, 2025)
5. Stanford Health Care Consolidated Financial Statements and Accompanying Consolidating Information (Stanford Health Care, 2025)
6. Hospital Financial Data Interactive Series: Hospital Financials (Department of Health Care Access and Information, 2025)
7. Care Compare – Washington Hospital (Medicare.gov)
8. For purposes of the case study, Washington Health System refers to Washington Health that is governed by the Washington Township Health Care District.
9. Washington Township Health Care District – Annual Report – June 30, 2025 and 2024 (Washington Health, 2025)
10. Transparent California – Washington Township Health Care District (Transparent California, 2024)
11. February 2025 Health Care Affordability Board Meeting Presentation (Office of Health Care Affordability, 2025)
12. February 2025 Health Care Affordability Board Meeting Presentation (Office of Health Care Affordability, 2025)
13. Criteria: Governments: U.S. Public Finance: U.S. and Canadian Not-For-Profit Acute Care Health Care Organizations (S&P Global, 2018)
14. Criteria: Governments: U.S. Public Finance: U.S. and Canadian Not-For-Profit Acute Care Health Care Organizations (S&P Global, 2018)
15. Stanford Hospital and Clinics, California (Fitch Ratings, 2025)
16. Washington Township Health Care District Board of Directors Meeting (June 10, 2026) (Washington Health Board of Directors, 2026)
17. 2024 Pivot Table – Hospital Annual Selected File (Department of Health Care Access and Information)
18. Facility Market Share and Patient Origin (Department of Health Care Access and Information, 2022)
19. February 2025 Health Care Affordability Board Meeting Presentation (Office of Health Care Affordability, 2025)
20. “% of Medicare” is a unit of measurement for the cost of health care. 100% of what Medicare pays is seen as a “baseline.” The average rate charged to commercial insurers by California hospitals is 200% of Medicare. Medicare accounts for cost of living.
21. 2024 Pivot Table – Annual Hospital Financial File (April 2026 Extract) (Department of Health Care Access and Information)
22. Nonoperating revenue includes investment income, rental revenue, retail operations, transfers from restricted funds for non-operating expenses, gains from sale of property, and unrestricted contributions.
23. Stanford Health Care Consolidated Financial Statements and Accompanying Consolidating Information (Stanford Health Care, 2025)
24. 2024 Pivot Table – Annual Hospital Financial File (April 2026 Extract) (Department of Health Care Access and Information)
25. Financial Health of California Hospitals (Department of Health Care Access and Information, 2026) – El Camino Health
26. The Prices That Commercial Health Insurers and Medicare Pay for Hospitals’ and Physicians’ Services (Congressional Budget Office, 2022)
27. For-profit hospitals referred to here are referred to “investor” in the Department of Health Care Access and Information data. HCAI defines investor-owned as Investor owned Corporation, Investor-Limited Liability Company, Investor-Partnership.
28. Supplier Diversity in California Hospital Procurements – Glossary (Department of Health Care Access and Information
29. 2024 Pivot Table – Annual Hospital Financial File (April 2026 Extract) (Department of Health Care Access and Information)
30. Facility Finder (Department of Health Care Access and Information)
31. Stanford Health Care Consolidated Financial Statements and Accompanying Consolidating Information (Stanford Health Care, 2025)
32. Stanford Health Care Consolidated Financial Statements and Accompanying Consolidating Information (Stanford Health Care, 2025)
33. Form 990 Stanford Health Care 227 (ProPublica, 2024)
34. Stanford Health Care Consolidated Financial Statements and Accompanying Consolidating Information (Stanford Health Care, 2025)
35. Stanford Hospital and Clinics, California (Fitch Ratings, 2025)
36. Stanford Health Care Consolidated Financial Statements and Accompanying Consolidating Information (Stanford Health Care, 2025)
37. “% of Medicare” is a unit of measurement for the cost of health care. 100% of what Medicare pays is seen as a “baseline.” The average rate charged to commercial insurers by California hospitals is 200% of Medicare. Medicare accounts for cost of living.
38. Health Care Affordability Board Meeting – August 28, 2024 (Office of Health Care Affordability)
39. Nonoperating revenue includes investment income, rental revenue, retail operations, transfers from restricted funds for non-operating expenses, gains from sale of property, and unrestricted contributions.
40. Financial and Utilization Reports (Department of Health Care Access and Information, 2024)
41. 2024 Pivot Table – Hospital Annual Selected File – Stanford Health Care (Department of Health Care Access and Information_
42. 2024 Pivot Table – Hospital Annual Selected File – Stanford Health Care (Department of Health Care Access and Information_
43. Financial Health of California Hospitals (Department of Health Care Access and Information, 2026) – Stanford Health Care
44. Stanford Hospital and Clinics, California (Fitch Ratings, 2025)
45. Care Compare – Stanford Health Care (Medicare.gov)
46. Patient Characteristics by County and Facility (Department of Health Care Access and Information, 2023)
47. Patient Characteristics by County and Facility (Department of Health Care Access and Information, 2023)
48. Patient Characteristics by County and Facility (Department of Health Care Access and Information, 2023)
49. Relocating to Santa Clara County (County of Santa Clara)
50. San Jose: The second most expensive place to rent in the country (San José Spotlight, 2021)
51. Silicon Valley remains blind to its inequalities (San José Spotlight, 2024)
52. Paying the Price: Californians Struggle with the High Cost of Care (California Pan-Ethnic Health Network, 2026)
53. Projected reduction in Medi-Cal Coverage due to Federal H.R. 1 and 2025-26 State Budget, by county, 2028 (UC Berkeley Labor Center, 2026)
54. Outpatients Hospital Prices are Higher Among System-Affiliated, For-Profit, and Urban Hospitals (Health Care Cost Institute, 2025)
55. From Check-Ups to Cha-Ching: Consumers’ Exposure to Facility Fees (Georgetown University Center on Health Insurance Reforms, 2025)
56. Transparent California – Washington Township Health Care District (Transparent California, 2024)
57. Washington Township Health Care District – Annual Report – June 30, 2025 and 2024 (Washington Health, 2025)
58. Facility Finder (Department of Health Care Access and Information)
59. 2024 Pivot Table – Annual Hospital Financial File (April 2026 Extract) (Department of Health Care Access and Information)
60. Transparent California – Washington Township Health Care District (Transparent California, 2024)
61. Transparent California – Washington Township Health Care District (Transparent California, 2024)
62. Washington Township Health Care District – Annual Report – June 30, 2025 and 2024 (Washington Health, 2025)
63. Transparent California – Washington Township Health Care District (Transparent California, 2024)
64. Washington Township Health Care District – Annual Report – June 30, 2025 and 2024 (Washington Health, 2025)
65. Washington Health – 2024-2025 Annual Report (Washington Health, 2025)
66. Washington Township Health Care District – Annual Report – June 30, 2025 and 2024 (Washington Health, 2025)
67. Washington Township Health Care District Board of Directors Meeting (June 10, 2026) (Washington Health Board of Directors, 2026)
68. Transparent California – Washington Township Health Care District (Transparent California, 2024)
69. Washington Township Health Care District – Annual Report – June 30, 2025 and 2024 (Washington Health, 2025)
70. “% of Medicare” is a unit of measurement for the cost of health care. 100% of what Medicare pays is seen as a “baseline.” The average rate charged to commercial insurers by California hospitals is 200% of Medicare. Medicare accounts for cost of living.
71. February 2025 Health Care Affordability Board Meeting Presentation (Office of Health Care Affordability, 2025)
72. Nonoperating revenue includes investment income, rental revenue, retail operations, transfers from restricted funds for non-operating expenses, gains from sale of property, and unrestricted contributions.
73. Financial and Utilization Reports (Department of Health Care Access and Information, 2024)
74. 2024 Pivot Table – Annual Hospital Financial File (April 2026 Extract) (Department of Health Care Access and Information)
75. Days of Cash on Hand Q1 of 2026 Financial Health of California Hospitals (Department of Health Care Access and Information, 2026) – Washington Hospital – Fremont
76. Care Compare – Washington Hospital (Medicare.gov)
77. Patient Characteristics by County and Facility (Department of Health Care Access and Information, 2023)
78. Patient Characteristics by County and Facility (Department of Health Care Access and Information, 2023)
79. Hospital Profile – Washington Hospital – Fremont (Department of Health Care Access and Information, 2024)
80. About Us – Alameda County (Alameda County CA, 2026)
81. QuickFacts – Alameda County, California (United States Census Bureau, 2025)
82. Alameda County 2026 – Affordability Housing Needs Report (California Housing Partnership, 2026)
83. Solving the Affordability Crisis (Bay Area Council Economic Institute, 2018)
84. Paying the Price: Californians Struggle with the High Cost of Care (California Pan-Ethnic Health Network, 2026)
85. Projected reduction in Medi-Cal Coverage due to Federal H.R. 1 and 2025-26 State Budget, by county, 2028 (UC Berkeley Labor Center, 2026)
86. This represents written public comments to the Board as attached to OHCA Board public meeting invitations between April 2023 and July 2025. Additional written public comment was solicited for draft proposals, specifications, etc. but is not included in this count.
87. Health Care Affordability Board Meeting (Office of Health Care Affordability, April 2025)
88. Updated to Draft Motions Presented – April 2025 (Office of Health Care Affordability, 2025)

The post High Cost Hospitals in the Southern Bay Area appeared first on Health Access.