The northern California region of Stockton, including the city and most of the surrounding San Joaquin and Calaveras Counties, stands out along with Akron, Ohio, for having improved on more performance measures (19 of 33) than any other region on the Commonwealth Fund's Scorecard on Local Health System Performance, 2016 Edition. California's Medicaid expansion enabled local providers to increase capacity, which may explain the improvements on some measures of care quality and reductions in potentially avoidable hospitalizations, emergency department visits, and readmissions. Leaders have also expanded access by locating clinics in schools and a neighborhood community center. The region's improvement efforts appear to be facilitated by supportive state policy and the market dominance of a locally governed Medicaid managed care plan. To make further progress, community leaders are developing coalitions and seeking funds to address the social determinants of poor health, including poverty, violence, and poor nutrition.
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