Network & population

Population Health & Manageable Lives

How many lives Redlands Health could manage by aggregating the independent physicians from San Bernardino to Banning — the doctors who aren't Kaiser, Optum/Beaver, or Loma Linda — and the full toolkit to keep that population healthy, from prevention for the well to complex care for the sick.

1The aggregation field — independent providers

The whole strategy hinges on physician supply RCH doesn't have to fight Optum/LLU for. The corridor still has a deep independent bench.

~320
independent primary-care physicians (FM/IM/Peds) in-corridor
~378
independent NPs / APPs
37
named independent groups mapped (8 IPAs, 13 specialty, 14 PC)
~767
PCPs excluded as Kaiser / Optum / LLU
See them on the map The Competitor & Clinic Map now has an "Open-network targets" lens (magenta) showing all 37 independent groups. Raw data: independent_groups.json / .csv.

2How many lives can we manage?

From independent clinicians to a realistic first-wave network. Every figure is a modeled estimate — the assumption is shown.

~320 MDs + ~378 NPs — independent clinicians in the corridor (NPPES, ex-Kaiser/Optum/LLU)
~270–490 — panel-carrying PCP-FTEs (the realistic attribution base)
~500k–900k — theoretical capacity (PCP-FTEs × ~1,800 lives; mid ≈ 700k)
~80k–150k — realistic CIN first-wave landing zone (aggregate the willing anchors first)
The honest number The theoretical pool is enormous (~700k), but that assumes you sign nearly every independent. A disciplined first wave — CAMG + the newly-independent RYMG + a couple of IPAs + their attributed lives — is realistically 80k–150k lives. That alone is 4–7× the ~22k commercial lives in the employer analysis, because it includes Medicare and Medi-Cal panels, not just commercial.

3Healthy and unhealthy — the risk pyramid

A managed population isn't uniform. Applying a standard risk distribution, weighted by Inland Empire chronic-disease burden, to a ~100k first-wave panel:

~77,500 lives · 77.5% Healthy / low-risk — prevention & wellness keep them here
~15,000 · 15% Rising-risk — 1–2 chronic conditions (HTN, pre-diabetes, obesity)
~5,000 · 5% High-risk / complex — multi-chronic, high utilizers, most of the cost
Inland Empire skews sicker San Bernardino County: diabetes 17.0%, hypertension 30.2%, obesity 36.5% (Riverside diabetes 14.6%) — well above national averages. So the rising- and high-risk tiers run heavier here than a typical panel, which is both the cost risk and the opportunity: this is exactly the population where proactive management saves the most money under risk.

Tier shares are a standard population-health pyramid (≈77.5/15/5) adjusted upward for IE prevalence; counts shown for an illustrative 100k first-wave panel. Scale linearly for the full pool.

4A wide range of tools — managing every tier

"Manage the population" means a different toolkit for each tier. Under risk, all of it is investment that pays back in avoided cost.

TierGoalTools (the wide range)
Healthy
~77%		 Keep them well; catch early Annual wellness visits & screenings · wellness center (movement, nutrition, recovery) · portal + wearables with rewards for engagement · food-is-medicine & gyms · precision/biohacking options (genetics, methylation) for the motivated
Rising-risk
~15%		 Reverse or halt progression RPM (BP, glucose, weight) · pharmacist-led medication management · chronic-disease education & health coaching · care coordination · integrated behavioral health · nutrition therapy
High-risk / complex
~5%		 Stabilize; keep out of the hospital Intensive complex-care management · Acute Hospital Care at Home · transitional care after discharge · intensive RPM · serious-illness / palliative · behavioral & social-needs (housing, food, transport) via the 1% community fund
The data spine under all of it Every tier runs on the same engine: wearables & records feeding the EMR, AI risk-stratifying the panel weekly, and patients rewarded for the data that proves they're getting healthier (see Technology & Data). That's how you manage 100k+ lives without 100k+ visits.

5Top aggregation targets

#GroupWhy it's the target
1Community Alliance Medical Group (CAMG)Founded 2024 by Dr. John Steinmann explicitly to restore local independent care against Optum/LLU — the most philosophically aligned anchor. ~13 PCPs, Redlands/Yucaipa/Beaumont.
2Redlands-Yucaipa Medical Group (RYMG)Newly independent again (left Optum/Epic ~2024–25). 30–45 PCPs + its own urgent care — the largest single independent PC bloc near RCH.
3Arrowhead Orthopaedics (San Bernardino Med. Orthopaedic Grp.)27+ surgeons across 11 sites — the independent specialty depth to feed an OP surgery center and keep ortho volume local.
4Independent IPAs — LaSalle, All United, MedEx, SoCalHealthThey already bear risk and hold attributed lives (incl. large Medi-Cal panels) — the fastest route to managed lives, not just providers.
5Non-LLU FQHCs + Pass primary care (Neighborhood Healthcare, Unicare, Beaumont/Banning PC)Medi-Cal access + the under-served Pass corridor — RCH's clearest geographic whitespace.
Sequence Land the aligned anchors (CAMG, RYMG) first to prove the model, then the risk-bearing IPAs for lives at scale, then fill the Pass. This is the physician-supply solution to the network-adequacy constraint on Primary Care and The Pathway.
Sources & caveats. Provider counts from the CMS NPPES NPI Registry (organizational + individual, by city/taxonomy), with affiliation verified against group sites and health-plan directories; full list + sources in independent_groups.json and independent_provider_analysis.md. Lives figures are modeled planning estimates (panel ≈ 1,500–2,000/PCP-FTE), not actuarial. Prevalence: county public-health data. Aggregating any group requires the CPOM-compliant structure and (for risk) the Knox-Keene path on Definitions. Not legal, actuarial, or clinical advice.

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