This story is part of our November 2025 issue. To read the print version, click here.

When Ellen Pensky McGraw went in for her annual mammogram, she didn’t give it a second thought. After decades of standard screenings with no issues, she expected the same results.

“It was very routine for me, and I wasn’t worried at all,” she says.

But this time was different. The radiologist noted a small lump in her left breast and recommended a follow up. “They assured me the lump was small and could probably be removed with a lumpectomy,” she recalls.

She scheduled a follow-up appointment but received little guidance on what to do next. “There was no sense of urgency,” she says. “It was the most terrible experience that I’ve ever been through.”

One of her doctors asked if she had ever had a breast MRI or genetic testing. No one had mentioned those options to her before. She learned that doctors typically avoid bringing them up because of the cost. Pensky McGraw chose to get both anyway. The MRI revealed the cancer was in both breasts and more advanced than initially thought, and genetic testing confirmed she carried a breast cancer gene.

“If I had known about these options earlier, I would have done them years ago,” she says.

A recent transplant from the Bay Area, Pensky McGraw faced a choice: continue with a health care system that left her feeling lost and frustrated, or find better care. She chose the latter. An anesthesiologist friend helped her get a referral to a Sutter Health doctor, and she secured an appointment the next day.

“I will never forget what my doctor told me after hearing my story. He said, ‘I’m going to take care of you; I will figure this out.’ And he did. He got me on my treatment path the very next day,” she says.

Following her recovery, Pensky McGraw joined the board of the Sierra Cancer Wellness Foundation, where she now uses her experience to teach women to advocate for themselves — and to understand they have options.

Adapting to a growing population

Pensky McGraw’s story underscores the complexity of navigating health care in the growing Capital Region. Home to some of California’s most comprehensive health care systems, the region is also grappling with unprecedented demand. An influx of new residents — like Pensky McGraw — has led major providers including Sutter Health, Dignity Health, UC Davis Health, Kaiser Permanente and Marshall Medical in El Dorado County to accelerate expansion plans.

The population surge has been swift. According to U.S. Census data, the Capital Region added about 100,000 new residents between 2020 and 2024. Projections estimate another 580,000 people by 2050, pushing the population past 3 million.

To meet demand, health systems are rethinking how and where care is delivered.

Related: Boom From the Bay: The influx of high-skilled workers is boosting Sacramento’s economic prospects

“We’ve really embarked on an enterprise-wide expansion plan to respond to the demand for our services,” says Rachael McKinney, president of Sutter Health’s greater Sacramento division. She points to three key drivers: rapid population growth, shifting care delivery models and an aging population that requires managing chronic disease.

One major shift is moving services out of hospitals and into outpatient, community-based settings.

“We’re thinking about how we should be delivering care that is close to home for patients where they live, work and play,” McKinney says.

Sutter Health is renovating a 70,000-square-foot multi-specialty Arden Care Center that will include primary care, urgent care and other outpatient services. It’s set to open in December 2025. Its Folsom care complex will feature a new cancer center opening in 2027, and downtown Sacramento will see the launch of a center of excellence care facility for advanced orthopedics and sports medicine. Sutter is also testing retail-facing urgent care centers, starting with one in Rocklin, with plans to replicate the model in Elk Grove and West Roseville.

Hospital capacity is expanding as well: Sutter Roseville Medical Center added 24 acute care beds and 12 ICU beds, while Sacramento’s Sutter Medical Center will add 30 medical surgical beds and 12 ICU beds by late 2026.

UC Davis Health is also focused on expanding access closer to where patients live.

Construction is underway for the massive 14-story, $3.75 billion UC Davis Health California Tower next to the medical center that will feature 334 private rooms. The one million – square – foot building is expected to be completed in 2030.

In September, UC Davis Health opened a new three-story, 114,000-square-foot medical care clinic in Folsom that consolidates three existing facilities. It now offers primary and specialty care and expanded services including radiology, cardiology, oncology and a state-of-the-art infusion center. In downtown Sacramento, a new surgical complex opened at 48th and X Streets with 20 operating and procedural rooms, reinforcing the shift toward outpatient care without sacrificing specialty services.

Marshall Medical, which serves El Dorado County, opened a walk-in orthopedic clinic in El Dorado Hills in August. The clinic offers same-day X-rays, orthopedic consults and surgical assessments — often at lower costs and faster timelines than emergency departments. It also expanded its physical therapy department with an emphasis on sports medicine in response to the population shift and aging demographic. The health system plans to build out the second floor of the clinic with additional specialty care services.

For patients like Lori Schonert, a retired Cameron Park resident recovering from a fall, the new facilities make a difference. She has been receiving physical therapy for her shoulder at the El Dorado Hills clinic. Her therapist, Kimmy Reid, gave her hope after just one session.

“I felt very discouraged and wasn’t sure that physical therapy would even work,” she explains. “Kimmy listened to me and adjusted my treatment based on my health history. After only one session, I was surprised at how much my range of motion was better and my pain was a little less.”

Related: The Capital Region Is in the Vanguard of Autism Research and Treatment

The clinic will soon be adding a groundbreaking tool called ZeroG, a dynamic body-weight support system that builds patient confidence during therapy.

Dignity Health is also making significant investments in its ambulatory footprint in response to the region’s population explosion.

The health system recently opened a new imaging center in Folsom that integrates primary care, pediatrics, oncology infusion and radiology. In Elk Grove, a new Express Primary Care clinic with extended hours and weekend availability offers care that bridges the gap between urgent care and traditional primary care. An additional express clinic is also available in Roseville.

“We have plans to spread that model in multiple communities,” says Rob Marchuk, Dignity Health’s physician enterprise president for the Sacramento market. Dignity Health has also announced plans to build a full-service hospital in Elk Grove — a first for the city.

Kaiser Permanente is similarly expanding, adding a 138-bed hospital tower and 36 emergency room beds at its Roseville Medical Center. An urgent care clinic in Folsom will open in spring 2026, with plans for a comprehensive care center in Folsom as well. Earlier this year, the health system broke ground on its new all-electric Railyards Medical Center in downtown Sacramento — a modern, 310-bed hospital set to open in 2029. The eight-story facility, complete with a five-story parking garage, will replace the aging hospital on Morse Avenue. The project also marks the return of labor and delivery and maternal-child services, which had previously been discontinued.

In neighboring San Joaquin County, work is underway on a major behavioral health investment. The county broke ground on the $261 million, 18-acre SJ BeWell Campus, located near San Joaquin General Hospital. The South Campus will provide a continuum of behavioral health and substance use disorder care. A planned north campus will expand outpatient and residential programs, with added services for families and youth.

Responding to the silver tsunami

The Sacramento region’s population is not just growing — it’s aging. The number of residents aged 65 and older grew by more than 50 percent between 2010-2020, the fastest in 130 years.

Health systems are responding. UC Davis Health has opened a healthy aging clinic in Midtown Sacramento and is expanding cancer care access in suburban areas like Folsom and Rocklin.

UC Davis Health’s Condrin uses his father’s experience to underscore the importance of these shifts.

“He used to have to drive from El Dorado Hills to the cancer center in downtown Sacramento multiple times a week. Now patients can get infusions in Folsom, so it’s a much shorter drive for most of the routine cancer care,” he says.

Kaiser has partnered with Habitat Health to launch a new PACE (Program of All-Inclusive Care for the Elderly) center in the Arden-Arcade area of Sacramento, designed to provide wraparound services for older adults. The center offers a wide range of services under one roof, including a gym, physical therapy, nutrition classes, a primary care physician and opportunities for social connection. There’s even an onsite hair salon.

Related: When the Sun Sets on the Golden Years: The hardship and high cost of caring for a loved one in decline

“It’s like a drop-in center for our elderly patient population,” says Jay Robinson, senior vice president and area manager for Kaiser Permanente Sacramento and South Sacramento.

Dignity Health is also investing in aging care, with an ambulatory surgery and urgent care center with extended hours in Folsom Ranch. Sutter Health is evaluating new Sutter Senior Clinics that focus on managing chronic conditions through specialized primary care.

In El Dorado Hills, Marshall Medical is working with the Blue Zones initiative (places in the world with the healthiest, longest-living populations) to promote community health and longevity.

“It’s a multi-year project, and we’re just one small piece of the puzzle working to promote health and well-being so that people can age gracefully and stay active and connected to the community,” says Jonathan Russell, Marshall Medical’s chief ambulatory officer.

Russell notes that the aging population, particularly in El Dorado and Sacramento counties, combined with a nationwide shortage of physicians and allied health professionals, is posing a significant challenge for all health systems.

Marchuk of Dignity Health agrees and believes the nationwide shortage stems from deeper system issues. He points to the need for more educational pathways.

“I don’t think we have enough schools in this county, enough training programs to meet the demand. That’s number one,” he says. “And being a physician has changed over the last 30 years. We can grow the programs and keep the same quality and rigor, but not everyone wants to work 24/7 anymore. New graduates coming out of residencies and fellowships are also looking for that quality of life.”

Despite those challenges, Dignity Health has been able to prioritize physician recruitment and successfully recruit 60 new physicians to the region. Through its involvement in the Sacramento K16 Collaborative, Kaiser Permanente is also helping build education-to-career pipelines in health care. To support allied health staffing, Marshall Medical opened a medical assisting school in Cameron Park.

Related: The New Age of Aging: Developers in the Capital Region are building new models of senior housing — in preparation for the ‘silver tsunami’ to come

“We noticed there was this underserved population of health care professionals, so we’re proud to be able to offer that to the community,” says Russell.

Competitors and collaborators

Though Sacramento’s major health systems often compete, they also collaborate. They meet quarterly to share insights on emerging technologies, such as robotics and AI in charting and electronic health records, and to tackle shared challenges such as rising patient demand, persistent workforce shortages and federal funding.

“The thing that’s unique about Sacramento is that I have very good relationships with the other health system leaders,” says McKinney. “I call it ‘coopertition.’ We’re competitors, but we cooperate on a lot of community-related partnerships to better serve the community.”

Robinson agrees, saying, “It’s absolutely refreshing to be able to meet and talk about opportunities and problems we all have in common.”

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