Sutter has pursued an aggressive expansion strategy of mergers and acquisitions aimed at capturing large portions of regional health care markets. During the past eight years, the company has more than doubled in size. The company has used its market dominance to command exorbitant prices from consumers. According to the California Public Employees Retirement System, Sutter's prices are 80% higher than the statewide average and 60% higher than the Northern California average. Recently, CalPERS President Sean Harrigan told the Sacramento Bee that, "Every citizen in the state of California should be outraged by Sutter." Harrigan said CalPERS should take "every aggressive action possible" to stop Sutter from using its "monopoly hold on some markets" to demand high prices.