Assuming it is upheld, national health reform initiatives will be implemented in local markets, creating opportunities and challenges. Markets are different - in how providers organize and practice and in how health plans compete.
Our annual market reports and data are an invaluable source of insight into twelve state health care markets. We assemble data on health plans and provider systems and weave that analysis together with the perspectives of leaders in each market. By touring our web site, you can see samples of what is in those reports and data sets.
Through our consulting
research, we apply our analysis of local markets to help pharmaceutical companies, health plans, provider organizations, health purchasers, investment firms and governments to address the business competition and strategy issues that they face.
New Market Reports
These new reports share key themes:
Medicaid is now
the largest line of business for HMOs in many states and they should
enjoy significant, profitable growth under health reform. But are their profits too high? The Minneapolis StarTribune cites my research on payments and profits for Medicaid HMOs in Minnesota, Michigan and Wisconsin in an editorial entitled: "Is State Overpaying Health Plans?" In his blog at Forbes.com, Michael Millenson summarizes my new Texas report: "Big Government Brings Big Profits to Texas Health Plans." Minnesota introduced competitive bidding and a 1% cap on HMO Medicaid profits - after HMOs had average margins of 8.9%. The StarTribune quotes me and my research on those issues and the 2012 reports for those states will include an extended analysis of the financials of Medicaid HMOs.
Strong profits but risks for
hospitals with their ambitious construction projects, seeking to expand
their market share and extend their geographic reach. Colorado Public News used my analysis of hospital finances for its article, "Most Colorado hospitals report strong profits for 2010." Peter Frost's
article in the Chicago Tribune quotes me on who bears the cost for the billions in new hospital
construction underway in that region. But fewer people have comprehensive
insurance coverage, and providers are feeling downward pressure on
utilization. See my take in dBusiness on the impact of more than a billion dollars in new construction by Vanguard and the other Detroit systems, even as the market for hospital services there is shrinking.
Uncertainty over the implementation of national health reform initiatives at the local level. Examples include the readiness of providers to form accountable care organizations and the ability or willingness of health insurers to comply with new regulations, refocus on small groups and individuals and sell through exchanges. See my take in Minnesota Medicine on the recent trend toward provider consolidation.
Competitive pressures plus changes in Medicare payment may be driving more consolidation for both hospitals and health plans. See my comments in Crain's Detroit Business and the Detroit News on the acquisition by Vanguard of the Detroit Medical Center and note the recent acquisitions made by CIGNA, Humana, WellPoint and UnitedHealthcare.
Newest report
Michigan Health Market Review 2011, Part Two was released May 4: "Hospitals report strong profitability; Integration and system building continue"
Minnesota Health Market Review 2011, Part Two, was released March 30 and includes a comprehensive analysis of hospital finances and utilization. Part One of the 2012 report, analyzing health plan finances, is scheduled for release about June 1.
Allan Baumgarten presented at the annual conference of the Texas Association of Health Plans on October 18, on the topics: "Texas Health Market Review: Industry Trends and Predictions." Click here to view his presentation.
Minnesota Health Market Review 2011,
Part One, was released June 24, 2011 and includes a comprehensive
analysis of health plan profitability and enrollment growth. "Minnesota HMOs Post Record Profits, Driven by Medicaid Plans"
Florida Health Market Review 2011 was
released May 27: "Medicare drives increased profits for Florida health
plans, and Medicaid HMO enrollment tops 1.1 million"
A new Illinois market analysis is scheduled for release this spring.
The June 1 issue of Modern HealthCare includes the transcript of a roundtable discussion in which Allan Baumgarten participated on the topic "What's Next for Managed Care?" To read the transcript or view the video, click here. Other participants were Vicki Gregg, CEO of Blue Cross Blue Shield of Tennessee and Larry Boress, CEO of the Midwest Business Group on Health.
St. Luke's Health Initiatives of
Phoenix has released Allan Baumgarten's new market
analysis for Arizona. The report, Arizona Health Care Market Report 2008, is available for free PDF download at the SLHI web site. This is the 11th state where he prepares market
reports.
Allan Baumgarten was interviewed as a "visionary" by Managed Healthcare Executive in the July 2007 issue. "Impartial Perspective: Independent consultant Allan Baumgarten offers candid market analysis."
The Foundation for a Healthy Kentucky
has released Kentucky Health Care Market Report 2007, my new analysis of the health economy in Kentucky, including
health benefits and insurance, providers, purchasers and market trends
and issues. Later this spring data from the report will be available at the Foundation's web site. Laura Lipkin and Julie Sonier worked with Allan on this project. You can download an interactive PDF of the report at: http://www.healthy-ky.org/presentationsReports.aspx?yr=2007
Marie-Anne Hogarth wrote in the East Bay Business Times: "Report: Kaiser expansion keeps competitors on toes"
We hope you will visit this site frequently. We will regularly add information
about new reports as they are released. In addition, our Industry News section
will put breaking news into the context that you need. Please contact us if you have questions or comments. To reach us send E-mail
to: Baumg010@tc.umn.edu. or click on
Contact Us. If you prefer, call us at (952) 925-9121 or fax (952) 925-9341.
Our mailing address is:
Allan Baumgarten
4800 West 27th Street
Minneapolis, MN 55416