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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"

If you missed the 2011 reports for any of our states, you can order both the 2012 and 2011 reports for a special price of $225.00, $95.00 off the regular price for the two reports. Shipping is free on this offer. Click here to order.

Want to see a sample market study? Several reports are available for free PDF download. Follow the links for:

 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.

Ohio Health Market Review 2011 released January 20, 2012: "Medicaid and Medicare plans drive strong HMO profitability; Hospitals enjoy strong profits even as inpatient days decline"

Texas Health Market Review 2011 released October 28, 2011: "Medicare plans fuel strong HMO profitability; hospital utilization lags behind new capacity"

Michigan Health Market Review 2011, Part One, released August 2, 2011. "HMOs gain members and improve profits"

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"

Second update of New York United Hospital Fund annual health insurance market study released April 13: "Health Plan Profits Bounced Back After Three Years of Decline"

Wisconsin Health Market Review 2010 was released during the week of January 17.

Allan Baumgarten presented to a web seminar on Thursday, January 27, 2011. "What's Ahead for Managed Care 2011: Directions, Insights, Developments and Strategy."

Allan Baumgarten presented at the annual conference of the Texas Gulf Coast Chapter of the Healthcare Financial Management Association in Galveston on September 21. Click here to see his presentation, entitled: "The Future of Managed Care Under Healthcare Reform"

Colorado Health Market Review 2010 was released on August 25, 2010: "Hospital profits soar in 2009; Medicare HMOs grow and are strongly profitable." A new report will be released this summer.

Illinois Health Market Review 2009 released November 2009: "HMO and hospital profitability declines; Economic downturn creates new challenges"

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

California Health Care Market Report 2006, sponsored by the California HealthCare Foundation, is available for free download

  • Read a report summary here
  • 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

 





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