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

• Medicaid is now the largest line of business for HMOs in many states and they should enjoy significant, profitable growth under health reform. In his blog at Forbes.com, Michael Millenson summarizes my new Texas report: "Big Government Brings Big Profits to Texas Health Plans." Minnesota, stung by reports of high profits for Medicaid HMOs and facing a large budget shortfall, is introducing 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.
• 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.
  
• Risks for hospitals with their ambitious construction projects, seeking to expand their market share and extend their geographic reach. As fewer people have comprehensive insurance coverage, providers are feeling downward pressure on utilization. See the February 16 issue of Becker's Hospital Review for Leigh Page's interview with me: "15 Key Factors Affecting Hospitals' Longer-Term Outlook." And 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.
  
• 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: 

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"

• See coverage by Carrie Ghose in Columbus Business First:  "Larger, lucrative Medicaid regions likely to attract managed care plans"
• James Ritchie wrote in the Cincinnati Business Courier:  "Cincinnati hospitals post big jump in '10 net income"
• Allan Baumgarten presented a web seminar on March 26, 2010 to members of the Health Action Council of Ohio.  Click here to download his slides

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

• Jim Fuquay wrote in the Fort Worth Star-Telegram:  "HMOs are back by focusing on Medicare, Medicaid"
• See Allison Wollam's coverage in the Houston Business Journal: "Find the right prescription for growth - Houston hospital systems boost profits despite warnings of overbuilding"
• Carolyn Poirot wrote in the Fort Worth Business Press: "Study shows growth in Texas HMO plans"
  
• 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.

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

• Listen to an interview with Allan Baumgarten on the Craig Fahley show on WDET 101.9 FM on the public battle between Blue Cross Blue Shield of Michigan and the Beaumont hospitals. See also Melissa Burden's article in the Detroit News about their dueling newspaper ads, quoting me on payer and provider disagreements.
• Melissa Burden wrote in the Detroit News: "Michigan HMOs '10 growth hits 4.4%"
  
• See Jay Greene's coverage in Crain's Detroit Business: "Report: Profit margins of Michigan health plans up slightly in 2010"

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"

• Read coverage in the Minneapolis-St. Paul Business Journal: "Report: MN Health insurers post record profits"
• See Christopher Snowbeck's article in the St. Paul Pioneer Press: "Minnesota HMOs report record profits"
  

If you missed the 2010 reports for any of our states, you can order both the 2010 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:

• The Big Picture: Private and Public Health Insurance Markets in New York, by Peter Newell and Allan Baumgarten
  
• The Big Picture Update released April 2011
  
• Arizona Health Care Market Report 2008
• California Health Care Market Report 2006
• Florida Health Market Review 2008 (sampler)
  
• Kentucky Health Care Market Report 2007
• Texas Managed Care Review 2006

Florida Health Market Review 2011 was released May 27 in databook format: "Medicare drives increased profits for Florida health plans and Medicaid HMO enrollment tops 1.1 million"

• Abraham Aboraya wrote in the Orlando Business Journal: "HMO profits up for 2nd straight year"
• Bob LaMendola wrote in the Ft. Lauderdale Sun-Sentinel: "Florida HMO profits jump 16 percent"
  
• Margie Manning covered the report in the Tampa Bay Business Journal: "Florida HMOs post profit increase, enrollment decline"
  
• Allan Baumgarten presented at the annual conference of the South Florida Hospital and Healthcare Association on June 10. Click here to download his presentation on: "Managed Care: Can It Be Managed?"
  

Minnesota Health Market Review 2010, Part Two, was released May 11 and includes a comprehensive analysis of hospital finances and utilization.

• See Christopher Snowbeck's coverage in the St. Paul Pioneer Press: "Twin Cities hospitals post decade-high profits in 2009" and "Survey: Metro area hospitals profits health"
  
• See Jackie Crosby's article in the StarTribune: "Minnesota hospitals show jump in profits"

Michigan Health Market Review 2010, Part Two, released April 13, 2011. "Hospital profitability and inpatient days drop in 2009"

• See Tracy Samilton's coverage on Michigan Radio: "Many Michigan hospitals lost both patients and money in 2009"
• Jay Greene wrote in Crain's Detroit Business: "Region's hospitals had financially tough 2009; insurers did a bit better"
  

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 was the keynote speaker at the annual conference of the Wisconsin chapter of the Healthcare Financial Management Association in Wausau on May 26, on "Thinking Outside the Box on Health Reform." Click here to see his presentation slides. 
• Richard Rovito wrote in the Business Journal of Milwaukee: "State HMOs See Record Enrollment"

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

Colorado Health Market Review 2010 was released on August 25, 2010: "Hospital profits soar in 2009; Medicare HMOs grow and are strongly profitable"

• See Greg Griffin's article in The Denver Post: "Colorado HMO premiums rose with medical costs in 2009"
• Ed Sealover wrote in the Denver Business Journal: "Hospitals Post Record Profits"
  

• See 2007 presentation to Midwest Business Group on Health

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.

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"
  

Our mailing address is:

Allan Baumgarten
4800 West 27th Street
Minneapolis, MN 55416