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. 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%. In a blog posting for the Bluespire marketing firm, I suggested that the future trajectory of health reform may not be affected that much by who is elected on November 6 because strong constituencies are heavily invested in its continued implementation.
• 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.
• Competitive pressures plus changes in Medicare payment are driving more consolidation for both hospitals and health plans. Is a reinvigorated Detroit Medical Center, now owned by Vanguard, driving an announced merger of the Henry Ford and Beaumont systems? See my data and comments in the Detroit News. Note the recent health plan and provider group acquisitions made by Aetna, CIGNA, Humana, WellPoint and UnitedHealthcare. See my take in Minnesota Medicine on the recent trend toward provider consolidation. Some systems are pursuing other strategies for extending their geographic reach. Read my recent paper on Mayo Clinic's partnerships and what some other providers are doing.
  

Newest reports
Minnesota Health Market Review 2012, Part Two, was released April 29: "Minnesota Health Repeat Strong Profits, Pursue Acquisition and Partnership Strategies"

• Kathy Grayson wrote for The Business Journal: "What Park Nic acquisitions means to HealthPartners' market share"
  

Michigan Health Market Review 2012, Part Two, was released March 31: "Michigan Hospital Systems Expand With Mergers, Acquisitions and Partnerships; Profitability Grows But Inpatient Utilization Declines "

• Jay Greene wrote in Crain's Detroit Business: "Metro Detroit hospitals show strong financials despite operational losses; HMO margins decline"

If you skipped 2012 reports for Michigan or Minnesota, you can order both 2012 and 2013 reports for those states for $225. Click here to order.  And - watch for the grand opening on our new online store.

New Colorado and Florida reports up next.  Spring special!! Buy any two state reports - mix or match states and years - for a discounted price of $245.00. Free shipping included. Click here to order.

Wisconsin Health Market Review 2012 released February 4, 2013: "Implementation of Health Reform Creates New Opportunities and Challenges; Hospital Maintain Profitability Even as Utilization Declines"

• See Rich Kirchen's coverage in the Milwaukee Business Journal: "State HMOs See Shrinking Bottom Lines"
• Shamane Mills reported on Wisconsin Public Radio News: "Hospitals Still Make Money; HMO Profits Dip"
• Tim Stumm reported in Wisconsin Health News (subscription required): "Report: HMO, hospital profits dip slightly." And read Tim's interview with me released Friday, March 1.
  

Illinois Health Market Review 2012 released December 5, 2012: "Health insurers and hospital enjoy strong profits; inpatient hospital days decline for fourth straight year."

• Crain's Chicago Business reported: "Hospitals Still Investing in Facilities Despite Falling Admissions"
• Peter Frost wrote in the Chicago Tribune: "No-Wait Emergency Rooms?" Hospitals try to attract new patients while dealing with continued decrease in inpatient visits
  

Minnesota Health Market Review 2012, Part One, was released September 6: "Minnesota HMOs Post Excellent Profits on Employer Plans and Public Programs"

• Joe Carlson wrote in Modern Healthcare: "Minn. HMOs saw healthy profits despite capping Medicaid income: Report"
• Christopher Snowbeck reported in the St. Paul Pioneer Press: "HMO profits strong in 2011, despite earning cap"
  

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 IV: New York's Private and Public Insurance Markets, 2010, and the Affordable Care Act, released August 2012
  
• Arizona Health Care Market Report
• California Health Care Market Report
• Florida Health Market Review (sampler)
  
• Kentucky Health Care Market Report
• Texas Managed Care Review

Third update of New York United Hospital Fund annual health insurance market study released August 20: "2010 Was a Positive Year for New York's Health Plans." Report examines impact of Affordable Care Act on insurance markets

Michigan Health Market Review 2012, Part One was released July 18: "Health plan companies enjoy strong profitability and prospects for growth; new wave of consolidation changes market dynamic"

• See the Detroit News: "HMOs' Profitability Hits Record"
• Jay Greene wrote in Crain's Detroit Business: "Study: Michigan Health Plans Post Best Financial Year Ever in 2011"
• Melissa Anders wrote on MLive/Ann Arbor News: "Blue Care Network leads way in Michigan HMOs' record total profit as more people sign up"

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"
• Brandon Glenn wrote in MedCity News: "What are Ohio's most profitable hospitals and health systems?"
  
• James Ritchie wrote in the Cincinnati Business Courier:  "Cincinnati hospitals post big jump in '10 net income"
• Allan Baumgarten will present a web seminar about Ohio hospitals and health plans on April 10, 2012 to members of the Health Action Council of Ohio.  Click here to view his presentation.
  

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.

• 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?"
  

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Allan Baumgarten
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