Governors who vigorously opposed the Affordable Care Act are now supporting Medicaid expansion in their states. It proves our central point: 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 download 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%. 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.
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
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.
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.
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
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