Baltimore | Maryland | 2014 | Market Overview (Event Driven)

Analyst: Christopher Silva

Report Summary:
Baltimore is one of the stronger markets in the Mid-Atlantic region when it comes to consolidation of healthcare services and resources. The market boasts well-known academic medical centers, large nonprofit hospital systems, and several physician groups eager to participate in care coordination activities. Area providers have been inclined to participate in innovative care coordination activities, and such arrangements are likely to increase in 2014 as the state adjusts to the new all-payer rate-setting system adopted in January. This new system will have providers focusing even more on lower hospital readmissions, improving quality care, and monitoring population health. If certain parameters are not met over a five-year period and a certain amount of Medicare savings are not produced, the state could lose entitlement to its unique rate-setting program. Maryland was one of the first states to develop a health insurance exchange and to agree to expand Medicaid. The exchange, Maryland Health Connection, has had a lot of problems getting off the ground, and enrollment projections will not even come close to being met. The large health systems are very competitive with one another in terms of purchasing physician groups and developing and/or obtaining specialty services. 
Questions Answered In This Report: 

Over the next five years, providers will shift virtually all hospital revenue into global payment models, incentiving hospitals to work in partnerships and reduce readmissions. With providers already focusing on population health, it's unlikely that more commercial ACOs will form in the market.  What kind of impact will the new all-payer system adopted by the state in January have on Baltimore's provider communities? What will providers need to do to adapt to the changes, and what kind of effect does this have on accountable care organizations?

The large health systems have been aggressively expanding, and also undergoing vast re-branding and marketing campaigns in an effort to capture the next big asset. Carroll Hospital Center in Westminster is actively and publicly looking for a buyer, which is indicative of how the Baltimore market has been shaping up. Have the area's health systems been expanding? In what areas of development? Which are the next likely targets for system expansion?
What plans are being offered on Maryland Health Connection? Is there a delay in individual or SHOP implementation? What are the rates like in the Baltimore-Towson market?
There are six plans being offered on the individual component of the exchange, and nine on the SHOP, which is being delayed until April 2014. In the Baltimore area, individual rates can average around $169.50 for a 25 year-old nonsmoker.

Market Includes:
Baltimore, which includes the counties of Anne Arundel, Baltimore, Carroll, Harford, Howard and Queen Anne's 
Primary Research:
Analysis of HealthLeaders-InterStudy data, Billian’s HealthDATA, local and state news and industry reports and interviews with local healthcare executives
Companies Mentioned:

Managed Care Companies:
UnitedHealth Group
Diamond Plan
MedStar Family Choice
Riverside Health
Coventry Health Care

University of Maryland Medical Center
Johns  Hopkins Hospital
Sinai Hospital
Johns Hopkins Bayview Medical Center
MedStar Franklin Square Medical Center
University of Maryland St. Joseph Medical Center
Greater Baltimore Medical Center
MedStar Good Samaritan Hospital
St. Agnes Hospital
Anne Arundel Medical Center
MedStar Union Memorial Hospital
Baltimore Washington Medical Center
Mercy Medical Center
Northwest Hospital Center
Howard County General Hospital
MedStar Harbor Hospital
Carroll Hospital Center
University of Maryland Upper Chesapeake Medical Center
Bon Secours Hospital
University of Maryland Harford Memorial Hospital

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