Milwaukee | Wisconsin | 2014 | Market Overview (Event Driven)

Analyst: Sarah Wilson

Report Summary:
Though the state has deferred to the federal government to run its exchange, the Milwaukee market is in good position to offer innovative care to individuals and employer at a lower price point. Competition among health systems, health plans, and physician groups will continue to be fierce, promoting a region rich with accountable care organizations, patient-centered medical homes, and narrow networks. Competition among health plans on and off the exchange will help to control costs, as will narrow network plans. However, one Milwaukee broker believes, all things being equal, the plan designs with the lowest costs will be the most popular on the exchange.

Questions Answered In This Report:
Aurora Health continues to be the dominant health system in the Milwaukee market, offering innovative services to residents. Other health systems are collaborating to better compete against Aurora.  Which health systems have entered into collaboration talks with Aurora Health Care? What is the significance of the Quality Health Solutions accountable care organization? How will the ProHealth–Columbia St. Mary's cardiovascular collaboration affect the competitive landscape?

Local physician groups have been heavily involved in transitioning the market away from traditional care to collaborative care models to lower costs and improve area health. Of which health system–led ACO is Waukesha Elmbrook Health Care a member? Which specialty clinic has been designated a patient-centered medical home by the National Committee for Quality Assurance? What is the name of Independent Physicians Network's ACO, and which population does the ACO serve?

Carriers in Milwaukee continue to compete for commercial lives by offering low-cost plans, as well as high deductible offerings that will appeal to employers. Which health insurer will sell plans featuring the Quality Health Solutions ACO? Why are narrow network plans expected to be popular on the exchange, but less popular off the exchange? How will Medicaid reform affect BadgerCare managed care insurers?

Market Includes: The counties of Milwaukee, Ozaukee, Racine, Washington, and Waukesha in Wisconsin. Key cities covered are Milwaukee, Racine, Waukesha, and West Allis. 

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:
Anthem Blue Cross and Blue Shield of Wisconsin
UnitedHealth Group


Aurora Health Care
Business Health Care Action Group of Southeastern Wisconsin
Children's Hospital & Health System
Columbia St. Mary's
Froedtert & The Medical College of Wisconsin
ProHealth Care
Wheaton Franciscan Healthcare
Wisconsin State Health Information Network

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