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Charleston, SC Market Overview
HealthLeaders Interstudy, Aug 2011
Charleston’s provider landscape is shifting from one dominated by independent practice groups to a more consolidated market, owing largely to the aggressive acquisition strategy of Roper St. Francis Healthcare. While not as pronounced as in other South Carolina markets, such consolidation could create concern among managed care organizations and employers that it will drive up costs. BlueCross BlueShield of South Carolina retains its stronghold on the Charleston market, but the managed care organization is facing increased competition from national players offering a wide selection of products, including consumer-driven health plans. Meanwhile, South Carolina has made major changes to its Medicaid program by requiring beneficiaries to enroll in managed care, and the program enacted a second round of reimbursement cuts to providers in July 2011.
Questions answered in this report:
Charleston health systems are expanding in suburban areas, particularly east of the Cooper River. Which systems continue their turf war to build competing hospitals in Berkeley County? Which new hospitals opened in 2010? Which health system is monitoring high-risk pregnancies through a secure online health network?
The once-fragmented Charleston physician landscape is consolidating rapidly. Which physician group is planning to introduce a health insurance product to self-insured employers in 2012? How is the area’s only independent primary-care group competing with the integrated networks offered by MUSC Health and Roper St. Francis? Which medical condition is Palmetto Primary Care Physicians hoping to add as a focus within its patient-centered medical home?
BlueCross BlueShield of South Carolina accounts for 43 percent of total managed care enrollment in the market. Why did the Municipal Association of South Carolina cease operations of its health insurance pool? Which practice management company did BlueCross BlueShield of South Carolina recently purchase? How many Medicaid beneficiaries will join an MCO or medical home network through spring 2012?
Metrics:
- Key market indicators and leading organizations among health systems, physicians and health plans
- Health systems’ market share
- Income, revenue, enrollment and pharmacy spend for leading health plans
- Demographics
Scope:
Charleston, which includes the counties of Berkeley, Charleston, and Dorchester
Primary Research:
Analysis of HealthLeaders-InterStudy data, Billian’s HealthDATA, local and state news and industry reports and interviews with local healthcare executives
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