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Portland, ME Market Overview
HealthLeaders Interstudy, Nov 2011, Pages: 48
The innovative Portland, Maine, market is positioned to move smoothly into the structures demanded by federal healthcare reform. This region is the most populous, most affluent and best-educated in the state. However, Maine has the oldest population in the United States, and the Portland market is no exception, opening opportunities for pharmaceutical sales to Medicare recipients. In addition, the state is preparing to bid out its Medicaid business, which has been entirely state run, creating a golden opportunity for managed care organizations to enter the market.
Questions Answered in This Report
Hospitals in the Portland market are consolidating rapidly, as well as instituting EMR and forming medical homes and ACOS. Which hospital system is already working with employers to help design benefit plans? What killed a merger between the largest hospital system in the state and a small hospital? Which hospital has had layoffs and why?
Most physicians in this market are employed by hospitals and combined into large groups. Which two large pediatric groups merged and then aligned themselves with what hospital? Why was an acquisition of two cardiology group stymied? Which physicians group is working on becoming an ACO?
WellPoint’s Anthem Blue Cross and Blue Shield of Maine has just over half the total enrollment in the Portland market, which added with Aetna and Harvard Pilgrim’s smaller share represent 85 percent of the market. Which plans may have trouble meeting the minimum loss ratios required by healthcare reform? Which sector of the health insurance market has the insurance superintendent gone to bat for to reduce the MLR requirement? What laws passed in 2010 will affect the health insurance market?
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: Portland, Maine, which includes the counties of York, Cumberland, and Sagadahoc.
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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