Atlanta, GA - Healthcare Market Overview

HealthLeaders Interstudy, April 2011

While Atlanta has high unemployment, the economy is showing signs of growth, and that bodes well for all facets of the healthcare industry. The health systems sector is in expansion mode as systems look to tap into high-growth areas of the market. While competition between health systems remains heated, there are signs of consolidation, and we expect this to continue as economic pressure on smaller systems increases. The market has been slow to adopt medical homes and other coordinated patient care delivery models, but there is some movement in that direction. Health plans in the market continue to benefit from a favorable regulatory environment, and employer desire to shift additional healthcare costs to employees indicates continued growth in high-deductible health plans. While WellPoint’s Blue Cross and Blue Shield of Georgia and UnitedHealthcare continue to dominate the market in terms of enrollment, Kaiser Foundation Health Plans is making a sizeable investment in the region, looking to increase its share of the market.

Questions answered in this report:

- The hospital industry in the Atlanta region is currently unconsolidated. Attempts to establish joint ventures and partnerships have tended to fail to reach fruition or later unraveled. Which health systems have signed an agreement to merge? Which system is poised to launch the market’s fourth open-heart surgery program? Which health systems are building new hospitals?

- The Atlanta region has a shortage of both primary care physicians and specialists. Which specialties have been affected most by physician shortages? Which medical group is partnering with a managed care organization on an accountable care pilot program? Which medical group is expanding and is planning to develop a medical home?

- Managed care organizations in Georgia enjoy a favorable regulatory climate, and that will continue to work in favor of carriers. Which three plans have notified the state they will no longer offer child-only policies? Which managed care organization is piloting a medical home program for members with chronic diseases in the Atlanta area? Which MCO has launched a pilot bundled payment program for oncology groups?

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:

- Atlanta, which includes the counties of Barrow, Bartow, Butts, Carroll, Cherokee, Clayton, Cobb, Coweta, Dawson, DeKalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, Haralson, Heard, Henry, Jasper, Lamar, Meriwether, Newton, Paulding, Pickens, Pike, Rockdale, Spalding and Walton

Primary Research:

Analysis of HealthLeaders-InterStudy data, Billian’s HealthDATA, local and state news and industry reports and interviews with local healthcare executives

- Aetna Inc.
- Emory Healthcare
- Georgia Healthcare Leadership Council
- Piedmont Healthcare
- The Emory Clinic
- The Southeast Permanente Medical Group
- UnitedHealth Group (United Healthcare of Georgia)
- WellPoint Inc., (Blue Cross and Blue Shield of Georgia)
- WellStar Health System
- WellStar Physicians Group

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