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Harrisburg, PA Market Overview


Description: All the major players in the market are designing their strategies to prepare for the major overhauls underway in healthcare reform. Some health systems are benefiting from reclassifications in the Medicare wage index, resulting in additional revenues. But the reimbursement environment isn’t all positive, and growth continues in low-reimbursement government plans and high-deductible health plans. Also, some hospitals in the region are seeing declining demand for healthcare services because of a poor economic climate and strong competition from smaller medical facilities. The market is still without a regional health information exchange, although the state is making significant headway in this area.

Questions answered in this report:

The hospital market sector is expected to remain considerably consolidated, and there are no major shifts in the cards planned. Which health system is experiencing declining demand? What partnership outside the market is PinnacleHealth expanding in order to improve its cancer care offerings in Harrisburg? What cancer facilities have been expanded in the market to improve oncology services? Which health system is scheduled to open a new children’s hospital in 2012, bringing needed children’s care to Central Pennsylvania? Which health systems use telemedicine?

This market has movement toward medical home models of patient care and other initiatives by health plans, and that could provide higher reimbursements in exchange for coordinated patient care. Which large physician group connected to a health system is at the center of a transition to medical home care that will use dozens of the group’s clinic sites and outpatient centers throughout central Pennsylvania? Which managed care organization in this market is working directly with certified registered nurse practitioners in much the same way as network primary-care physicians? What does this mean for pharmaceutical companies?

Highmark remains the state’s and market’s dominant managed care organization, although it competes for market share in Harrisburg with Capital BlueCross. What is the outlook for consumer-driven health plans in the market? Which health plans are touting wellness and pharmacy cost management programs? Is generic use on the rise? Is Medicare Advantage private fee-for-service enrollment up or down, and why?

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:

- Harrisburg, which includes the counties of Cumberland, Dauphin, Lebanon and Perry

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 - PinnacleHealth - Penn State Milton S. Hershey Medical Center - Holy Spirit Hospital - PrimeSource Health Network - Penn State Hershey Medical Group - Good Samaritan Physician Hospital Organization - PinnacleHealth Physician Practice Network - Highmark - Capital BlueCross - Coventry Health Care (HealthAmerica) - SMC Business Councils - Accountable care organizations - Administrative services - Ambulatory/specialty hospitals


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