Miami, FL Market Overview
HealthLeaders Interstudy, March 2011, Pages: 56
Jackson Health System, a major safety net and tertiary-care provider in Miami-Dade County, is facing a severe financial crisis that could dramatically impact other providers in the surrounding area, including otherwise financially stable Baptist Health South Florida. Administrators for Jackson are scrambling to make cuts and maintain enough cash on hand to continue operating. As medical services are reduced, watch for other providers to see their uninsured loads increase. On the payer side of the market, federal payment rates to Medicare plans are extremely favorable, and there is a wide array of health plans in the managed Medicare and Medicaid sectors. At the same time, Medicare and Medicaid fraud is endemic, as is the illegal distribution of prescription drugs. There are signs of positive change in the market, including state data that show job growth starting to pick up and developing signs of innovation among providers in a region that has been marked by a lack of integration.
Questions answered in this report:
The once seemingly stable hospital market in south Florida is feeling pressure from the economic downturn and the struggles of Jackson Health System. What impact does the area’s uninsured rate have? Do hospitals face competition from physician-owned outpatient facilities? What is the financial status of hospitals outside Jackson Health System? What health systems are best positioned in terms of market share and bargaining clout with health plans? How well positioned are for-profit health systems in the local area? What steps are health systems taking to improve physician alignment?
Physicians in this market are not consolidated. How does the lack of consolidation impact physicians’ business and pay? What impact is the economy having on physician practices? What are commercial reimbursement rates like? What impact does the prevalence of managed Medicare in south Florida have on physicians? What is the medical liability environment like? What signs of innovation are appearing in the physician sector? In what ways are local physicians technologically behind?
Health plans in the Miami market have the opportunity to expand Medicare and Medicaid enrollment. What are the prospects for health plan enrollment growth? Is the health insurance industry in this market consolidated? Are there any positive financial signs for health plans? What is Blue Cross and Blue Shield of Florida doing to gain a larger footprint in this market? What new employer contract has caused a major enrollment shift between carriers? What larger trend does this change reflect?
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: Miami market, which includes the counties of Miami-Dade and Broward
Primary Research: Analysis of HealthLeaders-InterStudy data, Billian’s HealthDATA, local and state news and industry reports and interviews with local healthcare executives
Miami Market
- Market Indicators
- Leading Organizations
- Market Stage
Management Summary
Health Systems & Hospitals
- HCA East Florida Division
- Description
- News and Analysis
- Memorial Healthcare System
- Description
- News and Analysis
- Baptist Health South Florida
- Description
- News and Analysis
- Jackson Health System
- Description
- News and Analysis
- Other Health Systems and Hospitals
Physicians
- University of Miami Medical Group
- Cleveland Clinic Florida
- Holy Cross Medical Group
- Additional Physician Organizations
Health Plans
- UnitedHealth Group
- Aetna
- Humana
Medicaid/Medicare/Uninsured
- Medicaid
- Medicare
- Uninsured
Pharmacy
Legislation
Employers
Demographics & Statistics
- UnitedHealth Group
- Aetna
- Humana
- University of Miami Medical Group
- Cleveland Clinic Florida
- Holy Cross Medical Group
- HCA East Florida Division
- Memorial Healthcare System
- Baptist Health South Florida
- Jackson Health System
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