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Emerging Health Care Market Trends: Insights from Communities

pdf Monday, Dec. 10, 2001
9 a.m. - 3:15 p.m.
Registration and coffee at 8:30 a.m.
The Grand Hyatt Hotel
1000 H Street, N.W.
Washington, D.C.

With the retreat from tightly managed care in full swing and health care costs sharply on the rise, policy makers again will face tough trade-offs over access, costs and quality of care. Add a weakening economy to the mix, and the outlook for American health care—often lauded as the finest in the world—seems bleak at best. This conference promises to offer real-world insights about emerging local market trends that policy makers should have on their radar screens as they grapple with these tradeoffs

The conference will bring together HSC researchers and local and national experts to explore trends identified on HSC's recent site visits, including how health plans and employers are responding to rising costs, providers' flight from risk contracting, resurgence of the medical arms race, resilience of the safety net and interactions between local markets and Medicare+Choice.

HSC visits 12 nationally representative communities every two years to track how the health system is changing. The communities include: Boston; Cleveland; Indianapolis; Lansing, Mich.; Little Rock, Ark.; Greenville, S.C.; Miami; northern New Jersey; Orange County, Calif.; Phoenix; Seattle; and Syracuse, N.Y.


9-9:15 A.M.


Paul B. Ginsburg, HSC President, and Cara S. Lesser, HSC Director of Site Visits

9:15-10:30 A.M.

Managing Care and Costs: Perspectives from Plans and Employers
  • An Empty Toolbox? Changes in Health Plan Approaches for Managing Costs and Care, Glen P. Mays, Mathematica Policy Research, Inc.
  • As managed care cost-containment efforts decline, plans are reducing benefits and shifting costs to consumers.
  • Managing Costs, Managing Benefits: Employer Decisions in Local Health Care Markets, Jon B. Christianson, University of Minnesota
  • Employers led the charge into managed care but then demanded changes that weakened its hold on costs and quality, leaving them in a bind as health care costs increase and labor markets slacken.
Brian Ancell, Premera Blue Cross, Seattle, and Joe Reilly, Aon Consulting, New Jersey


Providers' Response to the Retreat from Managed Care
  • Risk Contracting Reconsidered, Lawrence P. Casalino, University of Chicago
  • Burned by financial losses, some providers are abandoning risk contracting altogether, while others now are sharing risk with health plans.
  • The Return of the Medical Arms Race, Linda R. Brewster, consultant to HSC
  • Instead of competing on price, hospitals again are competing over specialty physicians, services and facilities, prompting a new medical arms race.
J. B. Silvers, Case Western Reserve University, Cleveland, and Ellen Zane, Partners Community Health Care, Inc., Boston

Noon-1 P.M.


Keynote Speaker: Janet M. Corrigan, Board on Health Care Services, Institute of Medicine, National Academy of Sciences

1-2 P.M.

Effects of Market Change on the Safety Net
  • The Resilience of the Health Care Safety Net, Laurie E. Felland, HSC Research Analyst
  • Despite dire predictions and some notable exceptions, the nation's overall safety net has expanded in recent years and stabilized financially, but new pressures are looming.
Bruce Bragg, Ingham County Health Department, Lansing, Mich., and Marion Lewin, formerly with the Institute of Medicine

2-3:15 P.M.

Medicare+Choice and Local Markets
  • Medicare Risk Contracting: A Lifecycle View from Local Markets, Robert E. Hurley, Virginia Commonwealth University
  • Recent turmoil in Medicare+Choice has demonstrated the complexity of relying on private organizations and local markets.
Brian Jeffrey, PacifiCare, Orange County (invited); Mark Miller, Congressional Budget Office; and William Scanlon, General Accounting Office

Panels moderated by Paul Ginsburg and HSC Vice President Len Nichols


Emerging Health Care Market Trends

Insights from Communities Conference Transcript


Private Coverage


Public Coverage



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The Center for Studying Health System Change Ceased operation on Dec. 31, 2013.