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Analysis

Under M&A Pressure, System Launches Medicare Advantage Plan

By Gregory A. Freeman  
   April 18, 2018

A not-for-profit health system in Florida is launching its own Medicare Advantage plan. The local market has plenty of competition but the system sees the health plan as the right move.

With innovation and bold ideas driving boardroom decisions lately, health care provider BayCare Health System in the Tampa Bay area is launching its own Medicare Advantage (MA) plan despite strong competition and potential market saturation.

The move is another example of how players in the healthcare industry are feeling pressure to expand, combine, merge, and evolve.

BayCare Health System will launch BayCare Plus in January 2019, partnering with Lumeris to manage the day-to-day operations.

The health system is located in one of the nation's fastest growing Medicare markets, but that market also is near saturation, says Jim Beermann, president of BayCare Select Health Plans.

Beermann estimates there is 45% market penetration for MA, making the Tampa Bay area one of the more competitive markets in the country. No single plan dominates the market, however.

Despite the substantial competition, BayCare's analysis still indicated that a new MA plan was the right choice.

"The Tampa Bay and Polk County areas we serve have more than 800,000 Medicare-eligibles who live here full time, and that doesn't even count the snowbirds," Beermann says. "For a system of our size, with 15 hospitals and numerous employed physicians, close to half of our services is providing care to the Medicare population."


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Beermann notes that BayCare Plus will not be a BayCare narrow network.

It will contract with other significant health systems and hospitals in the area, he says, and the MA plan will not set up tiered benefits to drive volume to its higher-cost facilities in the market.

Gregory A. Freeman is a contributing writer for HealthLeaders.


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