The Boston market is on the cusp of a dynamic shift in power with two major mergers shaking up the landscape for the first time in decades. A merger creating Beth Israel Lahey Health is completing its first year, and the state is reviewing a proposed merger between two nonprofit insurers that will give market leader Blue Cross Blue Shield of Massachusetts new competition it has never experienced. Payment reform initiatives are well established and extensive in Boston, but challenges still remain. The market embraces value-based care and boasts a healthy population and some of the highest-quality care in the nation, but it also has high prices and above-average hospital utilization and readmissions rates. The MassHealth Medicaid program also drives reform as it implements a multibillion-dollar overhaul of the Medicaid program that moved most members into ACO plans. Look for drug companies to alter spending habits as a new drug pricing review law forces drug companies to provide more transparency around prices and price increases. Expect this new oversight to build as lawmakers look to additional legislation and regulatory proposals impacting drug pricing.

Related Reports

Hartford | Connecticut | 2020 | Market Overview (Event Driven)

Market Outlook: Consolidation, integration, and collaboration continue to drive change at a rapid pace in the Hartford market. Hartford HealthCare remains the dominant health system be...

View Details

Las Vegas | Nevada | 2020 | Market Overview (Event Driven)

While Las Vegas hospitals grow incrementally, the impact of the COVID-19 pandemic threatens to hurl the market back into a recession, and the last recession took longer to end in the Las Vegas market...

View Details

Louisville | Kentucky | 2020 | Market Overview (Event Driven)

The Louisville market is a battleground for the three largest health systems, which are consolidating into integrated delivery networks. University of Louisville Health’s acquisition of KentuckyOne He...

View Details

Raleigh | North Carolina | 2020 | Market Overview (Event Driven)

The rapid spread of COVID-19 is threatening health systems and physicians in the Raleigh market with new financial challenges that will impact growth strategies in the near term. Although the market’s...

View Details