Kansas City has traditional tendencies in healthcare delivery, with pockets of innovation in the payer space. HCA Midwest Health leads the health system sector, and the IDN has a fee-for-service approach to payment that has helped it stay at the top of the sector year over year. The physician sector is the market’s key driver of payment reform, engaging in ACO contracts as well as alternative payment models through the Centers for Medicare and Medicaid Services. Centrus Health is the market’s top clinically integrated network, and allows smaller players in the health system and physician space to coalesce and participate in payment reform. Centrus Health includes AdventHealth Shawnee Mission, whose small market share in 2020 is inverse to its potential. AdventHealth Shawnee Mission’s connection to one of the country’s largest IDNs may allow it to tap into financial resources to support growth. Expect AdventHealth to engage in merger and acquisition activity and take advantage of a moderately consolidated health system sector to boost its market share. The payer sector is not so consolidated as to preclude competition, though there are dominant players, like Blue KC. New entrants and plans have come into the fore in the payer sector, including Oscar Health and Blue KC’s Spira Care plan, which is moving onto the individual exchange for 2021. UnitedHealthcare is a major carrier of consumer-driven health plans in the market, and employers who want to manage health care costs going into 2021 may turn to UHC for a solution. Kansas City payers have been responsible for one of the most innovative trends in Kansas City healthcare delivery in recent years: Payer-owned primary care clinics acting as the first point of contact for patients. Blue KC enjoyed enrollment growth in its Spira Care plan, which uses Blue KC’s Spira Care clinics, and Aetna is following suit with a new PPO that guides beneficiaries to CVS MinuteClinics.


Related Reports

Birmingham | Alabama | 2020 | Market Overview Brief

Birmingham, a statewide hub for specialty care, has historically been a slow-moving market from the perspective of value-based contracting. BCBS of Alabama is the power player and key driver of...

View Details

Birmingham | Alabama | 2020 | Market Overview

Birmingham, a statewide hub for specialty care, has historically been a slow-moving market from the perspective of value-based contracting. BCBS of Alabama is the power player and key driver of qua...

View Details

Grand Rapids | Michigan | 2020 | Market Overview

Healthcare in Grand Rapids is consolidating around Spectrum Health, Mercy Health, and Metro Health. Dominant insurer Blue Cross Blue Shield of Michigan continues to drive payment reform. The carrie...

View Details

Portland | Maine | 2020 | Market Overview

Consolidation is on the rise in Portland’s provider sector with a merger between MaineHealth and Mid Coast – Parkview Health, which has centralized decision-making about medical care an...

View Details