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(HealthNewsDigest.com) – In July 2010, a team of researchers from the Center for Studying Health System Change (HSC), as part of the Community Tracking Study (CTS), visited the Phoenix metropolitan area to study how health care is organized, financed and delivered in that community. Researchers interviewed more than 45 health care leaders, including representatives of major hospital systems, physician groups, insurers, employers, benefits consultants, community health centers, state and local health agencies, and others. The Phoenix metropolitan area encompasses Maricopa and Pinal counties.
After more than a decade of rapid population growth and a thriving economy, Phoenix’s once-booming health care market has adopted a more cautious outlook amid the lingering effects of the great recession. Job losses and the subsequent loss of employer-sponsored health insurance, along with a high rate of home foreclosures, have adversely affected many Phoenix residents. At the same time, employers, especially small firms, and health plans continued to search for ways to reduce health insurance premiums. In response, hospitals and physicians increasingly were rethinking expansion plans and seeking closer collaborations.
Against this backdrop of new-found provider caution, significant state-level attention to illegal immigration and a state budget crisis have sparked changes across the area’s health care system. State laws enacted over the past few years reportedly have led many immigrant families to either leave Arizona or go underground, avoiding interaction with public agencies and health care providers and programs. At the same time, the state is struggling to close the wide gap between declining tax revenue and rising public program costs, leading to reductions of public health coverage that could drive the area’s already high rate of uninsurance even higher.
Key developments include:
The ongoing state budget crisis has led to an enrollment freeze for most childless adults in the state’s innovative Medicaid program, which had extended coverage to low-income residents without children and incomes up to 100 percent of poverty, or $10,830 for a single person in 2010.
Hospitals and physicians increasingly were aligning either through contractual or employment arrangements, a sharp change for the historically highly independent medical profession.
The health plan market remained relatively fragmented, fostering some price competition as employers regularly switch carriers to achieve even small savings. Other than developing products with more patient cost sharing, health plans showed little innovation in payment methods or quality improvement.
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