Lexington, KY Market Overview

Analyst: Chris Clancy

Report Summary

The Lexington market is taking its cues from competition among health systems and health plans in Louisville. Both UK HealthCare and Saint Joseph Health System have partnered with health systems in Louisville to address residents’ healthcare needs statewide. Louisville-based Humana remains the Lexington area’s largest managed care organization. Meanwhile, the state transitioned its Medicaid program to managed care, effective November 2011, creating an influx of three national health plans to Lexington and the rest of the Commonwealth.

Questions Answered in this Report

Competition is significant among the area’s top health systems. What is the overarching strategy of partnerships being formed by UK HealthCare and Saint Joseph Health System’s parent company Catholic Health Initiatives? Where does the concept of accountable care organizations stand among area health systems? Which health system has retail clinics located inside area Wal-Mart stores?

Despite pockets of physician independence, more physicians are expected to gravitate toward the region’s health-system heavyweights. Which health system has been on a physician hiring spree for much of the past decade? How will teaching programs be affected by health-system mergers and partnerships? What are the implications of Kentucky’s transition to managed Medicaid for local physicians?

Health plan enrollment growth may not be out of the question for carriers in 2012 because of the relative health of the Lexington economy. How will the changing provider landscape affect contract negotiations? Are consumer-driven health plans likely to see growth in 2012? What other benefit designs are local employers considering?

Metrics

Key market indicators and leading organizations among health systems, physicians and health plans
Health systems’ market share
Income, revenue, enrollment and pharmacy spend for leading health plans
Demographics

Scope

Lexington, which includes the counties of Bourbon, Clark, Fayette, Jessamine, Scott and Woodford

Primary Research
Analysis of HealthLeaders-InterStudy data, Billian’s HealthDATA, local and state news and industry reports and interviews with local healthcare executives

Select Companies Listed in the Report

• UK HealthCare
• Saint Joseph Health System
• Baptist Healthcare System
• The Physicians’ Network
• Lexington Clinic
• Baptist Physicians Lexington
• Humana
• WellPoint (Anthem Blue Cross and Blue Shield in Kentucky)
• UnitedHealth Group
• Kentucky League of Cities
• The Jockeys’ Guild