These groups were formed and have expanded primarily to contract with managed care organizations. The formation of PHOs by hospitals and their physician staffs imposes an organizational structure on these physician sub-markets.Ī small number of statewide physician groups exist in Arizona, including the Thomas Davis Medical Centers, which has 217 physicians, 75 of whom are in Phoenix Casa Blanca, with 79 physicians and Arizona Physicians Group, which has 35 physicians. Like the health system market, the physician market may be described broadly as a set of geographically separated sub-markets specific to individual hospitals. The physician market in Phoenix historically has been organized around solo and small-group practices, with only a handful of larger groups. However, the proposed acquisition by Columbia/HCA of not-for-profit Samaritan generated substantial opposition from community leaders. The Phoenix market is attractive to for-profit hospital systems, in part because of its growing population and the large number of independent hospital-based health systems located there. It participated in merger discussions with Samaritan Health Systems and reportedly has approached other hospitals with acquisition offers. Tenet/OrNda has the largest for-profit presence in the Phoenix hospital market, with four hospitals:Īnother national for-profit hospital system, Columbia/HCA, owns two hospitals in Phoenix and is attempting to increase its presence there. The next-largest hospital in central Phoenix, the 474-bed Maricopa Medical Center, is owned by the county and primarily serves the indigent population and AHCCCS beneficiaries. Josephs Hospital and Medical Center and the nationally known Barrow Neurological Institute, competes with Samaritan for central Phoenixs tertiary care market. Mercy Healthcare Arizona, which includes the 570-bed St. It owns Arizona Physicians IPA, the largest AHCCCS contractor in Phoenix, and HealthPartners Health Plans, which serves 180,000 private sector enrollees statewide and is cosponsored by Tucson Medical Center. Samaritan has been the most active of the health care systems in developing health plans. In addition, Samaritan operates three hospital-based ambulatory surgery centers and three freestanding ambulatory surgery centers in a joint venture with Columbia/HCA. The Samaritan system includes two rural hospitals (one owned and one managed by the system), two family health centers, two skilled nursing facilities and a variety of other programs and facilities. Thunderbird Samaritan Medical Center, with 221 beds.Maryvale Samaritan Medical Center, with 213 beds and.Desert Samaritan Regional Medical Center, with 331 beds.Its flagship hospital, 582-bed Good Samaritan Regional Medical Center, is in central Phoenix, and it has three hospitals in the suburban areas: Samaritan Health System is the largest health system in the state and the most geographically dispersed system in the Phoenix area. Although a substantial amount of tertiary and specialized care is provided in downtown Phoenix, many suburban hospitals also deliver tertiary care because of the markets large geographic size. Phoenixs hospital market does not follow the "hub and spoke" configuration common to many older cities, where large tertiary care hospitals are located in the downtown area and the less technologically equipped institutions are found in the suburbs or surrounding communities. Phoenix is home to 35 hospitals, including federal government, psychiatric and rehabilitation facilities, most of which are not-for-profit and locally owned.
Although respondents believed this situation to be relatively stable in the short term, many predicted increased consolidation among hospital systems and the emergence of more physician networks over time. Some provider systems view themselves as indispensable to plans because of their dominance in geographic sub-markets. Health plans are perceived as powerful but not dominant in this market.
In particular, several provider systems have been able to carve out strong positions in geographic sub-areas of Phoenix, although the local health care market as a whole is not highly concentrated at either the health plan or the provider system level. Case Study hoenixs rapid and geographically dispersed growth has supported the entry and development of multiple health plans and systems.
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