Local Organizations Retain Market Dominance:

Publication Date: January 1998

Publisher: Center for Studying Health System Change

Author(s): Claudia Williams; Jon B. Christianson; Christina A. Andrews; Raymond J. Baxter

Research Area: Health

Type: Report

Coverage: Ohio


In June 1998, a team of researchers visited Cleveland, Ohio, to study that community's health system, how it is changing and the impact of those changes on consumers. More than 50 leaders in the health care market were interviewed as part of the Community Tracking Study by Health System Change (HSC) and The Lewin Group. Cleveland is one of 12 communities tracked by HSC every two years through site visits and surveys. Individual community reports are published for each round of site visits. The first site visit to Cleveland, in June 1996, provided baseline information against which changes are being tracked. The Cleveland market includes the city of Cleveland and its suburbs.

In 1996, the Cleveland market appeared to be in turmoil. The community had experienced or was anticipating a number of high-profile mergers. Historic collaboration among providers had given way to competition, sparked by the market entry of two for-profit hospital systems. Local providers and plans, it seemed, were threatened. Yet, change in Cleveland did not materialize as expected. The proposed merger between Blue Cross and Blue Shield of Ohio and Columbia/HCA disintegrated. The three large local, not-for-profit institutions - The Cleveland Clinic, University Hospitals Health System (UHHS) and Medical Mutual of Ohio, the former Blue Cross and Blue Shield Plan - remain dominant.

After an active period of deal making, focus now seems to have shifted to internal organizational issues.