Miami | Florida | 2021 | Market Overview Brief

Miami’s healthcare market is defined by strategic partnerships, including narrow networks, integrated physician clinics, and IDN affiliations. Physician groups are committed to autonomy and independence, but clinical integration has taken root. HCA Healthcare specializes in inpatient and emergency care, while Baptist Health South Florida has adopted more of an innovator role, with specialty centers, urgent care clinics, and a new interest in artificial intelligence. Competition in the payer sector depends more on diversity, and the top managed care organizations have built market shares through playing in both the government-sponsored and commercial spaces. The market’s latest narrow networks, Florida Blue’s Truli plan and Oscar’s new Medicare Advantage plan, both have Memorial Healthcare System and Holy Cross Health at their core. Medicare Advantage’s capitated payments have introduced many physicians to risk-bearing agreements and quality metrics they may not have otherwise engaged in. Expect physicians’ interest in capitation to grow due to COVID-19, which may push independent physicians toward larger organizations that can offer support navigating value-based care.