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Market Analysis and Satellite Clinic Opportunity Assessment

Planned Parenthood League of Massachusetts - Springfield. Market Analysis and Satellite Clinic Opportunity Assessment. April 2, 2002. Danielle A. Dyer 41 Cliffwood Street Lenox, MA 01240 413-637-4481 danielle.dyer@verizon.net. Agenda. I. Review Project Objectives and Methodology

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Market Analysis and Satellite Clinic Opportunity Assessment

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  1. Planned Parenthood League of Massachusetts - Springfield Market Analysis and Satellite Clinic Opportunity Assessment April 2, 2002 Danielle A. Dyer 41 Cliffwood Street Lenox, MA 01240 413-637-4481 danielle.dyer@verizon.net

  2. Agenda I. Review Project Objectives and Methodology II. Review PPLM-Springfield Market Analysis Define current service area Identify unique characteristics of current market Review competitive assessment Discuss implications III. Review Satellite Clinic Opportunity Assessment Agree on assessment criteria Identify potential target markets Discuss summary assessment IV. Identify Next Steps

  3. Current Operating Environment Significant Medicaid payer mix creating operating margin pressure Juggling steadily increasing patient volumes in increasingly insufficient space Limited marketing presence due to limited ability to handle additional volume growth Sub-optimal service levels due to limited numbers of clinic sessions and extended access times I. PROJECT OBJECTIVES The purpose of PPLM’s market analysis study is to both establish a baseline set of market demographic data that will enable the on-going development of more accurate financial projections, and to identify the potential opportunity to open a satellite clinic designed to off-set Springfield operating costs.

  4. I. PROJECT ANALYSES: Sources of Data • PPLM - Springfield volume data by zip code for FY01 clustered by town and region • US Census 2000 data for zip codes associated with 2001 PPLM - Springfield visits for both GYN and AB broken out into 4 regional areas • Berkshires (approximates Berkshire County) • Pioneer Valley (approximates Hampshire and Franklin Counties) • Springfield (approximates Hampden County) • Central (approximates western Worcester County) • Census 2000 data for 4 Counties in Western Massachusetts • Berkshires • Franklin • Hampshire • Hampden • Data from Massachusetts Department of Public Health and the MassCHIP (Community Health Information Profile) database • Interviews with College health services staff, physicians, community clinic staff, internet research

  5. I. DEMOGRAPHIC ANALYSES: Definition of Regions PPLM volume data was grouped into five regional market areas consisting of a series of towns that were “clustered” together based on geographic proximity and travel patterns. • Springfield* • Chicopee area • East Hartford area • Enfield area • Forest Park area • Hartford, CT area • Longmeadow area • Route 19 • Route 20 west • Route 90 east • Springfield zip 09 • Springfield East • Springfield River • West Springfield • Berkshires • Adams area • Berkshire Central towns • Berkshire South towns • Pittsfield area • Pioneer Valley • Amherst area • Greenfield area • Holyoke area • Northampton area • PV East area • PV North area • PV West area Zip data source: PPLM volume data from Medical Manager. * Local Springfield market represents PPLM’s primary service area with nearly 70% of total visits. Note: Volume attributed to “Other” towns was excluded from the demographic analyses.

  6. II. MARKET ANALYSIS: Summary • Service Area Characteristics • PPLM volume is driven by its ABT services and by its strong local presence in the Springfield market (nearly 70% of volume) • PPLM attracts a more racially diverse population than the overall regional populations it serves • The typical PPLM patient is single and between the ages of 20 - 29 • Medicaid and Self pay are the predominant PPLM payers • Access to public bus transportation: • Clustered around the major towns/cities • Available regionally for a nominal or no cost • Most rural area residents are accustomed to driving greater distances for even routine services • Competitive Landscape • PPLM is the dominant Western Massachusetts ABT provider, but there is competition from clinics in Hartford area • More competition for GYN services from MD practices, College Health Centers, Tapestry and other Clinics across the region • Least amount of competition in Berkshire region, but smaller market than more competitive but well-structured Pioneer Valley market • Opportunity to grow both GYN and ABT volume in Springfield market through relationship/awareness-building initiatives

  7. II. MARKET ANALYSIS: Current Volume Distribution PPLM’s Springfield clinic volume is driven primarily by terminations. . . Source: PPLM Medical Manager Note: Total Visits include patients seen for both GYN and AB

  8. ABGynTotal Total Volume: 2,375 1,115 3,530 Percentage: 67% 33% II. MARKET ANALYSIS: Service Area . . . and its primary service area is the local Springfield market. 66% 34% 70% 86% 30% 58% 42% 14% 74% 26% Data Source: Medical Manager Note: excludes double-counted GYN/AB volume

  9. II. MARKET ANALYSIS:Race and Ethnicity Key Findings • The overall population of Western MA is predominantly (>75%) White • The population seen by PPLM is significantly more diverse than the population overall • The Springfield region is the most diverse market and the Berkshire region is the least diverse • Racial/ethnic characteristics of the Springfield Region include: • 75% of the population is White, yet only 47% of PPLM’s AB patients and 58% of GYN patients are White • 11% of the population is African American, while 22% of PPLM’s AB patients and 19% of GYN patients are African American • 10% of the population is Hispanic/Latino, while 24% of PPLM’s AB patients and 17% of GYN patients are Hispanic /Latino • Future marketing efforts, and perhaps in-office services (e.g. bilingual staff, multi-lingual literature etc.) should begin to reflect the racial/ethnic diversity in the Springfield market.

  10. II. MARKET ANALYSIS: Race/Ethnicity PPLM’s attracts a slightly more racially diverse mix of patients for its AB services, than for its GYN services. Total GYN Volume by Race/Ethnicity Total AB Volume by Race/Ethnicity Data Source: PPLM Medical Manager 2001

  11. II. MARKET ANALYSIS: Berkshire Race/Ethnicity AB volume is more racially/ethnically diverse in each regional market . . . Notes: *Includes American Indian or Alaska Native, Native Hawaiian or Other Pacific Islander and Other Single Race Data Source: Census 2000 Summary File 1 (SF 1) 100-Percent Data and PPLM Medical Manager

  12. II. MARKET ANALYSIS: Pioneer Valley Race/Ethnicity The Pioneer Valley contributes the largest proportion of Hispanic volume to PPLM’s patient mix. Notes: *Includes American Indian or Alaska Native, Native Hawaiian or Other Pacific Islander and Other Single Race Data Source: Census 2000 Summary File 1 (SF 1) 100-Percent Data and Medical Manager

  13. II. MARKET ANALYSIS: Springfield Region Race/Ethnicity Springfield-based PPLM volume reflects the more ethnically diverse market population. Notes: *Includes American Indian or Alaska Native, Native Hawaiian or Other Pacific Islander and Other Single Race Data Source: Census 2000 Summary File 1 (SF 1) 100-Percent Data and Medical Manager

  14. II. MARKET ANALYSIS:Age Distribution Key Findings • Over 60% of visits for both Gyn and AB are from women 20-29 years of age and the majority of those are within 20-24 years of age • There is no significant difference in the age distribution across regions in terms of patient volumes… • …although, because of the large college student population, the Pioneer Valley region has the largest proportion of 20-24 year olds.

  15. II. MARKET ANALYSIS: PPLM Volume Age Distribution Data Source: PPLM Medical Manager

  16. II. MARKET ANALYSIS: Berkshire Region Age Distribution Data Source: Census 2000 Summary File 1 (SF 1) 100-Percent Data and Medical Manager

  17. II. MARKET ANALYSIS: PV Region Age Distribution Data Source: Census 2000 Summary File 1 (SF 1) 100-Percent Data and Medical Manager

  18. II. MARKET ANALYSIS: Springfield Region Age Distribution Data Source: Census 2000 Summary File 1 (SF 1) 100-Percent Data and Medical Manager

  19. II. MARKET ANALYSIS:Family Composition Key Findings • 83-85% of PPLM’s patients are single • There is little difference in marital status between Gyn and AB patients or between regions • Over 58% of the women in Western Massachusetts colleges are in the Pioneer Valley

  20. II. MARKET ANALYSIS: PPLM Volume Marital Status Single women clearly dominate the PPLM-Springfield patient base, regardless of service line. Total GYN Volume by Marital Status Total AB Volume by Marital Status Data Source: Medical Manager

  21. II. MARKET ANALYSIS: College Population Because of the five college network in the Pioneer Valley, Hampshire County is the home of nearly 14,000 women students, most of whom are single and between the ages of 18-22. Source: 2001 Massachusetts College directories

  22. II. MARKET ANALYSIS: Payer Mix Key Findings • There is a significant difference in payer mix by region as well as by PPLM service • Almost half (48%) of GYN payers are self-pay and only 23% of AB payers are self-pay. 47% of AB patients are Medicaid while only 31% of Gyn patients are Medicaid • Identify opportunities to build “repeat” AB/GYN volume rather than having 2 separate streams of volume • While Berkshire County has proportionately more Commercial payers and slightly less Managed Care, it also has more Medicare volume because of its retirement community population • In every regional area, PPLM attracts disproportionately more Medicaid and Self-Pay volume relative to the market… • . . .There is an opportunity to focus on growing Commercial and Managed Care volume in both service lines.

  23. II. MARKET ANALYSIS: PPLM Volume payer Mix PPLM’s GYN volume is dominated by Self Pay patients whereas its AB volume is dominated by Medicaid patients, suggesting two separate streams of volume. Total GYN Volume by Payer Total AB Volume by Payer 52% 53% 52% Source: 2001 Medical Manager visit data

  24. II. MARKET ANALYSIS: Berkshire Region Payer Mix PPLM has attracted proportionately more GYN managed care and commercial volume from the Berkshires than other regions. Data Source: County Data from the Department of Public Health Behavioral Risk Factor Surveillance System (BRFSS), and Medical Manager

  25. II. MARKET ANALYSIS: Pioneer Valley Region Payer Mix The Pioneer Valley patient base represents highest proportion of Self Pay patients in both service lines. Data Source: County Data from the Department of Public Health Behavioral Risk Factor Surveillance System (BRFSS), and Medical Manager

  26. II. MARKET ANALYSIS: Springfield Region Payer Mix Springfield volume is more distributed across payers than the other regions, but continues to be dominated by Medicaid and Self Pay volume. Data Source: County Data from the Department of Public Health Behavioral Risk Factor Surveillance System (BRFSS), and Medical Manager

  27. II. MARKET ANALYSIS: Public Transportation Public bus is available in the major Berkshire County towns running on the North-South axis. There is also limited taxi service available in Pittsfield. Hours of operation: daily Monday - Friday: 5:45 am-7:20 pm Saturday: 7:15 am-7:00 pm Sunday: No Service No Service: on holidays Cost: $.75 per ride Source: Berkshire County Transit Authority

  28. II. MARKET ANALYSIS: Public Transportation Public bus service is available in the Greenfield/Amherst area through Greenfield Montague Transportation. It runs between Greenfield, Amherst, Millers Fall, Montague, Turners Falls, Greenfield Community College, and UMass. Operation: Monday-Friday No Service: Weekends and on holidays Routes: wide variety of routes and schedules Cost: range from $1 - $2.50 per ride Source: Greenfield Montague Transportation Area Note: the map above represents only one of many routes.

  29. II. MARKET ANALYSIS: Public Transportation Pioneer Valley Transit Authority offers public bus service across the region. Operation: 7 days/weeks Routes: 43 bus routes across the Pioneer Valley Cost: range from $1 - $.75 per ride; discount passes also available Source: PVTA

  30. II. MARKET ANALYSIS: Public Transportation The UMass Transit Service offers a “no fare” shuttle bus service that serves approximately 19,000 passengers everyday. Source: UMass Transit Service

  31. II. MARKET ANALYSIS: Public Transportation The following map illustrates in blue and yellow those areas of Springfield that have easy access to public transportation. Easy access is defined as no more than a one-half mile walk from a bus route. These services are offered by a variety of public bus lines across the region. Source: Federal Transit Administration and Synergos Technologies, Inc

  32. II. MARKET ANALYSIS: Summary Competitive Assessment • PPLM has little competition for AB volume in Western Massachusetts as it currently provides over 80% of the AB services in the area • The proportion of hospitals and MD practices providing AB services is shrinking somewhat • AB competition is most intense in the Hartford area which will limit PPLM’s ability to increase its draw from south of Springfield • OB/GYN and Family Practice providers are widely distributed throughout Western Massachusetts and those who offer AB services, do so only for their existing patient base • College Health Centers vary in the scope of services provided with Springfield area college health centers being the most limitedand the Pioneer Valley colleges being the most comprehensive • Tapestry Clinics are located in all key western Massachusetts markets with a primary focus on the MassHealth and self-pay market segments

  33. II. COMPETITIVE ASSESSMENT: ABT Volume PPLM – Springfield accounts for over 80% of the ABT volume. This volume has grown slightly over time, while hospitals continue to exit the ABT market. Source: 1997-2000 Massachusetts Abortion Tables, Dept of Public Health

  34. II. COMPETITIVE ASSESSMENT: ABT Volume While total ABT volume was down slightly in 2000, PPLM has an opportunity to continue to grow market share as both Berkshire Medical Center and NE Permanente are no longer offering ABT services. Source: 1997-2000 Massachusetts Abortion Tables, Dept of Public Health

  35. II. COMPETITIVE ASSESSMENT: ABT Providers Of the over 35 OB/GYN physician practices in Western Massachusetts, only five groups offer ABT services and almost exclusively only to patients currently in their practice. Source: telephone interviews, directories, internet research

  36. II. COMPETITIVE ASSESSMENT: ABT Providers There are 3 other ABT Clinic providers with whom PPLM-Springfield “competes” for volume: Source: telephone interviews, directories, internet research

  37. II. COMPETITIVE ASSESSMENT: Tapestry Services Tapestry Health Services competes for PPLM’s GYN and family planning volume and, based on interviews, enjoys higher name recognition. Tapestry is organized regionally and operates 10 clinics across Western Massachusetts. Source: telephone interviews with Tapestry staff, College Health services, other clinicians and internet research

  38. II. COMPETITIVE ASSESSMENT: Five College Health Services Hampshire County colleges account for over 14,000 female students. While the “Five College” network provides comprehensive Women’s Health services to their student populations, it is valuable to establish close ties to each Health Service to strengthen referral relationships and build awareness. Source: telephone interviews, directories, internet research

  39. II. COMPETITIVE ASSESSMENT: Five College Health Services (con’t) Source: telephone interviews, directories, internet research

  40. II. COMPETITIVE ASSESSMENT: College Health Services Springfield area colleges offer limited on-campus health services and often confuse PPLM with Tapestry Health Services to whom many refer their GYN patients. With over 6000 female students enrolled in Hampden County colleges, building close ties to these institutions could represent a source of additional volume growth for PPLM. Hamden County College Health Services Source: telephone interviews, directories, internet research

  41. II. COMPETITIVE ASSESSMENT: College Health Services There are over 4,400 female students enrolled in Berkshire County colleges. Only the approximately 1200 women at Williams and Simon’s Rock Colleges can access comprehensive health services on campus; all others must find “off campus” providers Berkshire County College Health Services Source: telephone interviews, directories, internet research

  42. Berkshire County: Pittsfield: Hillcrest Family Health Center 510 Medical Walk-In Center Pregnancy Support Services of Berkshire County Franklin County: Greenfield Community Health Center of Franklin County Hampden County Springfield: Brightwood Health Center Mason Square Neighborhood Health Center II. COMPETITIVE ASSESSMENT: Other Clinic Services Typical Services • Staffed by mix of MDs, nurse practitioners, RNs etc. • Offer primary care/family health services to lower income patients (predominantly women, adolescents and families) • Accept MassHealth and other insurers; offer sliding fee scale • Typical clinic services: HIV, STD, TB, diabetes, basic GYN and family health, early childhood care etc. • Refer to PPLM, Hartford and private MD groups for ABT services

  43. II. MARKET ANALYSIS: Summary Implications • PPLM clearly dominates the AB market north of Hartford, but… • …Expect competition to increase from 2 Hartford clinics which now accept MassHealth for ABTs only • There is an opportunity to fill the gap from both Berkshire Medical Center and NE Permanente market exits, but it will require improved name recognition and relationship building in the Berkshire and Pioneer Valley regions • It will be important to counteract Tapestry’s efforts to establish stronger relationships with College Health Services in Springfield and Pioneer Valley • Focus marketing on key objectives: • Differentiate from Tapestry Clinics throughout western Massachusetts • Target college student population in local Springfield market who have limited on-campus health services • Increase awareness North and West of local Springfield market with other college health centers, physician practices, local community clinics • Target market to specific ethnic groups (i.e. Hispanics and Asians)

  44. Attract strong payer mix to off-set increased operating expenses in Springfield Extend reach into new market with limited set of services Offer high volume/high margin services and leverage Springfield clinic for ABTs Size of market Demographics Payer mix Competitive landscape Unique market opportunities III. SATELLITE CLINIC: Overview PRELIMINARY EVALUATION CRITERIA OBJECTIVES

  45. III. SATELLITE CLINIC: Current Service Area PPLM has an opportunity to expand further into Western Massachusetts by opening a satellite clinic in either the Pioneer Valley or Berkshire region. 69% 21% 6% 3% 1% Data Source: Medical Manager Note: excludes double-counted GYN/AB volume

  46. III. SATELLITE CLINIC: County Population While Berkshire and Hampshire Counties are similar in size, they differ somewhat in their demographic and demand profiles. 52% 53% 52% 52% Data Source: Census 2000 Summary File 1 (SF 1)

  47. III. SATELLITE CLINIC: County Race/Ethnicity Hampshire County is slightly more ethnically diverse than Berkshire County. RACE 52% 52% Note: Other single race includes: American Indian or Alaska Native, Native Hawaiian or Other Pacific Islander, other single race, and two or more races Data Source: Census 2000 Summary File 1 (SF 1)

  48. III. SATELLITE CLINIC: County Age Distribution The large College population in the Pioneer Valley region drives the disproportionately large base of 18-24 year old women in that area. 52% 53% 52% 52% Data Source: Census 2000 Summary File 1 (SF 1)

  49. III. SATELLITE CLINIC: County Payer Mix Berkshire County has a slightly more favorable payer mix because of lower managed care and higher commercial penetration. Payer Mix 52% 53% 52% Note: Other includes VA, Indian, and Other Data Source: County Data from the Department of Public Health Behavioral Risk Factor Surveillance System (BRFSS),

  50. III. SATELLITE CLINIC: Market Demand Hampshire County demand for contraceptive services is higher than in Berkshire County. . . 1990 1995 1990 1995 1990 1995 1990 1995 Berkshire County Franklin County Hampden County Hampshire County Source: MassCHIP (Community Health Information Profile database

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