As hospitals collide, who will come out ahead?(Industry Overview)

With more than 70% of area hospitals aligned with three major systems, the battle is now under way for market dominance.

Although BJC Health System leads in total patient days of care and in occupancy rates, other factors, including profitability, geographic location, services, and insurance, will determine which system will lead the pack.

Unity Health Network, for example, has strong finances, is less dependent on government insurance payments than its rivals and holds a large share of the maternity business, a key to holding on to patients in the long run. Unity, however, lacks full geographic coverage and a major organ transplant program.

BJC, Unity and the St. Louis Health Care Network, which is under the SSM Health System, are the area's hospital network giants.

"We are witnessing a major revolution in health care," said Susan Feigenbaum, an economics professor at the University of Missouri-St. Louis who specializes in health care. "It will be interesting to see, when the smoke clears, who the survivors are."

BJC is out in front in terms of local market share, based on total patient days, with 31%. Unity follows closely, with 27%, and SSM trails at 15%, according to the St. Louis Business Health Coalition, which tracks hospital costs for major companies here. A patient day is one patient spending one day in a hospital.

There are several key indicators to evaluate which system will thrive in the coming years, experts say. They include: …