Amerigroup Media Kit.

Size: px
Start display at page:

Download "Amerigroup Media Kit. www.amerigroup.com"

Transcription

1 Amerigroup Media Kit Media Contact Maureen C. McDonnell Vice President External Communications and Health Reform Amerigroup Corporation

2

3 About Amerigroup Who We Are Amerigroup is the leading and largest publicly traded corporation that focuses solely on meeting the health care needs of financially vulnerable Americans. What We Do Amerigroup works exclusively through publicly funded programs such as Medicaid and Medicare. We have two goals. We help the financially vulnerable Americans we serve as well as seniors and people with disabilities to lead better, healthier and often more independent lives through preventive health care programs. And by helping them avoid unnecessary sickness, we help the state and federal governments that pay for Medicaid and Medicare save money. Who We Serve Amerigroup is a managed health care organization with more than 2.7 million members as of September 30, They live in Florida, Georgia, Louisiana, Maryland, Nevada, New Jersey, New Mexico, New York, Ohio, Tennessee, Texas, Virginia and Washington. Where We ve Been When Amerigroup was founded in 1994, we initially targeted the health problems of children, mothers and pregnant women enrolled s that address diseases and conditions common to them, including asthma, diabetes and inadequate prenatal care. Amerigroup expanded rapidly and became a publicly traded corporation in fall In 2005, Forbes magazine named Amerigroup one of America s Best Managed Companies. Amerigroup was also ranked No. 1 as top insurer by Modern Healthcare magazine for Best Places to Work in Healthcare. Where We re Going In recent years, spending on Medicaid has accelerated rapidly ($908 billion by 2020), and governments increasingly have turned to Amerigroup to help control costs. Amerigroup now serves a more diverse and seriously ill group of people including Supplemental Security Income-eligible recipients and seniors and people with disabilities addressing complex physical and psychological illnesses. In 2006, Amerigroup also entered the Medicare Advantage program, serving older, low-income people who are eligible for both Medicare and Medicaid through Special Needs Plans. In 2007, we began operation of traditional Medicare Advantage plans. Current Medicare expenditures are projected to hit $922 billion in Today, Amerigroup is the country s eighth largest publicly traded health care company, ranks No. 385 on Fortune magazine s list of America s 500 largest publicly traded corporations and was named among the Most Admired Companies by the magazine. In 2008, for the fourth time, Forbes magazine named Amerigroup one of America s Best Big Companies. Table of Contents About Amerigroup 1 National Advisory Board 2 Dual Eligibles Fast Facts 3 Risk-based Managed Care 4-5 Healthy Communities 6 Remote Area Medical 7 Childhood Obesity Prevention 8 Real Story: Lorri 9 Executive Bios

4 National Advisory Board National Advisory Board Members In 2007, Amerigroup developed a first for the health care industry: a National Advisory Board (NAB) focused solely on meeting the needs of seniors and people with disabilities a significant population within our membership. Convened by Lex Frieden, who was instrumental in conceiving and drafting the landmark Americans with Disabilities Act of 1990, the NAB is comprised of culturally diverse community advocates, health care experts and academics. They represent millions of Americans with disabilities and seniors and their family members, who have struggled with the complexities of our fragmented health care system. Individually and collectively, they have worked to overcome the many hurdles to obtain the services needed to live successfully in our communities hurdles such as the lack of coordination between acute and long-term services and supports, antiquated systems and policies, and lack of infrastructure development for long-term services. A Call to Action In April 2009, the NAB developed a white paper, A Declaration for Independence: A Call to Transform Health and Long-term Services for Seniors and People With Disabilities. This call to action is designed to bring attention and fuel change based on the principles of transforming and modernizing our health care system, including ways to address the long-term needs for services and supports needed by people with disabilities and those who are aging. The white paper outlines the following Six Foundational Principles required to meet the needs of people with disabilities and seniors, as follows: 1. Enhance Self-care Through Improved Coordination Transform America s health care system from one that focuses on episodic illnesses to one that assists individuals in self-managing their whole health, with the support of providers and communities 2. Encourage Community Integration and Involvement Coordinate support services, housing and transportation so people are able to participate in the social, economic, educational and recreational activities available through community living 3. Expand Accessibility to Services and Supports Retool programs and regulations to enable people to access the services they need to live independently without creating financial hardship for the family 4. Uphold Personal Preference Leverage the success of long-term service models that promote personal strengths and preferences and preserve the dignity of participants 5. Empower People to Participate in the Economic Mainstream Encourage the employment of people with disabilities and seniors by removing disincentives for people to work and redefine antiquated descriptions of disability 6. Invest in Improved Technology Invest resources in the continued development of technology that improves individuals abilities to self-monitor chronic health conditions and live independently The NAB advocates that the modernized health care infrastructure be required to meet the needs of people with disabilities and seniors. It will only come about as others (i.e., consumers, the medical community, policymakers, program directors, academics, health care organizations and human service providers) join in promoting the cause. 2 Use your smartphone to watch our video about the NAB. Get the free mobile app at / gettag.mobi

5 Dual Eligibles Fast Facts ABOUT DUAL ELIGIBLES More than 9 million Americans qualify for Medicare and are eligible for some level of Medicaid benefits. They receive health care in often fragmented settings from two distinct programs. Commonly referred to as dual eligibles, almost two-thirds are age 65 and older, are more likely to have a disability and are twice as likely to report poor health. Nearly half have family incomes below 100 percent of the Federal Poverty Level (FPL). There are two types of dual eligibles: Full Dual Eligibles Medicare beneficiaries who also qualify to receive full benefits offered by Medicaid and coverage of Medicare premiums and cost sharing Partial Dual Eligibles Medicare beneficiaries with somewhat higher household income who qualify for assistance with Medicare premiums and cost sharing through Medicaid programs known as Medicare Savings Programs Role of Medicare vs. medicaid Medicare Covers most acute care services and some long-term care services (e.g., nursing facility, home health and hospice) Medicaid Covers most long-term care services, provides some services that Medicare covers only in limited ways (e.g., vision, dental and transportation), and is responsible for some or all Medicare premiums and cost sharing Medicare Advantage Special Needs Plans Tailored health plans providing the full range of Medicare-covered services plus additional Medicaid services and lower out-of-pocket costs in a coordinated, person-centered setting reform focuses on dual eligibles Under health reform, the new Medicare Medicaid Coordination Office brings increased focus on ways to integrate care for dual eligibles. New demonstrations invite states to enter into three way partnerships with the Centers for Medicare & Medicaid Services and health plans to ensure the full spectrum of benefits and services are coordinated. Thirty-eight states expressed interest in participating, with 15 states selected to receive funding to support the design of programs to bring integrated care to dual eligibles in Right now, less than 15 percent of dual eligibles have access to comprehensive, coordinated care. Amerigroup serves 124,000 dual eligibles through Medicaid and Medicare Advantage across 8 states nationwide. 94% 9 Million Number of Medicare- Medicaid dual eligibles nationwide 15% Share of all dual eligibles who live below 200 percent of the FPL Medicare Medicaid Percent of Popula on Percent of dual eligibles in Medicare and Medicaid populations versus percent of costs $300 Billion Total government spending on dual eligibles. It makes up an oversized proportion of the Medicare and Medicaid programs total costs $434 Billion Percent of care for dual eligibles in coordinated care today 20% 200% Below FPL, or $22,000 Annually 15% 39% Percent of Cost 31% $330 Billion $300 Billion = 4,000 Dual Eligibles All Medicare All Medicaid Dual Eligibles 3

6 Benefits of Comprehensive Risk-Based Managed Care Comprehensive, risk-based managed care plans are the most prevalent type of managed care arrangements in Medicaid. This delivery model s success lies in improving quality of care, while also saving costs. The percentage of Medicaid enrollees in these programs has grown year over year. A recent report found that Medicaid enrollment in comprehensive risk-based programs increased to 47 percent of enrollees in 2009, up from 15 percent in Growth is expected to continue as 17 states expand their comprehensive risk-based managed care programs through These states include Texas and Louisiana, who have already switched to comprehensive risk-based managed care and overhauling their Medicaid programs. Two other states of the 17 are New Hampshire and Florida, which both have submitted requests for proposals for competitive bidding to switch many of their Medicaid participants over to risk-based comprehensive care. The fundamental idea behind the switch is (1) to improve access to care and coordination of care by ensuring enrollees have a medical home with a Primary Care Provider (PCP); and (2) to rely more heavily on preventive and primary care. Comprehensive, risk-based managed care plans offer case management programs that leverage technology and data to identify high-risk members who will benefit from hands-on, personal assistance. Using predictive modeling tools, data such as diagnoses, hospitalizations, emergency room encounters, expenditures and demographics are used to develop individualized risk profiles, allowing plans and providers to personalize care for each enrollee. States typically use a Managed Care Organization (MCO) model in which enrollees are assured access to a network of primary and specialty care providers. In the Medicaid Fee-For-Service (FFS) environment, Medicaid beneficiaries often lack access to a medical home, and turn to higher-cost and less coordinated sources of care, such as hospital emergency rooms. In other managed care approaches that employ the FFS payment delivery system, such as Administrative Service Organizations (ASOs) or Primary Care Case Management (PCCM), access to a medical home is highly variable, and the state reimburses providers according to each of the services rendered. Comprehensive managed care plans assume the financial risk, receiving a fixed monthly capitation rate to provide all or a defined set of covered services for each enrollee. This payment arrangement provides incentives to managed care plans that support a collaborative approach with health providers, enrollees and caregivers, emphasizing early identification and treatment of health issues and coordinated management of patients conditions. Summary Comparison of Cost-Containment Features of Various Medicaid Models 4

7 Increasingly, states are turning to comprehensive, risk-based managed care as a tool to coordinate care for enrollees, provide greater control and predictability over Medicaid spending, and establish provider networks for enrollees. Percentage of Medicaid Enrollees in Medicaid Managed Care in Risk-Based Managed Care, 1995 and (excludes limited-benefit plans) % 38% 40% 40% 41% 42% 43% 46% 46% 47% 48% % Source: The MACPAC Report to Congress, The Evolution of Managed Care in Medicaid, June Comprehensive risk-based managed care: States establish a contract with multiple managed care plans to provide Medicaid beneficiaries a choice of plans, covering all or most Medicaid-covered services. Plans have more flexibility than FFS to offer additional services that improve their members health. Plans are at financial risk if spending on benefits and administration exceeds payments, and must demonstrate their financial solvency to take on that risk. Plans work with their members to select a PCP as their medical home, and the PCP works with the plan to coordinate care. Plans are accountable to the state for improving member health outcomes, ensuring an adequate provider network, and meeting other state requirements, such as licensure or accreditation by an organization such as the National Committee for Quality Assurance. Programs are designed to increase quality, cost less than FFS due to better access to and coordination of care, prevent fraud and abuse, and offer budget certainty PCCM: Medicaid PCCM requires a Medicaid enrollee to choose a PCP that is responsible for coordinating the enrollee s care and the PCP is paid a monthly fee for doing so, in addition to a payment for providing medical services. In general, all medical services are reimbursed on a FFS basis. PCCM is similar to a traditional FFS Medicaid model with basic care coordination that varies widely by provider. States vary highly in the degree of support and oversight they provide over PCCM programs Accountable Care Organizations (ACOs): ACOs were proposed as an alternative to current payment and service-delivery models, primarily for Medicare by creating a network of doctors and hospitals that share responsibility for providing care. They are emerging in Medicaid, but are not well-established, and there is no data on their success in the Medicaid environment. Building an ACO is likely to require the investment of considerable capital by the hospitals and providers. Another dilemma is the governance and structure of the ACO: It is uncertain who will lead them because the law does not prescribe a specific requirement. The American Medical Association suggests physician-led ACOs, but many people think hospitals have a greater chance of taking the helm. 2,3 FFS: Under the FFS system, providers obtain reimbursement from the state as services are rendered. Authorization procedures and care coordination are limited. Enrollees and caregivers receive minimal assistance in navigating the health care system to ensure they receive necessary services 1.The Medicaid and CHIP Payment Access Commission (MACPAC) Report to the Congress, The Evolution of Managed Care in Medicaid, June Tara Adams Ragone, The Normative Meets the Practical: Who Can Lead ACOs, Health Reform Watch, Seton Hall University School of Law, Health Law & Policy Program (April 12, 2011). 3.Scott Gottlieb, Accountable Care Organizations: The End of Innovation in Medicine? American Enterprise Institute for Public Policy Research No. 3 (February 2011). 5

8 Amerigroup Supports Healthy Communities Overview Amerigroup Corporation improves the quality of life in the communities in which members and associates reside due to the efforts of two particular branches of the Company: the Amerigroup Foundation and the Amerigroup Community Volunteers program. With a growing number of members and programs throughout the country, the Foundation and Community Volunteers program are both dedicated to promoting community improvement and encouraging safe and healthy children, families and individuals of all ages. Amerigroup associates participating in the JT Walk for ALS. Community Volunteers The Amerigroup Community Volunteers program is a reflection of our belief that real solutions in health care begin when we put our passion and care to work. As a testament to this belief, in 2011, Amerigroup associates dedicated 21,234 hours toward volunteer efforts. As part of these overall efforts, each Amerigroup associate is granted a volunteer day of paid leave. This compensation policy is evidence that Amerigroup values the time associates put into genuine volunteer efforts. In addition, the Amerigroup Disaster Response Team, which operates as a part of the Community Volunteers program, is an example of associates improving communities by providing the time, energy and resources needed to have a measurable impact. What began as a grassroots initiative, the Disaster Response Team currently provides assistance to communities struck by disaster, specifically to people with disabilities who are often at additional risk and exposure during disasters. Amerigroup has partnered with the federal government and the Red Cross to develop training and is working to expand this program. Amerigroup Foundation The Amerigroup Foundation is the philanthropic branch of the Amerigroup Corporation. The Foundation works to create healthy communities by fostering access to health care, encouraging healthy children and families, and promoting education improvements and healthy neighborhoods. In the past year, the Foundation contributed $2.4 million to various community organizations across the country. Since its inception in 2001, the Foundation has awarded a total of $16.1 million to worthy causes that align with the Amerigroup mission of doing well by doing good. Through two new programs, the Foundation directly connects charitable resources with associate-led volunteer initiatives. First, the Workplace Giving Campaign matches associate donations with Amerigroup Foundation funds. Secondly, in the Dollars for Doers program, nonprofit organizations to which employees donate hours of their time annually will receive a cash donation from the Foundation. As a result of this program, the Foundation donated approximately $21,000 to nonprofit organizations in the past year. Virginia Beach Mayor Will Sessoms and members of the community at the Grommet Island Park for EveryBODY ribbon-cutting ceremony Amerigroup contributed to the building of the park and continues to raise funds for its maintenance. 6

9 Amerigroup Foundation Helps Relieve Health Care Disparities Through Remote Area Medical Event For the second consecutive year, the philanthropic arm of Amerigroup the Amerigroup Foundation partnered with the Remote Area Medical (RAM) clinic in Wise, Va., in July RAM is a nonprofit, all-volunteer medical relief corps serving remote and impoverished areas across the United States and abroad. An estimated 2,500 people attended the 2012 event for the opportunity to receive medical, dental and vision treatment. For many participants, this was their only chance all year to see a doctor, and some waited in line as long as 30 hours for their chance to receive care. This year s RAM event provided an estimated $2 million in free medical services, which are calculated at Medicaid rates for the commonwealth of Virginia. More than 1,400 volunteers, including 30 associates from Amerigroup, provided hands-on assistance. Amerigroup An estimated 2,500 people attended the 2012 RAM event in Wise, Va. volunteers donated 1,000 hours of community service at the 2012 event. In addition to the volunteer effort, the Amerigroup Foundation has provided more than $290,000 in support of the clinic during our two years of participation, including $120,000 to the Health Wagon, $80,000 to the Virginia Dental Amerigroup has allowed us to expand our reach into underserved communities. Their support will benefit the community at large, decrease the disparities in health care, increase health literacy and encourage better personal choices. Dr. Terry D. Dickinson Executive Director of the Virginia Dental Association Foundation Association Foundation and $40,000 to the University of Virginia Office of Telemedicine. Additionally, in 2011 Amerigroup provided an additional $20,000 to the Health Wagon to purchase a portable X-ray machine; an estimated $30,000 worth of grocery totes filled with day-of supplies; and 1,000 overthe-counter medications, such as acetaminophen and ibuprofen. RAM is a living example of our values in action. We re creating a culture of service by providing real solutions to the people who need it the most, said Amerigroup Chairman and CEO Jim Carlson, who has volunteered at patient check-in both years. This clinic won t solve all of their problems, but it was our chance to help ease their burden for a weekend. A recent study published by the University of Virginia School of Medicine found that residents living in Virginia Appalachian county communities are not receiving adequate health care, even among those with health insurance. 1 According to the study, people who live in rural communities are less likely to seek medical care or receive specialized treatments due to lack of insurance, inability to make co-payments or lack of transportation to medical providers. In comparison to the rest of the nation, this area has poverty rates of 125 percent above the national average and earns 67 percent less income. The barriers to health care affecting Appalachian residents closely resemble those faced by significant portions of our membership. In committing to these outreach efforts, we advance our understanding of our members needs. Use your smartphone to watch a video on RAM 1 E.L McGarvey et al., Health Disparities Between Appalachian and Non-Appalachian Counties in Virginia USA (Charlottesville, VA: Springerlink.com, 2010). Get the free mobile app at / gettag.mobi 7

10 Childhood Obesity Prevention Through Education Real Story Amerigroup Health Educator MaryAnne Kokidis engages students in learning about nutrition during a health education workshop. According to the Centers for Disease Control and Prevention, nearly 12.5 million children and adolescents between the ages of 2 and 19 are obese. Amerigroup believes implementing early education will help raise awareness of the obesity epidemic facing our country. Our health education workshops serve to prevent obesity before it begins. MaryAnne Kokidis, an Amerigroup health educator, engages schoolchildren in interactive presentations that provide information the students can use at home and later in life. In a typical day, 80 percent of youths consume more than 11 percent of their calories from items such as soda and sports drinks. MaryAnne helps illustrate this point by asking students to help count the tablespoons of sugar contained in one bottle of soda. By breaking down the composition of the students favorite drinks and treats, MaryAnne educates the students about nutritional facts and teaches them to be aware of what they consume. It s really great when you see the kids are participating, and they re learning something new that they actually might be able to use when they leave the class, MaryAnne said. Obese teens are 16 times more likely to become severely obese adults than teenagers of normal weight, increasing the importance of understanding the consequences of childhood obesity. Approximately 17 percent of U.S. health care costs are due to obesity. Not only are overweight children at greater risk of having high blood pressure, high cholesterol and breathing problems, but they are also more likely to endure social and psychological implications from society and peers. While nutritional workshops alone will not solve the obesity epidemic, Amerigroup hopes to provide a starting point for discussion and awareness. Lessons extend beyond the classroom when children go home and share what they learned about the food they eat with their parents and family members. Instead of simply managing the existing health conditions facing children and adults today, Amerigroup is proactive in being a part of the solution. Through our community outreach efforts, such as these health education workshops, we better understand and prevent the issues facing our members and the communities in which they live. MaryAnne is one example of how Amerigroup goes above and beyond to encourage healthier and better lifestyles for our members and the community. Preventing problems before they begin. Another real solution from Amerigroup. Use your smartphone to watch a video of our Real Story Get the free mobile app at / gettag.mobi 8

11 Empowering Members to Choose the Care They Need Real Story Lorri was born with infantile cerebral palsy, a condition that disrupts the brain s ability to control movement and posture. In Lorri s case, the only part of her body she can move on her own is her right index finger. As a result, she is totally dependent on other people to help her. Lorri used to live in a deteriorating high-rise apartment building. She received care 24 hours a day, seven days a week from certified nursing assistants. By contract, these assistants were not allowed to travel with her outside the apartment, making Lorri a prisoner in her own home. It was costing the state more than $200,000 a year, said Tina Brill, vice president of Long-term Care for Amerigroup Tennessee. Lorri (right) and one of her personal care companions at a bowling alley. In 2010, Tennessee created a new program for people like Lorri. It has a consumer-directed option that lets members choose and hire their own workers. It also allows them to use personal care companions instead of certified nursing assistants. In Lorri s case, she doesn t need nursing care. She needs help with bathing, dressing, eating and hygiene. By hiring a mother-and-daughter team, Eryn and Robin, to be her consumer-directed workers, Lorri gets the right level of care at home. As an added bonus, they can go with her wherever she wants. Since joining this program, Lorri has seen her life change dramatically. Lorri is very active. She has lots of energy. She loves bowling, Eryn said, smiling. Now, Lorri is so happy. She just glows. There is another side to this story, as well. Not only is Lorri getting the care she needs, instead of costing hundreds of thousands of dollars, her care is now costing $55,000 a year, Tina added. Not only is Lorri getting the care she needs, instead of costing hundreds of thousands of dollars, her care is now costing $55,000 a year. Tina Brill Amerigroup vice president of Long-term Care Today, Lorri leads an active lifestyle that includes going to work, competing in bowling tournaments and having lunch with the governor. In Lorri s own words, I love it. It gives me more freedom. Empowering our members to choose the care they need: another real solution from Amerigroup. 9

12 Executive Biographies James G. Carlson has enjoyed a distinguished career with more than 30 years of experience in health insurance. In September 2007, he became the second chief executive officer in the 18-year history of Amerigroup, having previously served as president and chief operating officer of the Company, a position he held since Under his leadership, Amerigroup has more than doubled the number of state Medicaid programs it serves, while revenues have grown substantially, positioning the Company in the Fortune 500. Mr. Carlson has strengthened the operational and medical management processes of Amerigroup and has recruited experienced executives to help expand the business, securing the position of Amerigroup as one of the leading voices on behalf of health care for the financially vulnerable, seniors and people with disabilities. Earlier in his career, Mr. Carlson was an executive vice president of UnitedHealth Group and president of its UnitedHealthcare business unit. Mr. Carlson was also the founder of HealthSpring, a physician group practice management company, and co-founder of Workscape, a software company that was later acquired by ADP. He began his career with the Prudential Insurance Company of America, serving as president of Western Group Operations. Mr. Carlson attended Morningside College in Sioux City, Iowa, and graduated from Rider University in New Jersey. He serves on the boards of the National Kidney Foundation, the Virginia Aquarium & Marine Science Center and the Virginia Beach Neptune Festival, as well as America s Health Insurance Plans, Morningside College, the Health Sector Advisory Council for the Fuqua School of Business at Duke University and Virginia Gov. Robert F. McDonnell s Health Reform Initiative Advisory Council. John E. Littel is executive vice president of External Relations. He is responsible for Amerigroup communications, corporate compliance, and government and community affairs initiatives, including new business development. He also chairs the Company s charitable foundation. Mr. Littel joined Amerigroup from the Bush administration and previously was deputy director and counsel for the citizenship project at the Heritage Foundation. He served as the deputy secretary of Health and Human Resources for the commonwealth of Virginia. On the federal level, he served as the director of intergovernmental affairs for the White House s Office of National Drug Control Policy under President George H.W. Bush. He has taught government, politics and communications at the graduate level. He began his career in Pennsylvania as a regional office manager for the late U.S. Sen. H. John Heinz III and is a member of the Pennsylvania Bar. He earned his bachelor s degree in philosophy and political science from the University of Scranton and a law degree from The Columbus School of Law at Catholic University. Mr. Littel previously served on the boards of the Family and Children s Trust Fund Board, which is Virginia s family violence prevention agency, and ForKids, a program for homeless families in Norfolk, Va. 10

13 Mary T. McCluskey, M.D., is executive vice president and chief medical officer for Amerigroup, overseeing health care services for the more than 2 million members of Amerigroup. Prior to Amerigroup, Dr. McCluskey served in a variety of senior medical positions with Aetna Inc., most recently as chief medical officer, Northeast region. In this role, she was the senior clinical and medical quality leader for a division that provided health insurance for 2.4 million people through employer-sponsored and Medicare programs. Under her guidance, the company s Northeast region earned an excellent accreditation rating from the National Committee for Quality Assurance. Her previous positions at Aetna included national medical director and head of Clinical Cost Management and senior regional medical director, Southeast region. Prior to Aetna, Dr. McCluskey was vice president of Medical Affairs for Medpartners Medical Management in Tampa, Fla. She previously served as internist and medical director of Bridgeton Health Center in St. Louis. Dr. McCluskey began her career as an urgent care physician in St. Louis. A graduate of St. Louis University and the St. Louis University School of Medicine, she completed her residency in internal medicine at Jewish Hospital/Washington University. Nicholas J. Pace is executive vice president, general counsel and secretary for Amerigroup. Mr. Pace joined Amerigroup in 2006 and previously served the Company as senior vice president, deputy general counsel and assistant secretary. His areas of responsibility include corporate governance, U.S. Securities and Exchange Commission and New York Stock Exchange reporting and compliance, corporate finance, and mergers and acquisitions. Prior to joining Amerigroup, Mr. Pace served as assistant general counsel for CarMax Inc., where his focus included corporate governance, corporate finance, and mergers and acquisitions. In private practice, he was associated with Morrison & Foerster LLP, where he advised issuers and investors on corporate governance matters, securities and debt offerings, venture capital financing, and mergers and acquisitions. Prior to practicing law, Mr. Pace served as consultant in Ernst & Young s tax group. He earned his Bachelor of Science in both accountancy and finance from Miami University in Ohio and a graduate cum laude from the University of Richmond T.C. Williams School of Law. He also holds a master s degree in business administration from the University of Richmond E. Claiborne Robins School of Business. Leon A. Root is executive vice president and chief information officer of Amerigroup. In this role, he is responsible for the information systems and strategies to meet organizational business goals. Mr. Root joined the Company in 2002 as chief technology officer. Previously, he served as chief information officer at Medunite Inc., a private e-commerce company founded by Aetna, CIGNA, PacifiCare Health Systems and five other managed care companies. Medunite focuses on secure, web-enabled administrative transactions and services for health care constituents. At Medunite, he was responsible for the information technology and operations division. Also, he was the senior vice president and general manager at McKesson HBOC s business systems division. Mr. Root began his career as a systems architect at Eastman Kodak. He earned his Master of Science in Business Administration from Pennsylvania State University 11

14 Executive Biographies James W. Truess is executive vice president and chief financial officer of Amerigroup, overseeing all aspects of the Company s financial operations. Mr. Truess has enjoyed more than a two-decade career in financial roles, including the past 20 years in the managed care industry and the last 13 years as a chief financial officer. Prior to joining Amerigroup, he served as executive vice president, chief financial officer and treasurer of Group Health Cooperative, one of the largest vertically integrated health maintenance organizations in the country. Mr. Truess holds a master s degree in finance from Seattle University and a bachelor s degree in business administration from the University of Washington. He is a Chartered Financial Analyst charter holder. Linda K. Whitley-Taylor is executive vice president of Human Resources for Amerigroup. In this position, Ms. Whitley-Taylor is responsible for human resource functions and programs, including associate policy development, compensation and benefits administration, travel and events planning, and training and leadership development. She has two decades of experience in the field of human resources and talent development. Ms. Whitley-Taylor came to Amerigroup from Genworth Financial, where she served as senior vice president of Human Resources Operations at the company s Richmond, Va., headquarters. At Genworth, her roles in human resources, training and quality steadily increased in responsibilities and scope, ultimately resulting in oversight of human resources operations for 6,500 employees in 24 countries. In addition to her international experience, Ms. Whitley-Taylor has significant experience in talent development and people strategy initiatives. 12 Richard C. Zoretic is executive vice president and chief operating officer of Amerigroup. In this role, he is responsible for Amerigroup health plan operations in 12 states, as well as the Health Care Management Services, Health Care Delivery Systems, Health Care Economics and Customer Service operations. With three decades of experience in managed care and health care benefits, Mr. Zoretic joined Amerigroup in 2003 as chief marketing officer. In 2005, Mr. Zoretic transitioned into health plan operations, assuming responsibility for the Southern region of Amerigroup. In 2006, he assumed responsibility for all health plan operations and was promoted to his current position in Mr. Zoretic began his career in 1980 with MetLife s Group Life & Health operations, where he held a series of positions of increasing responsibility over a 13-year period. From 1994 to 2000, he held several leadership positions at UnitedHealth Group, including senior vice president of UnitedHealthcare s Mid-Atlantic operations and president of the company s Middle Market Business segment. He subsequently served as a management consultant in Deloitte Consulting s health care practice. Mr. Zoretic earned a degree in finance at Pennsylvania State University. He currently serves as the chairman of the board for Eastern Virginia Medical School Health Services, a not-for-profit physician practice affiliated with Eastern Virginia Medical School, with more than 150 physicians representing 20 specialties. He is also a member of the board of visitors for Eastern Virginia Medical School, and he serves on the boards of Families of Autistic Children of Tidewater and Cape Henry Collegiate School.

15

16 Amerigroup Plan Service Area Amerigroup health plans serve beneficiaries through a variety of public programs in 13 states, including Medicaid, Medicare, Temporary Assistance for Needy Families (TANF), Seniors and People with Disabilities (SPD)/Supplemental Security Income (SSI), and Children s Health Insurance Program (CHIP). We began serving Washington on July 1, State Florida Georgia Louisiana Maryland Nevada New Jersey New Mexico New York Ohio Tennessee Texas Virginia Washington TANF CHIP SPD/SSI Medicare Total Membership 2,737,000* * Membership as of 9/30/12. 9/2012

Medicaid Topics Impact of Medicare Dual Eligibles Stephen Wilhide, Consultant

Medicaid Topics Impact of Medicare Dual Eligibles Stephen Wilhide, Consultant Medicaid Topics Impact of Medicare Dual Eligibles Stephen Wilhide, Consultant Issue Summary The term dual eligible refers to the almost 7.5 milion low-income older individuals or younger persons with disabilities

More information

Examples of Consumer Incentives and Personal Responsibility Requirements in Medicaid

Examples of Consumer Incentives and Personal Responsibility Requirements in Medicaid TECHNICAL ASSISTANCE TOOL Examples of Consumer Incentives and Personal Responsibility Requirements in Medicaid Many states are incorporating policies into their Medicaid programs that seek to enhance beneficiaries

More information

Community Health Needs Assessment Implementation Plan FY 14-16

Community Health Needs Assessment Implementation Plan FY 14-16 Community Health Needs Assessment Implementation Plan FY 14-16 South Miami Hospital conducted a community health needs assessment in 2013 to better understand the healthcare needs of the community it serves

More information

Medicaid Health Plans: Adding Value for Beneficiaries and States

Medicaid Health Plans: Adding Value for Beneficiaries and States Medicaid Health Plans: Adding Value for Beneficiaries and States Medicaid is a program with numerous challenges, both for its beneficiaries and the state and federal government. In comparison to the general

More information

Creating Healthy States: Promoting Healthy Living in the Medicaid Program

Creating Healthy States: Promoting Healthy Living in the Medicaid Program Creating Healthy States: Promoting Healthy Living in the Medicaid Program Executive Summary Medicaid provides health and long-term care coverage to more than 53 million Americans and maintains an annual

More information

Medicare- Medicaid Enrollee State Profile

Medicare- Medicaid Enrollee State Profile Medicare- Medicaid Enrollee State Profile The National Summary Centers for Medicare & Medicaid Services Introduction... 1 Data Source and General Notes... 2 Types and Ages of Medicare-Medicaid Enrollees...

More information

An Internist s Practical Guide to Understanding Health System Reform

An Internist s Practical Guide to Understanding Health System Reform An Internist s Practical Guide to Understanding Health System Reform Prepared by: ACP s Division of Governmental Affairs and Public Policy Updated October 2013 How to cite this guide: American College

More information

PHYSICIANS. 202.420.7896 888 16 th St. NW, Suite 800, Washington DC 20006 www.npalliance.org

PHYSICIANS. 202.420.7896 888 16 th St. NW, Suite 800, Washington DC 20006 www.npalliance.org N A T I O N A L PHYSICIANS A L L I A N C E My name is Dr. Valerie Arkoosh. I am an Anesthesiologist at the University of Pennsylvania School of Medicine and the President of the National Physicians Alliance.

More information

Home Care Association of Washington Conference. MaryAnne Lindeblad, State Medicaid Director Washington Health Care Authority

Home Care Association of Washington Conference. MaryAnne Lindeblad, State Medicaid Director Washington Health Care Authority Home Care Association of Washington Conference MaryAnne Lindeblad, State Medicaid Director Washington Health Care Authority April 25, 2013 Overview Overview of Health Care Authority Public Employees Benefits

More information

While health care reform has its foundation and framework at

While health care reform has its foundation and framework at CENTER FOR HEALTHCARE RESEARCH & TRANSFORMATION Policy Brief June 2010 The Patient Protection and Affordable Care Act at the State and Local Level While health care reform has its foundation and framework

More information

INDIGENT CARE PROGRAMS IN SELECTED STATES WITHOUT COPN PROGRAMS Arizona

INDIGENT CARE PROGRAMS IN SELECTED STATES WITHOUT COPN PROGRAMS Arizona INDIGENT CARE PROGRAMS IN SELECTED STATES WITHOUT COPN PROGRAMS Arizona The Arizona Health Care Cost Containment System (AHCCCS) is a comprehensive, statewide managed care program which combines state

More information

Division of Medical Assistance Programs

Division of Medical Assistance Programs January 23-24, 2007 CLIENTS WE SERVE Medicaid eligibility is limited to individuals who fall into specified categories and who are in financial need. The federal Medicaid statute identifies over 25 different

More information

Maryland Medicaid Program: An Overview. Stacey Davis Planning Administration Department of Health and Mental Hygiene May 22, 2007

Maryland Medicaid Program: An Overview. Stacey Davis Planning Administration Department of Health and Mental Hygiene May 22, 2007 Maryland Medicaid Program: An Overview Stacey Davis Planning Administration Department of Health and Mental Hygiene May 22, 2007 1 Maryland Medicaid In Maryland, Medicaid is also called Medical Assistance

More information

State of North Carolina. Medicaid Dental Review

State of North Carolina. Medicaid Dental Review State of North Carolina Medicaid Dental Review October 2010 EXECUTIVE SUMMARY The Centers for Medicare & Medicaid Services (CMS) is committed to improving pediatric dental care in the Medicaid program

More information

West Virginians for Affordable Health Care. The Affordable Care Act: What It Means for Nurses and Future Nurses

West Virginians for Affordable Health Care. The Affordable Care Act: What It Means for Nurses and Future Nurses West Virginians for Affordable Health Care The Affordable Care Act: What It Means for Nurses and Future Nurses The Affordable Care Act: What It Means for Nurses and Future Nurses Prepared by Renate Pore

More information

Medi-Growth Medicaid, Medicare Poised to Expand

Medi-Growth Medicaid, Medicare Poised to Expand C H A P T E R 7 Medi-Growth Medicaid, Medicare Poised to Expand More than 100 million Americans rely upon Medicaid and Medicare for insurance coverage. Medicaid, the government s insurance program for

More information

Geneva Association 10th Health and Aging Conference Insuring the Health of an Aging Population

Geneva Association 10th Health and Aging Conference Insuring the Health of an Aging Population Geneva Association 10th Health and Aging Conference Insuring the Health of an Aging Population November 18, 2013 Diana Dennett EVP, Global Issues and Counsel America s Health Insurance Plans (AHIP) America

More information

Key Features of the Affordable Care Act, By Year

Key Features of the Affordable Care Act, By Year Page 1 of 10 Key Features of the Affordable Care Act, By Year On March 23, 2010, President Obama signed the Affordable Care Act. The law puts in place comprehensive health insurance reforms that will roll

More information

Ohio Health Plans. Maximizing best practices & leading reform efforts. Search. Ohio Association of Health Plans

Ohio Health Plans. Maximizing best practices & leading reform efforts. Search. Ohio Association of Health Plans Ohio Association of Health Plans File Edit View History Bookmarks Tools Window Help http://www.oahp.com Ohio Health Plans Search Maximizing best practices & leading reform efforts HELPING OHIOANS GET NEEDED

More information

Timeline: Key Feature Implementations of the Affordable Care Act

Timeline: Key Feature Implementations of the Affordable Care Act Timeline: Key Feature Implementations of the Affordable Care Act The Affordable Care Act, signed on March 23, 2010, puts in place health insurance reforms that will roll out incrementally over the next

More information

WHAT S IN THE PROPOSED FY 2016 BUDGET FOR HEALTH CARE?

WHAT S IN THE PROPOSED FY 2016 BUDGET FOR HEALTH CARE? An Affiliate of the Center on Budget and Policy Priorities 820 First Street NE, Suite 460 Washington, DC 20002 (202) 408-1080 Fax (202) 408-1073 www.dcfpi.org April 16, 2015 WHAT S IN THE PROPOSED FY 2016

More information

What this means for Idaho?

What this means for Idaho? What this means for Idaho? Why now? The 2011 Idaho Legislature approved the Medicaid Cost Containment and Health Care Improvement Act : The current fee-for-service health care delivery system of payment

More information

Maryland Medicaid Program

Maryland Medicaid Program Maryland Medicaid Program Maryland s Pharmacy Discount Waiver Tuesday, November 19, 2002 Debbie I. Chang Deputy Secretary for Health Care Financing Maryland Department of Health and Mental Hygiene Overview

More information

Who We Are We re a coalition of concerned Kentuckians, over 250 organizations and individuals, who believe that the best health care solutions are found when everyone works together to build them. Right

More information

FEDERAL GRANTS TO STATES AND LOCALITIES CUT DEEPLY IN FISCAL YEAR 2009 FEDERAL BUDGET By Iris J. Lav and Phillip Oliff

FEDERAL GRANTS TO STATES AND LOCALITIES CUT DEEPLY IN FISCAL YEAR 2009 FEDERAL BUDGET By Iris J. Lav and Phillip Oliff 820 First Street NE, Suite 510 Washington, DC 20002 Tel: 202-408-1080 Fax: 202-408-1056 center@cbpp.org www.cbpp.org February 4, 2008 FEDERAL GRANTS TO STATES AND LOCALITIES CUT DEEPLY IN FISCAL YEAR 2009

More information

Plenary: Compliance and Legal Trends Tuesday, May 24 4:15 p.m. 5:15 p.m.

Plenary: Compliance and Legal Trends Tuesday, May 24 4:15 p.m. 5:15 p.m. Plenary: Compliance and Legal Trends Tuesday, May 24 4:15 p.m. 5:15 p.m. Join us for a special session with senior leaders as they discuss key issues affecting the regulatory landscape. Panelists will

More information

Your Guide to Medicare Private Fee-for-Service Plans. Heading CENTERS FOR MEDICARE & MEDICAID SERVICES

Your Guide to Medicare Private Fee-for-Service Plans. Heading CENTERS FOR MEDICARE & MEDICAID SERVICES Heading CENTERS FOR MEDICARE & MEDICAID SERVICES Your Guide to Medicare Private Fee-for-Service Plans This official government booklet has important information about Medicare Private Fee-for-Service Plans

More information

How Health Reform Will Help Children with Mental Health Needs

How Health Reform Will Help Children with Mental Health Needs How Health Reform Will Help Children with Mental Health Needs The new health care reform law, called the Affordable Care Act (or ACA), will give children who have mental health needs better access to the

More information

Patient Protection and Affordable Care Act [PL 111-148] with Amendments from 2010 Reconciliation Act [PL 111-152] Direct-Care Workforce

Patient Protection and Affordable Care Act [PL 111-148] with Amendments from 2010 Reconciliation Act [PL 111-152] Direct-Care Workforce DIRECT-CARE WORKFORCE AND LONG-TERM CARE PROVISIONS AS ENACTED IN PATIENT PROTECTION AND AFFORDABLE CARE ACT AND HEALTH CARE AND EDUCATION RECONCILIATION ACT OF 2010 Key Provisions Direct-Care Workforce

More information

Medicaid. Administration

Medicaid. Administration MEDICAID care is reasonable, necessary, and provided in the most appropriate setting. The PROs are composed of groups of practicing physicians. To receive Medicare payments, a hospital must have an agreement

More information

Maryland Data as of July 2003. Mental Health and Substance Abuse Services in Medicaid and SCHIP in Maryland

Maryland Data as of July 2003. Mental Health and Substance Abuse Services in Medicaid and SCHIP in Maryland Mental Health and Substance Abuse Services in Medicaid and SCHIP in Maryland As of July 2003, 638,662 people were covered under Maryland's Medicaid/SCHIP programs. There were 525,080 enrolled in the Medicaid

More information

Statement of the U.S. Chamber of Commerce

Statement of the U.S. Chamber of Commerce Statement of the U.S. Chamber of Commerce ON: TO: BY: SMALL BUSINESS HEALTH CARE STRUGGLES HOUSE COMMITTEE ON ENERGY AND COMMERCE HEALTH SUBCOMMITTEE TONY MONTVILLE DATE: APRIL 25, 2007 The Chamber s mission

More information

COMMON PATHWAYS TO ELIGIBILITY

COMMON PATHWAYS TO ELIGIBILITY IN THIS FACT SHEET: PENNSYLVANIA MEDICAID, SCHIP, AND STATE-FUNDED HEALTH PROGRAMS AUGUST 2008 An Overview of Pennsylvania s Publicly Funded Insurance Programs This summary is intended to assist professionals

More information

Partnering to Improve Access to Oral Health in Ohio. Through Strategic Grantmaking and Collaboration

Partnering to Improve Access to Oral Health in Ohio. Through Strategic Grantmaking and Collaboration Partnering to Improve Access to Oral Health in Ohio Through Strategic Grantmaking and Collaboration November 2013 WE MET AND TALKED ABOUT WHAT EACH OF US THOUGHT THE CHALLENGES WERE WITH GRANTEE SUSTAINABILITY,

More information

Strengthening Community Health Centers. Provides funds to build new and expand existing community health centers. Effective Fiscal Year 2011.

Strengthening Community Health Centers. Provides funds to build new and expand existing community health centers. Effective Fiscal Year 2011. Implementation Timeline Reflecting the Affordable Care Act 2010 Access to Insurance for Uninsured Americans with a Pre-Existing Condition. Provides uninsured Americans with pre-existing conditions access

More information

Enhancing Medicaid Primary Care Case Management to Improve Care Management and Accountability

Enhancing Medicaid Primary Care Case Management to Improve Care Management and Accountability Enhancing Medicaid Primary Care Case Management to Improve Care Management and Accountability Prepared by James M. Verdier Mathematica Policy Research, Inc. for the Fourth National Medicaid Congress Washington,

More information

How Health Reform Will Affect Health Care Quality and the Delivery of Services

How Health Reform Will Affect Health Care Quality and the Delivery of Services Fact Sheet AARP Public Policy Institute How Health Reform Will Affect Health Care Quality and the Delivery of Services The recently enacted Affordable Care Act contains provisions to improve health care

More information

Health Disparities in H.R. 3590 (Merged Senate Bill)

Health Disparities in H.R. 3590 (Merged Senate Bill) Health Disparities in H.R. 3590 (Merged Senate Bill) Definitions: Health disparity population is defined in the bill as defined in Section 485E (Sec. 931) Current Law: a population is a health disparity

More information

Florida Data as of July 2003. Mental Health and Substance Abuse Services in Medicaid and SCHIP in Florida

Florida Data as of July 2003. Mental Health and Substance Abuse Services in Medicaid and SCHIP in Florida Mental Health and Substance Abuse Services in Medicaid and SCHIP in Florida As of July 2003 2,441,266 people were covered under Florida's Medicaid and SCHIP programs. There were 2,113,820 enrolled in the

More information

[ chapter one ] E x ecu t i v e Summ a ry

[ chapter one ] E x ecu t i v e Summ a ry [ Chapter One ] Execu tive Summ a ry [ Executive Summary ] Texas faces an impending crisis regarding the health of its population, which will profoundly influence the state s competitive position nationally

More information

A Consumer Guide to Understanding Health Plan Networks

A Consumer Guide to Understanding Health Plan Networks A Consumer Guide to Understanding Health Plan Networks Table of Contents steps you can take to understand your health plan s provider network pg 4 What a provider network is pg 8 Many people are now shopping

More information

The Ryan White CARE Act 2000 Reauthorization

The Ryan White CARE Act 2000 Reauthorization POLICY BRIEF january 2001 The Ryan White CARE Act 2000 Reauthorization Overview As the Ryan White CARE Act enters its second decade, it continues to be a critical source of care and services for people

More information

Associate Chief Financial Officer Commonwealth Care Alliance Boston, MA

Associate Chief Financial Officer Commonwealth Care Alliance Boston, MA Associate Chief Financial Officer Commonwealth Care Alliance Boston, MA Position Specification July 2014 The Summary Commonwealth Care Alliance is seeking an Associate Chief Financial Officer (ACFO) for

More information

The Obama Administration s Record on Supporting the Nursing Workforce

The Obama Administration s Record on Supporting the Nursing Workforce The Obama Administration s Record on Supporting the Nursing Workforce Nurses are at the center of the American health system. There are more nurses in our country than any other type of health care provider.

More information

Why the Affordable Care Act Matters. Mindy Owen RN, CRRN, CCM Phoenix HealthCare Assoc. LLC Coral Springs Florida

Why the Affordable Care Act Matters. Mindy Owen RN, CRRN, CCM Phoenix HealthCare Assoc. LLC Coral Springs Florida Why the Affordable Care Act Matters Mindy Owen RN, CRRN, CCM Phoenix HealthCare Assoc. LLC Coral Springs Florida Objectives The participant will be able to define the relationship between the ACA and the

More information

An Overview of Children s Health Issues in Michigan

An Overview of Children s Health Issues in Michigan An Overview of Children s Health Issues in Michigan Sponsors Michigan Chapter American Academy of Pediatrics Michigan Council for Maternal and Child Health School - Community Health Alliance of Michigan

More information

P a g e 1. Ken Cuccinelli Mental Health Forum Responses

P a g e 1. Ken Cuccinelli Mental Health Forum Responses P a g e 1 Ken Cuccinelli Mental Health Forum Responses 1) Virginians of all ages and situations in life can experience mental health problems. Almost a quarter million adults in Virginia live with co-occurring

More information

INSIGHT on the Issues

INSIGHT on the Issues INSIGHT on the Issues AARP Public Policy Institute Medicare Beneficiaries Out-of-Pocket for Health Care Claire Noel-Miller, PhD AARP Public Policy Institute Medicare beneficiaries spent a median of $3,138

More information

Testimony. Submitted to the. U.S. Senate Subcommittee on Public Health. Hispanic Health Improvement Act of 2002

Testimony. Submitted to the. U.S. Senate Subcommittee on Public Health. Hispanic Health Improvement Act of 2002 Testimony Submitted to the U.S. Senate Subcommittee on Public Health Hispanic Health Improvement Act of 2002 by Elena Rios, M.D., M.S.P.H. President & CEO National Hispanic Medical Association CEO, Hispanic-Serving

More information

The Patient Protection and Affordable Care Act. Implementation Timeline

The Patient Protection and Affordable Care Act. Implementation Timeline The Patient Protection and Affordable Care Act Implementation Timeline 2009 Credit to Encourage Investment in New Therapies: A two year temporary credit subject to an overall cap of $1 billion to encourage

More information

Indiana Coalition for Human Services ICHS) Comments on the Healthy Indiana Plan (HIP) 2.0 Waiver Application (submitted 9/20/14)

Indiana Coalition for Human Services ICHS) Comments on the Healthy Indiana Plan (HIP) 2.0 Waiver Application (submitted 9/20/14) Indiana Coalition for Human Services ICHS) Comments on the Healthy Indiana Plan (HIP) 2.0 Waiver Application (submitted 9/20/14) Indiana Coalition for Human Services (ICHS) appreciates the opportunity

More information

Health Insurance Reform at a Glance Implementation Timeline

Health Insurance Reform at a Glance Implementation Timeline Health Insurance Reform at a Glance Implementation Timeline 2010 Access to Insurance for Uninsured Americans with a Pre-Existing Condition. Provides uninsured Americans with pre-existing conditions access

More information

LEARNING WHAT WORKS AND INCREASING KNOWLEDGE

LEARNING WHAT WORKS AND INCREASING KNOWLEDGE About This Series In February 2010, the George Washington University School of Public Health and Health Services, Department of Health Policy released Changing po 2 licy: The Elements for Improving Childhood

More information

MEDICAID PAYMENT. Comparisons of Selected Services under Fee-for- Service, Managed Care, and Private Insurance

MEDICAID PAYMENT. Comparisons of Selected Services under Fee-for- Service, Managed Care, and Private Insurance United States Government Accountability Office Report to Congressional Committees July 2014 MEDICAID PAYMENT Comparisons of Selected Services under Fee-for- Service, Managed Care, and Private Insurance

More information

Accountable Care Communities 101. Jennifer M. Flynn, Esq. Senior Director, State Affairs Premier healthcare alliance January 30, 2014

Accountable Care Communities 101. Jennifer M. Flynn, Esq. Senior Director, State Affairs Premier healthcare alliance January 30, 2014 Accountable Care Communities 101 Jennifer M. Flynn, Esq. Senior Director, State Affairs Premier healthcare alliance January 30, 2014 Premier is the largest healthcare alliance in the U.S. Our Mission:

More information

A summary of HCSMP recommendations as they align with San Francisco s citywide community health priorities appears below.

A summary of HCSMP recommendations as they align with San Francisco s citywide community health priorities appears below. All recommendations and guidelines in this HCSMP address important health policy goals for San Francisco. Certain guidelines are designated in this HCSMP as Eligible for. Guidelines with this designation

More information

Colorado Choice Health Plans

Colorado Choice Health Plans Quality Overview Colorado Choice Health Plans Accreditation Exchange Product Accrediting Organization: Accreditation Status: URAC Health Plan Accreditation (Marketplace HMO) Provisional Accreditation Commercial

More information

Optimum HealthCare Sales Video Script - H5594_14SalesVideo_CMS Approved

Optimum HealthCare Sales Video Script - H5594_14SalesVideo_CMS Approved Optimum HealthCare Sales Video Script - H5594_14SalesVideo_CMS Approved Thank you for joining us for this special presentation on Optimum HealthCare s Medicare Advantage Plans. Today we will explain the

More information

kaiser medicaid commission on and the uninsured May 2009 Community Care of North Carolina: Putting Health Reform Ideas into Practice in Medicaid

kaiser medicaid commission on and the uninsured May 2009 Community Care of North Carolina: Putting Health Reform Ideas into Practice in Medicaid P O L I C Y B R I E F kaiser commission on medicaid SUMMARY and the uninsured Community Care of North Carolina: Putting Health Reform Ideas into Practice in Medicaid May 2009 Why is Community Care of North

More information

Help protect your future from one of life s uncertainties

Help protect your future from one of life s uncertainties Help protect your future from one of life s uncertainties group long term care insurance PROGRAM 46871 06/01/09 Reference # 46871VRSG 04/01/10 Plan today In these uncertain times, it is often difficult

More information

Burns & McDonnell On-Site Clinic

Burns & McDonnell On-Site Clinic Burns & McDonnell On-Site Clinic A Prescription for Financial and Productivity Success Fall 2013 Lockton Companies C OMPAN Y P R OFI L E Engineering, architecture, construction, environmental and consulting

More information

MEDIA KIT. Senior Resource Center. Mission Programs History Leadership Event Photos

MEDIA KIT. Senior Resource Center. Mission Programs History Leadership Event Photos Senior Resource Center MEDIA KIT Items enclosed: Mission Programs History Leadership Event Photos FAQs Updated January 2012 1075 S. Brannon Stand Road, Dothan AL 36305 334.793.6843 800.239.3507 www.sarcoa.org

More information

7/31/2014. Medicare Advantage: Time to Re-examine Your Engagement Strategy. Avalere Health. Eric Hammelman, CFA. Overview

7/31/2014. Medicare Advantage: Time to Re-examine Your Engagement Strategy. Avalere Health. Eric Hammelman, CFA. Overview Medicare Advantage: Time to Re-examine Your Engagement Strategy July 2014 avalerehealth.net Avalere Health Avalere Health delivers research, analysis, insight & strategy to leaders in healthcare policy

More information

AHLA. Q. Medicaid ACOs: Coming to a Neighborhood Near You. Clifford E. Barnes Epstein Becker & Green PC Washington, DC

AHLA. Q. Medicaid ACOs: Coming to a Neighborhood Near You. Clifford E. Barnes Epstein Becker & Green PC Washington, DC AHLA Q. Medicaid ACOs: Coming to a Neighborhood Near You Clifford E. Barnes Epstein Becker & Green PC Washington, DC Jennifer E. Gladieux Senior Health Policy Analyst Health Policy Source, Inc. Alexandria,

More information

Obama Administration Record on Health Care

Obama Administration Record on Health Care Obama Administration Record on Health Care Today, two years after we passed health care reform, more young adults have insurance, more seniors are saving money on their prescription drugs, and more Americans

More information

Maryland Medicaid Program. Aaron Larrimore Medicaid Department of Health and Mental Hygiene May 15, 2012

Maryland Medicaid Program. Aaron Larrimore Medicaid Department of Health and Mental Hygiene May 15, 2012 Maryland Medicaid Program Aaron Larrimore Medicaid Department of Health and Mental Hygiene May 15, 2012 1 Maryland Medicaid In Maryland, Medicaid is also called Medical Assistance or MA. MA is a joint

More information

Health Reform and the AAP: What the New Law Means for Children and Pediatricians

Health Reform and the AAP: What the New Law Means for Children and Pediatricians Health Reform and the AAP: What the New Law Means for Children and Pediatricians Throughout the health reform process, the American Academy of Pediatrics has focused on three fundamental priorities for

More information

Public notice. No changes are proposed for the FAMIS Select program. Background -- FAMIS MOMS

Public notice. No changes are proposed for the FAMIS Select program. Background -- FAMIS MOMS Public notice Virginia s Title XXI Child Health Insurance Plan (CHIP) covers children with family income from 143% to 200% federal poverty level (FPL) under a separate child health plan known as the Family

More information

How Proposed Cuts in Vital Services Will Hurt New Jersey

How Proposed Cuts in Vital Services Will Hurt New Jersey How Proposed Cuts in Vital Services Will Hurt New Jersey January 12, 2006 On February 1, 2006, the U.S. House of Representatives is scheduled to take up legislation cutting $40 billion in health care,

More information

Customized Care Coordination Strategies that Fill Workforce Gaps and put a Human Face on Health Systems. Page 1

Customized Care Coordination Strategies that Fill Workforce Gaps and put a Human Face on Health Systems. Page 1 Customized Care Coordination Strategies that Fill Workforce Gaps and put a Human Face on Health Systems Page 1 Customized care coordination strategies that fill workforce gaps and put a human face on health

More information

Maureen Mangotich, MD, MPH Medical Director

Maureen Mangotich, MD, MPH Medical Director Maureen Mangotich, MD, MPH Medical Director Prepared for the National Governors Association Healthy America: State Policy Leaders Meeting, December 2005 Delivering value from the center of healthcare Pharmaceutical

More information

Kyser Trifold:Layout 8 9/7/11 10:15 AM Page 3

Kyser Trifold:Layout 8 9/7/11 10:15 AM Page 3 Kyser Trifold:Layout 8 9/7/11 10:15 AM Page 3 Kyser Trifold:Layout 8 9/7/11 10:15 AM Page 4 Transition of Keiser University to Not-for-profit Belinda Keiser Vice Chancellor of Community Relations and Student

More information

Simple. 2015 Benefit Guide. Personal. Empowering.

Simple. 2015 Benefit Guide. Personal. Empowering. 2015 Benefit Guide Simple. Personal. Empowering. An easy-to-use guide to understanding your UnitedHealthcare benefits offered by the Cook County Pension Fund. Open Enrollment is November 1 - November 30

More information

Diabetes Coverage in the Health Insurance Exchanges & Essential Health Benefits

Diabetes Coverage in the Health Insurance Exchanges & Essential Health Benefits Diabetes Coverage in the Health Insurance Exchanges & Essential Health Benefits Dr. LaShawn A. McIver, MD, MPH National Director, Public Policy & Strategic Alliances American Diabetes Association O Presentation

More information

The Health Insurance Marketplace 101

The Health Insurance Marketplace 101 The Health Insurance Marketplace 101 National Newspaper Association 127th Annual Convention & Trade Show September 13, 2013 Office of the Regional Director Community Resource California-Based Arizona,

More information

Your guide to UnitedHealthcare

Your guide to UnitedHealthcare Your guide to UnitedHealthcare Face the future with confidence The benefits environment remains challenging. Uncertainty reigns as a wave of new regulation sweeps across the industry. Costs continue to

More information

Proven Innovations in Primary Care Practice

Proven Innovations in Primary Care Practice Proven Innovations in Primary Care Practice October 14, 2014 The opinions expressed are those of the presenter and do not necessarily state or reflect the views of SHSMD or the AHA. 2014 Society for Healthcare

More information

FOUR COMMON PATHWAYS TO ELIGIBILITY

FOUR COMMON PATHWAYS TO ELIGIBILITY IN THIS FACT SHEET: WASHINGTON MEDICAID, SCHIP, AND ADULT HEALTH PROGRAMS AUGUST 2008 An Overview of Washington s Publicly Funded Health Insurance Programs This summary is intended to assist professionals

More information

Community and Social Services

Community and Social Services Developing a path to employment for New Yorkers with disabilities Community and Social Services Mental Health and Substance Abuse Social Workers... 1 Health Educators... 4 Substance Abuse and Behavioral

More information

Creating a new model of care for a healthier Ohio

Creating a new model of care for a healthier Ohio Creating a new model of care for a healthier Ohio A Collaborative Vision of Introducing Health Innovations Ohio In the true spirit of collaboration, four of Ohio s most highly regarded health systems are

More information

Health care with a difference. Montgomery County Public Schools Employee and Retiree Health Benefits Program 2011 Group Policy Number 704567

Health care with a difference. Montgomery County Public Schools Employee and Retiree Health Benefits Program 2011 Group Policy Number 704567 Health care with a difference. Montgomery County Public Schools Employee and Retiree Health Benefits Program 2011 Group Policy Number 704567 One of a kind. We re delivering health care from a fresh -

More information

The Health Care Transformation Glossary

The Health Care Transformation Glossary The Health Care Transformation Glossary which was compiled using a variety of sources helps to educate your staff, governance and community about the new language associated with transformation. Using

More information

Organizational Structure: Vision, Mission and Values: BCBSF COMPANY FACTS

Organizational Structure: Vision, Mission and Values: BCBSF COMPANY FACTS Headquarters: Jacksonville, Florida Founded: In 1944, the Florida Hospital Service Corporation, the forerunner of Blue Cross of Florida, began operations in Jacksonville with a staff of four. In 1946,

More information

Medicare Explained (For the rest of us!) A plain English version

Medicare Explained (For the rest of us!) A plain English version Produced by & Not affiliated with any Government Agency A Brief History of Medicare Medicare is a national social insurance program, administered by the U.S. federal government since 1965, that guarantees

More information

Innovative State Practices for Improving The Provision of Medicaid Dental Services:

Innovative State Practices for Improving The Provision of Medicaid Dental Services: Innovative State Practices for Improving The Provision of Medicaid Dental Services: SUMMARY OF EIGHT STATE REPORTS: (Alabama, Arizona, Maryland, Nebraska, North Carolina, Rhode Island, Texas and Virginia)

More information

Community Paramedicine

Community Paramedicine Community Paramedicine A New Approach to Integrated Healthcare Prepared by a committee of: 600 Wilson Lane Suite 101 Mechanicsburg, PA 17055 (717) 795-0740 800-243-2EMS (in PA) www.pehsc.org 1 P age Community

More information

St. Vincent s Medical Center Southside Implementation Strategy

St. Vincent s Medical Center Southside Implementation Strategy St. Vincent s Medical Center Southside Implementation Strategy Implementation Strategy Narrative Overview St. Vincent s Medical Center Southside is a 313-bed comprehensive, acute care hospital. It was

More information

GAO MEDICARE ADVANTAGE. Relationship between Benefit Package Designs and Plans Average Beneficiary Health Status. Report to Congressional Requesters

GAO MEDICARE ADVANTAGE. Relationship between Benefit Package Designs and Plans Average Beneficiary Health Status. Report to Congressional Requesters GAO United States Government Accountability Office Report to Congressional Requesters April 2010 MEDICARE ADVANTAGE Relationship between Benefit Package Designs and Plans Average Beneficiary Health Status

More information

TIMELINE FOR IMPLEMENTATION OF THE AFFORDABLE CARE ACT

TIMELINE FOR IMPLEMENTATION OF THE AFFORDABLE CARE ACT TIMELINE FOR IMPLEMENTATION OF THE AFFORDABLE CARE ACT 2010: NEW CONSUMER PROTECTIONS Eliminated pre-existing coverage exclusions for children: under age 19. Prohibited insurers from dropping coverage:

More information

hospitals within a hospital system for other payment purposes and could easily do so for this program as well.

hospitals within a hospital system for other payment purposes and could easily do so for this program as well. Statement by Phyllis Teater on Health Information Technology and the Electronic Health Records Incentive Program submitted to the Committee on Ways and Means United States House of Representatives July

More information

The Civic Federation

The Civic Federation Department of Healthcare and Family Services Rod R. Blagojevich, Governor Barry S. Maram, Director Presents Illinois: Achievements and Innovations In Healthcare Coverage March 15, 2007 The Civic Federation

More information

What is Healthcare Reform? Get a view of the future health care system in the US; learn. success factors for healthcare administrators?

What is Healthcare Reform? Get a view of the future health care system in the US; learn. success factors for healthcare administrators? What is Healthcare Reform? Get a view of the future health care system in the US; learn about primary resources and tools for the healthcare administrator, and what are the success factors for healthcare

More information

Raiding Seniors Health Care for ObamaCare s Medicaid Expansion

Raiding Seniors Health Care for ObamaCare s Medicaid Expansion FEBRUARY 28, 2014 www.uncoverobamacare.org Raiding Seniors Health Care for ObamaCare s Medicaid Expansion OBAMACARE BREAKS THE PROMISE OF MEDICARE FOR SENIORS TO BANKROLL A MEDICAID EXPANSION FOR ABLE-BODIED,

More information

POPULATION HEALTH MANAGEMENT The Lynchpin of Emerging Healthcare Delivery Improve Patient Outcomes, Engage Physicians, and Manage Risk

POPULATION HEALTH MANAGEMENT The Lynchpin of Emerging Healthcare Delivery Improve Patient Outcomes, Engage Physicians, and Manage Risk POPULATION HEALTH MANAGEMENT The Lynchpin of Emerging Healthcare Delivery Improve Patient Outcomes, Engage Physicians, and Manage Risk Julia Andrieni, MD, FACP Vice President, Population Health and Primary

More information

2015 Freedom Health Sales Presentation Video Transcript- (Host) (Member Testimony) H5427_15FHSalesPresVidv2_CMS Approved

2015 Freedom Health Sales Presentation Video Transcript- (Host) (Member Testimony) H5427_15FHSalesPresVidv2_CMS Approved 2015 Freedom Health Sales Presentation Video Transcript- H5427_15FHSalesPresVidv2_CMS Approved Welcome to this presentation on Freedom Health s Medicare Advantage Plans. Today you will learn about the

More information

Patient Navigators and Community Health Workers: The Evolving Role of Certification

Patient Navigators and Community Health Workers: The Evolving Role of Certification Patient Navigators and Community Health Workers: The Evolving Role of Certification Presented by: Jan Chamness, MPH, Public Health Director, Montgomery County Health Department Frances J. Feltner, DNP,

More information

issue brief Medicaid: A Key Source of Insurance in New Hampshire

issue brief Medicaid: A Key Source of Insurance in New Hampshire issue brief April 20, 2011 Medicaid: A Key Source of Insurance in New Hampshire As state and federal policymakers come to grips with substantial budget shortfalls both now and into the future one public

More information

Coinsurance A percentage of a health care provider's charge for which the patient is financially responsible under the terms of the policy.

Coinsurance A percentage of a health care provider's charge for which the patient is financially responsible under the terms of the policy. Glossary of Health Insurance Terms On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. When making decisions about health coverage, consumers should

More information

Q&A: Group Health Joining Kaiser Permanente

Q&A: Group Health Joining Kaiser Permanente Q&A: Group Health Joining Kaiser Permanente Select the topic you d like to see questions and answers about: General Overview................. page 1 Acquisition Details................. page 2 Information

More information