Managed Care Report
Managed Care Report
• HIP Health Plan of New York has been awarded three-year, full accreditation by the National Committee for Quality Assurance.
• Aetna U.S. Healthcare of Philadelphia has earned the 1999 Sachs Seal of Excellence. The award, given by Sachs Group (Evanston, IL), identifies the plan as one of the nation’s leading health plans for members satisfaction with health and wellness information.
• Horizon Blue Cross Blue Shield of New Jersey’s (Newark, NJ) Horizon HMO commercial managed care plan has received full, three-year accreditation from the National Committee for Quality Assurance.
• A.M. Best (Oldwick, NJ) last week affirmed its A rating on Blue Cross & Blue Shield of Florida (Jacksonville, FL). The rating reflects the company’s strong position in the Florida healthcare market, established managed care capabilities, and consistently good earnings, A.M. Best said. Offsetting these strengths, A.M. Best added, are the challenges facing the company in maintaining both market share and historical levels of profitability in light of Florida’s increasingly competitive healthcare environment.
• Humana (Louisville, KY) and Columbia/HCA Health Care (Nashville, TN) have reached a deal in which Humana will continue to give care to thousands of plan members in Florida. The terms of the two-year contract were not disclosed. More than 1.3 million Humana members in Florida were in danger of losing coverage for using the 56 Columbia hospitals in the state, reported the Wall Street Journal.
• Four preferred provider organizations have joined to form a PPO network that covers six states, including Colorado, Iowa, Kansas, Missouri, Nebraska, and South Dakota. The network of provider-sponsored PPOs provides employers with access to more than 19,000 healthcare professionals and 400 hospitals. The network will provide coverage through the following health plans: HealthCare Colorado, HealthNet in Kansas and Missouri, Midlands Health Partners in Iowa, Nebraska, and South Dakota, and Preferred Health Systems in Kansas.
• RightChoiceManaged Care (St. Louis), in its first review, was granted a one-year accreditation from the National Committee for Quality Assurance for its HMO Missouri, doing business as BlueChoice HMO, subsidiary.
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