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The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing for-profit health care and providing American health insurance while improving the quality of that care. It has become the essentially exclusive system of delivering and receiving American health care since its implementation in the early 1980s, and has been largely unaffected by the Affordable Care Act of 2010.
...intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as Health Maintenance Organizations and Preferred Provider Organizations.
Highmark is a non-profit healthcare company and Integrated Delivery Network based in Pittsburgh, Pennsylvania, United States. It is a large individual not-for-profit health insurer in the United States, which operates several for-profit subsidiaries.
Blue Cross Blue Shield Association (BCBSA) is a federation of 36 separate United States health insurance companies that provide health insurance in the United States to more than 106 million people. It was formed in 1982 from the merger of its two namesake organizations: Blue Cross was founded in 1929 and became the Blue Cross Association in 1960, while Blue Shield emerged in 1939 and the Blue Shield Association was created in 1948.
Cambia Health Solutions is a nonprofit health care company based in Portland, Oregon. It is the parent company of Regence, a member of the Blue Cross Blue Shield Association operating in Oregon, Idaho, Utah, and Washington; Asuris Northwest Health; BridgeSpan Health; and LifeMap.
BlueCross BlueShield of Tennessee is the largest health benefit plan company in Tennessee. It is an independent, not-for-profit organization governed by its own board of directors.
Blue Shield of California is a health plan provider founded in 1939. It is based in Oakland, California and serves over 4 million health plan members and nearly 65,000 physicians across the state. Blue Shield of California was founded by the California Medical Association. Founded as a not-for-profit, Blue Shield of California was stripped of its tax-exempt status by the California Franchise Tax Board in 2014.
Medavie Blue Cross is a non-profit Canadian medical care insurance company headquartered in Moncton, New Brunswick.
Health Care Service Corporation (HCSC) is a member-owned health insurance company in the United States. HCSC was formerly known as Hospital Service Corporation and changed its name to Health Care Service Corporation in 1975. The company was founded in 1936 and is based in Chicago, Illinois with a network of offices in the United States. Health Care Service Corporation is the licensee of the Blue Cross and Blue Shield Association for five states. It concentrates its operations in Illinois, Montana, New Mexico, Oklahoma, and Texas.
Excellus BlueCross BlueShield is a non-profit health insurance company headquartered in Rochester, New York. It is part of the Blue Cross Blue Shield Association. Excellus BCBS is upstate New York's largest nonprofit health plan.
Premera Blue Cross is a not-for-profit Blue Cross Blue Shield licensed health insurance company based in Mountlake Terrace, Washington, United States. It sells health insurance plans under the Blue Cross license in Washington state except Clark County and under both of the Blue Cross and Blue Shield licenses in Alaska.
Independence Blue Cross (Independence) is a health insurer based in Philadelphia, Pennsylvania, in the United States. Independence is the largest health insurer in the Philadelphia area, serving more than two million people in the region and seven million nationwide.
Council for Affordable Quality Healthcare, Inc. is a non-profit organization incorporated in California as a mutual benefit corporation. It was first incorporated under the name Coalition for Affordable, Quality Healthcare, Inc., and then was renamed the Council for Affordable Quality Healthcare, Inc. on July 22, 1998. It is based in Washington, D.C.. Previously a 501(c)6 tax-exempt organization, CAQH changed its tax status in 2016, although it remains a non-profit. Its mission is to accelerate the transformation of business processes in healthcare through collaboration, innovation and a commitment to ensuring value across stakeholders, including healthcare providers, trade associations, and health plans.
Medical Mutual of Ohio (MMOH) is an American mutual health insurance company. It is the oldest and largest health insurance company based in Cleveland, Ohio, and serves more than 1.6 million customers. Employing 2,500 people, Medical Mutual is one of the biggest employers in downtown Cleveland.
Blue Cross and Blue Shield of Alabama (BCBSAL) is a nonprofit health insurance company headquartered in Birmingham, Alabama. The company was founded in 1936, provides coverage to more than 3 million people and is a member of the Blue Cross and Blue Shield Association (BCBS). BCBSAL employs nearly 5,000 people, which includes almost 3,500 people at its corporate headquarters in Birmingham. The company also operates Cahaba Government Benefit Administrators and Cahaba Safeguard Administrators, both headquartered in Birmingham. It commands over 90 percent of the health insurance market in Alabama, a state with half a million uninsured people, one of the highest uninsured rates in the nation at 10 percent of the population.
The Penn Plaza East complex takes its name for its location near Penn Station in Newark, New Jersey. Fronting Raymond Boulevard on the banks of the Passaic River, the two office buildings were constructed during a period in the late 1980s and early 1990s when they and numerous postmodern skyscrapers were built near the station and Gateway Center. While others went up between the station and traditional Downtown Newark, Penn Plaza East is on the Ironbound, or east, side of the major transportation hub. As of 2010, the buildings are occupied by the corporate headquarters of New Jersey Transit, JOC Group, and Horizon Blue Cross Blue Shield of New Jersey, which owns their building.
Anthem, Inc., is a provider of health insurance in the United States. It is the largest for-profit managed health care company in the Blue Cross Blue Shield Association. As of 2018, the company had approximately 40 million members.
Hoboken University Medical Center is a hospital located in Hoboken, New Jersey. It was founded in 1863 as St. Mary Hospital and operated under that name until 2007. The hospital is owned by Hudson Hospital Opco, known as CarePoint Health, a for-profit organization that also owns Bayonne Medical Center and Christ Hospital.
Christ Hospital is in Jersey City, New Jersey. It is affiliated with Hoboken University Medical Center and the Bayonne Medical Center. It is one of the six hospitals in Hudson County, New Jersey operated by the for-profit organization Hudson Hospital Opco, known as Care Point Health. According to a study conducted by National Nurses United and released in January 2014, the hospital was the 9th most expensive in the state, charging 763% above costs.
BlueCross BlueShield of South Carolina (BlueCross) is an independent licensee of the Blue Cross and Blue Shield Association. BlueCross serves 21.5 million people through private business and government contracts.
Wellmark Blue Cross Blue Shield is a mutual insurance in the United States with more than two million members in Iowa and South Dakota. It is the dominant health insurance in Iowa. It is an independent licensee of the Blue Cross Blue Shield Association. Founded in 1939, Wellmark offers dental and health insurance as well as life insurance. It began participating in the health care exchange for 2017.
References
- ↑ "Horizon Blue Cross Blue Shield of New Jersey Named Among Top 10 Non-Profit Companies for Executive Women" (PDF). www.horizonblue.com. Retrieved 2019-06-05.
- ↑ "Fast Facts - Horizon Blue Cross Blue Shield of New Jersey". www.horizonblue.com. Retrieved 2018-05-27.
- ↑ "Review of Horizon BCBSNJ Omnia - Everything you need to know about Omnia Plans - NJ Insurance Plans - Mike Sheeran, CFP".
