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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 health care and providing American health insurance while improving the quality of that care. It has become the predominant 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 an American 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, also known as BCBS, BCBSA, or The Blues, is a United States-based federation with 33 independent and locally-operated BCBSA companies that provide health insurance in the United States to more than 115 million people as of 2022.
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.
Medavie Blue Cross is a not-for-profit Canadian medical care insurance company headquartered in Moncton, New Brunswick.
The Triple-S Management Corporation (TSM) —commonly known as Triple-S, or SSS— is an insurance holding company based in San Juan, Puerto Rico, which offers a wide range of insurance products and services in Puerto Rico through its wholly owned subsidiaries. Its headquarters are located at 1441 Franklin D. Roosevelt Ave., in the San Patricio section of San Juan.
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.
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 people in the region and seven million nationwide.
Banfield Pet Hospital is a privately owned company based in Vancouver, Washington, United States, that operates veterinary clinics. Part of the Mars Inc. family of companies, Banfield owns clinics in the United States, Mexico, and the United Kingdom. Founded in 1955, the company operates many of its 1,000 plus clinics inside PetSmart stores. Banfield is the largest privately owned veterinary practice in the United States. On April 2, 2014, Banfield Pet Hospital announced its headquarters would be relocating to Vancouver, Washington, from nearby Portland, Oregon.
The Council for Affordable Quality Healthcare, Inc. (CAQH) 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 renamed the Council for Affordable Quality Healthcare, Inc. on August 8, 2002. 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.
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.
Penn Plaza East is an office building complex located near Penn Station in Newark, New Jersey. Fronting Raymond Boulevard on the banks of the Passaic River, the two office building complex 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. The two towers sit above a four-story parking facility and lobby that joins them. An additional parking area in the shadow of the Dock Bridge will be developed as part of Newark Riverfront Park, a promenade along the banks of the Passaic River.
Blue Cross Blue Shield of Michigan (BCBSM) is an independent licensee of Blue Cross Blue Shield Association.
Elevance Health, Inc. is an American health insurance provider. Prior to June 2022, Elevance Health was named Anthem, Inc. The company's services include medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans through affiliated companies such as Anthem Blue Cross and Blue Shield, Anthem Blue Cross in California, Wellpoint, and Carelon. It is the largest for-profit managed health care company in the Blue Cross Blue Shield Association. As of 2022, the company had 46.8 million members within its affiliated companies' health plans.
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.
GuideWell, formally GuideWell Mutual Holding Corporation, is a mutual insurance holding company primarily focused on health insurance in Florida. It was created in 2013 by a reorganization initiated by Florida Blue, a member company of the Blue Cross Blue Shield Association. By health insurance premiums written, it is 10th largest in providing health insurance in the United States with about $15b in health insurance sales.
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".
