Universal American Corp., a specialty health and life insurance holding company, provides health insurance and managed care products and services to Medicare and Medicaid customers in the United States. Businesses The company focuses on three main businesses: Medicare Advantage: The company serves the Medicare population by providing Medicare Advantage products to approximately 105,000 members, as of January 1, 2015. Medicare Accountable Care Organizations: The company addresses the high cost of health care for the majority of the Medicare population enrolled in traditional fee-for-service Medicare. It has joined with primary-care and multi-specialty provider groups to operate 24 Accountable Care Organizations (ACOs), pursuant to the Medicare Shared Saving Program (MSSP). Medicaid: The company also provides services to Medicaid agencies and health plans through APS Healthcare and through its Total Care Medicaid health plan serving approximately 40,000 members in upstate New York. Strategy Below are the main elements of the company’s strategy: aligning incentives through gain sharing arrangements so that providers are incented to assist members to achieve healthy outcomes; and providing actionable data and analytics to providers and employ enabling technology to ensure that the right care is delivered at the right time in the right setting. Segments The company manages and reports its business as follows: Medicare Advantage segment includes Medicare Advantage businesses. Management Services Organization (MSO) segment supports its physician partnerships in the development of value-based healthcare models, such as ACOs, with various capabilities and resources including technology, analytics, clinical care coordination, regulatory compliance and program administration. Medicaid segment reflects the operations of its Total Care Medicaid health plan in upstate New York serving approximately 40,000 members in Syracuse and surrounding areas. Traditional Insurance segment reflects its closed block of insurance products not offered through government programs, which includes Medicare supplement, long-term care, other senior health insurance, specialty health insurance and life insurance. Corporate & Other segment reflects the activities of its holding company and the operations of APS Healthcare. Medicare Advantage The company offers Medicare Advantage plans in three states: Texas, New York and Maine. The company has a complementary collection of businesses centered in upstate New York, where the company serves approximately 35,000 Medicare Advantage members, 17,000 Medicare fee-for-service beneficiaries through its ACO, and 40,000 Medicaid lives through its Total Care plan. Medicare Advantage—Texas: The company's major Medicare Advantage market is Texas, primarily the Houston/Beaumont region and North Texas. The company markets its products using the TexanPlus brand. The company’s HMO plans are offered under contracts with the Centers for Medicare & Medicaid Services (CMS) and provides all basic Medicare covered benefits with reduced member cost-sharing, as well as additional supplemental benefits, including a defined prescription drug benefit. In connection with the HMOs, the company operates separate Medicare Advantage Management Service Organizations that manage that business and affiliated Independent Physician Associations (IPAs). Medicare Advantage—Northeast: The company’s other market is upstate New York, primarily the 10 counties that are part of the Syracuse market. The company markets its Medicare Advantage products using the Todays Options brand. The products provided in its Northeast market include PPO and Network PFFS plans. The company’s PPO plans are provided under the brand ‘Today's Options PPO’. They are offered under contracts with CMS and provide all basic Medicare covered benefits with reduced member cost-sharing, as well as additional supplemental benefits, including a defined prescription drug benefit. This coordinated care product is built around contracted networks of providers who, in cooperation with the health plan, coordinate an active care manag
universal american corp (UAM:New York)
44 South Broadway
White Plains, NY 10601
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