Associations
BABICM: British Association of Brain Injury Case M, National Managed Health Care Congress, Philippine Institute of Managed Care, Inc., South Africa - African Health Synergies (AHS), USA - - Academy of Managed Care Pharmacy (AMCP), USA - - Academy of Managed Care Providers (AMCP), USA - - American Association of Preferred Provider, USA - - National Committee for Quality Assurance (, USA - - Utilization Review Accreditation Committee
Health Maintenance Organizations [HMO]
Care Choices HMO, Care1st Health Plan, Chinese Community Health Plan (CCHP), Delta Dental Plan of California, Family Health Plan Ltd., FirstCare, Health Insurance Plan of New York (HIP), Kaiser Permanente, Neighborhood Health Plan, PersonalCare Health Management, Inc.
Preferred Provider Organizations [PPO]
1st Medical Network, LLC, Asuris Northwest Health, Blue Ridge Health Network, CCN, Consumer Health Network (CHN), Elkhart Medical Organization (EMO), EncoreConnect, Flora Midwest, Fortified Provider Network, Health Choice of Northwest Missouri
Resources
HealthMetrix Research, InterStudy Publications, Managed Care - Info, Managing Managed Care
American Rehabilitation, Inc. (ARI)
Offers medical and vocational rehabilitation, telephonic claims reporting, telephonic case management, and medical networks.
American Specialty Health Plans of California
[USA, California] Offers health plans for chiropractic care and acupuncture. Site describes the company and includes directory of participating care providers.
AmeriChoice Corporation
[USA] Organizes health care benefits and services for beneficiaries of Medicaid and other government-sponsored health care programs in more than one dozen markets nationwide.
Amerigroup Corporation
[USA] Provider of health care to low-income and uninsured families in several states and the District of Columbia. [English, some content in Spanish]
British Union Provident Association (BUPA)
[International] Provider of health insurance plans and services in several nations.
Choice One, Inc.
[USA, North Carolina] Offers ongoing review and negotiation of managed care agreements for physicians with HMOs, PPOs, and POS programs. Has assisted in establishing several independent practice associations (IPAs).
College Health IPA
[USA, California] A behavioral healthcare delivery system serving approximately 1.1 million members.
Community Care Behavioral Health Organization
Designed primarily to serve public sector consumers, and their families in Pennsylvania through the delivery of effective and accessible behavioral health services. Information on the company and its services is offered.
Concentra, Inc.
[USA] Provides occupational health services for cost containment and lost time prevention including: drug screens, physical therapy, first notice of injury, and case management.
CorVel Corporation
[USA] A national, independent provider of managed care and case management services for workers' compensation, accident and health, and auto insurance markets.
County Managed Care Resource (COMCARE)
[USA, Pennsylvania] A program of the County Commissioners Association, which provides services and assistance to the counties implementing behavioral managed healthcare within the state HealthChoices program.
Coventry Health Care, Inc.
[USA] A managed health care organization which offers HMOs and PPOs in many states. Site provides links to subsidiary organizations, offers investor information, and a company overview.
Definity Health, Inc.
[USA] A provider of consumer-driven health plans, consisting of an employer-funded personal care account, a traditional health coverage component, and an array of tools and resources to support its members.
First Health Group Corporation
[USA] Serves the group health, workers' compensation, and state public program markets in addition to offering claims services and clinical management. Site describes the company, its services, and offers consumer information.
GatesMcDonald HealthPlus
[USA, Ohio] A managed care program providing medical care via workers' compensation for injured workers. Site describes company, its services, and allows provider lookup.
Harvard Pilgrim Health Care
[USA] Nonprofit organization offers HMO, PPO, and POS plans in New England. Includes benefits, coverage, financial and employment information, and health news.
Health Plan of Nevada
[USA, Nevada] Offers HMO, Medicare HMO, PPO, and POS plans. Site includes information about plan options and benefits and a glossary. A subsidiary of Sierra Health Services, Inc.
Health Risk Management, Inc.
Provides integrated health care management and information services to manage the quality volume and cost of health care under employee benefit plans. (Nasdaq: HRMI).
Healthcare Recoveries, Inc.
Provides health insurance subrogation and related recovery services for private healthcare payors. (Nasdaq: HCRI).
HealthExtras, Inc.
Provides supplemental health and disability benefit programs directly to consumers over the Internet. (Nasdaq: HLEX).
HealthHelp
[USA] Provides radiology management services for insurers and physicians. Its national radiology network is used by many managed care organizations.
HealthSpring
[USA, Tennessee] A managed care organization in central part of state. Site describes products and services, allows provider search, and has areas for members, brokers, providers, and employers.
Humana, Inc.
Offers coordinated health insurance coverage and related services to employer groups, government-sponsored plans, small businesses and individuals. (NYSE:HUM).
Keystone Mercy Health Plan
[USA, Pennsylvania] Medical assistance (Medicaid) managed care health plan in the southeastern region of the state.
Lumenos, Inc.
[USA] Offers three phase program of consumer-driven healthcare, consisting of health savings account, traditional health coverage, and a health toolkit.
Medical Network One
[USA, Michigan] A for-profit organization committed to providing administrative services to physicians who have entered into both risk sharing and non-risk sharing agreements with managed care organizations.
Molina Healthcare, Inc.
[USA] Provides managed healthcare in California, Washington, Utah, and Michigan, to individuals covered under Medicaid and related programs. [English, Spanish, Chinese, Russian, Vietnamese, and Hmong]
Multimed
[South Africa] A medical scheme administrator. Services include managed care, claims management, and risk management.
National Medical Health Card Systems, Inc.
Offers prescription benefit management services to plan sponsors which include managed care organizations, local governments, unions, corporations and third party health care plan administrators. National network of licensed pharmacies, from Port Washington, New York. (Nasdaq: NMHC).
Pacificare Health Systems
[USA] A managed care health insurance company providing health plans for seniors, employer groups, families, and individuals. Includes areas for brokers, employers, and health care providers. Operates in western states and Guam.
Profit Line
[USA] Delivers high return, risk free managed care claim audit and recovery services to the managed healthcare industry.
Prospect Medical
[USA, California] An affiliation of several managed care plans in the Greater Los Angeles area who have joined together to provide the full range of medical services to patients.
Ravenswood Physician Associates (RPA)
[USA, Illinois] An independent physicians association (IPA) of nearly 250 private practice physicians in Chicago and select northern suburbs. Providing insurance contract management and healthcare.
Resolution Health Medical Scheme
[South Africa] Provides comprehensive, affordable medical cover to employer groups and individuals, and is supported by sound financial, administrative and medical controls.
Sierra Health Services, Inc.
Provider of managed care benefit plans for employers, government programs, and individuals. Site offers company, investor, career and product information. Products include HMO, PPO, and POS. Headquartered in Las Vegas, Nevada, USA
Spectrum Managed Care
[USA, Texas] A workers' compensation managed care firm offering claims and case management, occupational networks, and medical bill and utilization review.
Welsh Mountain Medical and Dental Center (WMMDC)
Primary care center serving everyone in Lancaster County, Pennsylvania. Offers programs to serve uninsured and low-income individual and families.