Health Insurance in Virginia

Innovation Health Plan, Inc.

Company Information

  • Company Providing Plan:Inova and Aetna
  • Address:151 Farmington Avenue, RT21
    Hartford, CT 06156
  • Telephone :703-914-2925
  • Website:www.innovation-health.com
2017
Number of Enrollees: 21,040
PMPM: $352
Number of Physicians: 79,982
NCQA Accreditation: Accredited

*The data elements noted with an asterisk (*) contain regional-specific values whereas those not noted with an asterisk (*) contain Virginia specific values.


Coverage Areas

Counties

Amelia, Arlington, Buckingham, Caroline, Charlotte, Charles City, Chesterfield, Cumberland, Dinwiddie, Fairfax, Fauquier, Goochland, Hanover, Henrico, King George, King William, Loudoun, Louisa, Lunenburg, New Kent, Nottoway, Powhatan, Prince Edward, Prince George, Prince William, Spotsylvania, Stafford, Surrey, Sussex, Westmoreland


Cities

Alexandria, Colonial Heights, Fairfax, Falls Church, Fredericksburg, Hopewell, Manassas, Manassas Park, Petersburg, Richmond

Information provided by HMOs to State Corporation Commission Bureau of Insurance.

Administrative Data

2017 2016 2015 2014 2013
Number of Enrollees 21,040 27,510 22,874 18,580 3,945
PMPM $352 $313 $318 $335 $2,042
Medical Cost Ratio 82% 88% 73% 73% 72%
Administrative Ratio 17% 19% 19% 23% 47%
Profit/Loss Ratio 1% -7% 7% 2% -26%
Number of Physicians 79,982 72,651 65,263 50,861 45,711

*The data elements noted with an asterisk (*) contain regional-specific values whereas those not noted with an asterisk (*) contain Virginia specific values.

Financial Data

2017 2016 2015 2014 2013
Premiums Earned $104,799,970 $95,876,576 $79,978,908 $42,248,104 $8,832,350
Income $277,269 ($4,890,121) $3,438,659 $1,088,809 ($2,262,863)
Net Worth $22,523,667 $18,427,637 $17,645,367 $12,139,629 $5,845,934

*The data elements noted with an asterisk (*) contain regional-specific values whereas those not noted with an asterisk (*) contain Virginia specific values.

Performance

  • Performance Information for Innovation Health Plan, Inc. not currently available.
Access/Availability of Care
Info
Adult Access To Preventive/Ambulatory Health Services 2017 Plan State Avg Nat Avg 90th Pctl.
Adult Access (Age 20-44) To Preventive/Ambulatory Health Services 90.18% 92.73% 92.45% 95.43%
Adult Access (Age 45-64) To Preventive/Ambulatory Health Services 92.91% 95.57% 95.61% 97.46%
Adult Access (Age 65 and Older) To Preventive/Ambulatory Health Services 99.54% 97.82% 97.07% 98.47%
Adult Access To Preventive/Ambulatory Health Services Year Plan State Avg. Natl. Avg. 90th Pctl.
Adult Access (Age 20-44) To Preventive/Ambulatory Health Services 2016 N/A 92.81% 92.73% 95.55%
2015 N/A 92.25% 92.83% 95.45%
2014 N/A 93.10% 92.91% 95.39%
2013 N/A 93.27% 93.13% 95.56%
Adult Access (Age 45-64) To Preventive/Ambulatory Health Services 2016 N/A 95.78% 95.78% 97.61%
2015 N/A 95.61% 95.90% 97.55%
2014 N/A 96.03% 95.85% 97.54%
2013 N/A 95.97% 95.93% 97.60%
Adult Access (Age 65 and Older) To Preventive/Ambulatory Health Services 2016 N/A 97.30% 97.19% 98.61%
2015 N/A 96.84% 97.32% 96.73%
2014 N/A 97.56% 97.50% 98.68%
2013 N/A 97.45% 97.36% 98.63%
Info
Alcohol and Other Drug Dependence Treatment 2017 Plan State Avg Nat Avg 90th Pctl.
Initiation of Alcohol and Other Drug Dependence Treatment - Total 28.33% 36.14% 36.11% 42.01%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 13-17 44.44% 40.06% 39.91% 52.54%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 27.49% 36.00% 35.97% 41.96%
Engagement of Alcohol and Other Drug Dependence Treatment - Total 11.11% 13.36% 12.65% 17.26%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 13-17 11.11% 14.40% 14.95% 23.85%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 11.11% 13.40% 12.55% 17.38%
Alcohol and Other Drug Dependence Treatment Year Plan State Avg. Natl. Avg. 90th Pctl.
Initiation of Alcohol and Other Drug Dependence Treatment - Total 2016 N/A 35.69% 32.93% 40.24%
2015 N/A 33.04% 33.42% 41.07%
2014 N/A 32.51% 35.63% 44.19%
2013 N/A 35.00% 39.01% 50.93%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 13-17 2016 N/A 40.15% 40.47% 51.96%
2015 N/A 37.03% 39.62% 50.00%
2014 N/A 37.09% 40.79% 52.00%
2013 N/A 39.67% 41.13% 53.51%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 2016 N/A 35.55% 32.64% 40.33%
2015 N/A 32.96% 33.20% 40.93%
2014 N/A 32.16% 35.21% 43.92%
2013 N/A 34.74% 38.83% 51.61%
Engagement of Alcohol and Other Drug Dependence Treatment - Total 2016 N/A 12.51% 11.46% 16.72%
2015 N/A 11.61% 12.46% 19.23%
2014 N/A 10.64% 13.66% 19.19%
2013 N/A 12.12% 14.64% 21.16%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 13-17 2016 N/A 11.28% 15.68% 23.73%
2015 N/A 12.06% 15.42% 22.12%
2014 N/A 13.00% 17.24% 25.29%
2013 N/A 18.05% 18.23% 27.05%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 2016 N/A 12.57% 11.32% 16.09%
2015 N/A 11.57% 12.34% 18.67%
2014 N/A 10.33% 13.45% 18.68%
2013 N/A 11.84% 14.47% 21.31%
Info
Child Access to Primary Care Practitioners 2017 Plan State Avg Nat Avg 90th Pctl.
12-24 month old Child Access to Primary Care Practitioners 97.80% 98.09% 97.93% 99.50%
25 month to 6 year old Child Access to Primary Care Practitioners 95.48% 94.63% 92.58% 96.95%
7-11 year old Child Access to Primary Care Practitioners 94.06% 95.40% 93.43% 98.48%
12-19 year old Child Access to Primary Care Practitioners 91.05% 92.00% 91.08% 96.99%
Child Access to Primary Care Practitioners Year Plan State Avg. Natl. Avg. 90th Pctl.
12-24 month old Child Access to Primary Care Practitioners 2016 N/A 98.34% 98.09% 99.72%
2015 N/A 98.78% 98.03% 99.48%
2014 N/A 98.49% 97.87% 99.62%
2013 N/A 97.92% 97.99% 99.48%
25 month to 6 year old Child Access to Primary Care Practitioners 2016 N/A 94.33% 92.60% 96.46%
2015 N/A 94.16% 92.67% 96.64%
2014 N/A 93.85% 92.33% 96.52%
2013 N/A 93.53% 92.38% 96.50%
7-11 year old Child Access to Primary Care Practitioners 2016 N/A 94.38% 93.25% 98.25%
2015 N/A 94.23% 93.23% 97.92%
2014 N/A 93.78% 93.02% 97.87%
2013 N/A 93.78% 93.11% 97.89%
12-19 year old Child Access to Primary Care Practitioners 2016 N/A 91.45% 90.76% 96.39%
2015 N/A 91.30% 90.66% 96.19%
2014 N/A 90.84% 90.44% 96.28%
2013 N/A 90.58% 90.31% 96.28%
Info
Prenatal and Postpartum Care 2017 Plan State Avg Nat Avg 90th Pctl.
Postpartum Care 56.59% 73.45% 75.05% 88.13%
Timeliness of Prenatal Care 81.01% 86.37% 84.34% 94.89%
Prenatal and Postpartum Care Year Plan State Avg. Natl. Avg. 90th Pctl.
Postpartum Care 2016 N/A 74.50% 73.95% 88.85%
2015 N/A 73.91% 73.72% 87.50%
2014 N/A 77.29% 77.64% 88.65%
2013 N/A 81.38% 91.35% 97.14%
Timeliness of Prenatal Care 2016 N/A 86.71% 85.57% 96.28%
2015 N/A 86.80% 84.28% 94.56%
2014 N/A 86.83% 88.00% 96.23%
2013 N/A 91.63% 81.00% 90.48%
Effectiveness of Care
Info
Asthma Medication Management 2017 Plan State Avg Nat Avg 90th Pctl.
Asthma Medication Management Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Asthma Medication Ratio 2017 Plan State Avg Nat Avg 90th Pctl.
Asthma Medication Ratio Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication 2017 Plan State Avg Nat Avg 90th Pctl.
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Initiation 38.24% 41.27% 41.13% 50.83%
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Continuation 40.00% 55.09% 47.07% 58.44%
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication Year Plan State Avg. Natl. Avg. 90th Pctl.
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Initiation 2016 N/A 41.91% 38.93% 48.61%
2015 N/A 41.43% 38.13% 50.00%
2014 N/A 39.00% 38.01% 46.81%
2013 N/A 35.14% 40.10% 51.06%
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Continuation 2016 N/A 46.92% 45.82% 56.86%
2015 N/A 49.06% 46.18% 58.06%
2014 N/A 46.49% 45.70% 57.75%
2013 N/A 41.32% 46.66% 58.62%
Info
Cardiovascular Disease Management 2017 Plan State Avg Nat Avg 90th Pctl.
Controlling High Blood Pressure 36.50% 56.61% 59.90% 74.82%
Persistence of Beta-Blockers 90.00% 85.80% 85.18% 93.41%
Cardiovascular Disease Management Year Plan State Avg. Natl. Avg. 90th Pctl.
Controlling High Blood Pressure 2016 N/A 56.91% 60.31% 74.43%
2015 N/A 58.35% 58.69% 73.89%
2014 N/A 59.30% 62.63% 75.63%
2013 N/A 60.92% 63.30% 74.65%
Persistence of Beta-Blockers 2016 N/A 90.70% 83.61% 90.83%
2015 N/A 88.70% 84.68% 91.00%
2014 N/A 84.03% 83.50% 91.43%
2013 N/A 83.43% 83.39% 91.72%
Info
Common Childhood Illnesses 2017 Plan State Avg Nat Avg 90th Pctl.
Appropriate Testing for Children With Pharyngitis 94.64% 92.30% 87.45% 94.64%
Common Childhood Illnesses Year Plan State Avg. Natl. Avg. 90th Pctl.
Appropriate Testing for Children With Pharyngitis 2016 N/A 90.38% 84.50% 93.75%
2015 N/A 90.13% 83.12% 93.11%
2014 N/A 88.64% 83.29% 91.40%
2013 N/A 87.54% 81.45% 91.30%
Info
Diabetes Care and Management 2017 Plan State Avg Nat Avg 90th Pctl.
Comprehensive Diabetes Care-Rate of Eye Exams 48.42% 63.40% 60.82% 76.41%
Comprehensive Diabetes Care-Rate of Medical Attention for Diabetic Nephropathy 87.35% 62.51% 57.48% 67.15%
Comprehensive Diabetes Care-Rate of Poor HbA1c control 38.69% 56.95% 54.06% 70.69%
Comprehensive Diabetes Care-Testing for HbA1c 90.27% 90.80% 90.38% 93.61%
Diabetes Care and Management Year Plan State Avg. Natl. Avg. 90th Pctl.
Comprehensive Diabetes Care-Rate of Eye Exams 2016 N/A 60.88% 61.06% 78.35%
2015 N/A 61.03% 58.80% 75.68%
2014 N/A 63.33% 63.85% 76.00%
2013 N/A 42.35% 64.44% 76.22%
Comprehensive Diabetes Care-Rate of Medical Attention for Diabetic Nephropathy 2016 N/A 58.36% 56.62% 66.39%
2015 N/A 57.59% 55.81% 66.67%
2014 N/A 59.12% 58.53% 68.61%
2013 N/A 55.47% 58.87% 69.16%
Comprehensive Diabetes Care-Rate of Poor HbA1c control 2016 N/A 58.46% 52.96% 72.04%
2015 N/A 57.15% 52.47% 70.44%
2014 N/A 57.54% 54.98% 71.93%
2013 N/A 56.05% 54.65% 71.53%
Comprehensive Diabetes Care-Testing for HbA1c 2016 N/A 90.56% 90.03% 92.71%
2015 N/A 91.11% 90.10% 93.40%
2014 N/A 86.26% 84.72% 89.60%
2013 N/A 84.97% 83.75% 89.19%
Info
Drug Therapy in Rheumatoid Arthritis 2017 Plan State Avg Nat Avg 90th Pctl.
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis 86.67% 90.16% 88.62% 93.75%
Drug Therapy in Rheumatoid Arthritis Year Plan State Avg. Natl. Avg. 90th Pctl.
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis 2016 N/A 89.05% 87.87% 93.92%
2015 N/A 89.72% 87.84% 92.86%
2014 N/A 88.05% 87.86% 93.59%
2013 N/A 88.24% 87.95% 94.49%
Info
Immunizations 2017 Plan State Avg Nat Avg 90th Pctl.
Childhood Immunization for Multiple diseases including Chicken Pox 65.03% 81.72% 79.44% 89.14%
Childhood Immunization for Multiple diseases including pneumovax 62.84% 80.09% 77.67% 87.61%
Flu Vaccinations for Adults Ages 18–64 0.49% 0.53% N/A N/A
Immunizations Year Plan State Avg. Natl. Avg. 90th Pctl.
Childhood Immunization for Multiple diseases including Chicken Pox 2016 N/A 84.29% 78.93% 89.03%
2015 N/A 81.56% 78.59% 88.08%
2014 N/A 80.25% 80.18% 88.07%
2013 N/A 80.24% 78.39% 87.14%
Childhood Immunization for Multiple diseases including pneumovax 2016 N/A 82.08% 77.04% 87.50%
2015 N/A 79.45% 76.49% 87.10%
2014 N/A 78.11% 78.13% 86.26%
2013 N/A 78.73% 76.21% 85.40%
Flu Vaccinations for Adults Ages 18–64 2016 N/A 47.13% N/A N/A
2015 N/A 0.50% 47.85% 58.01%
2014 N/A 0.52% 49.45% 59.73%
2013 N/A 0.49% 49.06% 59.59%
Info
Mental Health: Care and Follow-up 2017 Plan State Avg Nat Avg 90th Pctl.
Antidepressant Medication Management-Acute Phase Treatment 78.19% 71.12% 67.11% 75.76%
Antidepressant Medication Management-Continuation Phase Treatment 62.77% 54.87% 51.53% 60.24%
Follow-up After Hospitalization For Mental Illness within 7 days after hospital discharge 67.65% 52.18% 46.63% 62.81%
Follow-up After Hospitalization For Mental Illness within 30 days after hospital discharge 82.35% 69.80% 68.66% 82.58%
Mental Health: Care and Follow-up Year Plan State Avg. Natl. Avg. 90th Pctl.
Antidepressant Medication Management-Acute Phase Treatment 2016 N/A 70.29% 66.56% 74.77%
2015 N/A 67.61% 65.82% 74.06%
2014 N/A 68.52% 65.88% 75.35%
2013 N/A 65.67% 63.60% 73.26%
Antidepressant Medication Management-Continuation Phase Treatment 2016 N/A 53.51% 50.69% 58.60%
2015 N/A 49.81% 50.15% 57.56%
2014 N/A 50.31% 49.83% 59.11%
2013 N/A 48.37% 46.58% 57.12%
Follow-up After Hospitalization For Mental Illness within 7 days after hospital discharge 2016 N/A 52.99% 52.06% 67.31%
2015 N/A 47.66% 50.57% 67.57%
2014 N/A 51.82% 52.21% 70.33%
2013 N/A 55.07% 53.70% 69.16%
Follow-up After Hospitalization For Mental Illness within 30 days after hospital discharge 2016 N/A 73.85% 71.36% 84.17%
2015 N/A 71.58% 69.72% 83.80%
2014 N/A 72.52% 70.72% 85.71%
2013 N/A 73.03% 72.56% 84.19%
Info
Persistent Medications 2017 Plan State Avg Nat Avg 90th Pctl.
Annual Monitoring for Patients on Persistent Medications 86.17% 85.73% 83.71% 87.04%
Persistent Medications Year Plan State Avg. Natl. Avg. 90th Pctl.
Annual Monitoring for Patients on Persistent Medications 2016 N/A 84.90% 83.34% 87.04%
2015 N/A 83.34% 82.94% 86.72%
2014 N/A 83.28% 82.33% 86.25%
2013 N/A 83.44% 82.32% 86.12%
Info
Pharmacotherapy of COPD Exacerbation 2017 Plan State Avg Nat Avg 90th Pctl.
Pharmacotherapy of COPD Exacerbation - Bronchodilator 92.86% 80.88% 79.87% 87.50%
Pharmacotherapy of COPD Exacerbation - Corticosteroid 92.86% 78.84% 76.26% 84.38%
Pharmacotherapy of COPD Exacerbation Year Plan State Avg. Natl. Avg. 90th Pctl.
Pharmacotherapy of COPD Exacerbation - Bronchodilator 2016 N/A 84.12% 76.30% 85.98%
2015 N/A 78.48% 79.09% 87.10%
2014 N/A 80.03% 80.14% 86.90%
2013 N/A 78.88% 79.47% 87.58%
Pharmacotherapy of COPD Exacerbation - Corticosteroid 2016 N/A 79.54% 70.70% 81.82%
2015 N/A 72.98% 75.30% 84.56%
2014 N/A 75.53% 75.28% 83.54%
2013 N/A 73.76% 75.40% 83.33%
Info
Preventive Care 2017 Plan State Avg Nat Avg 90th Pctl.
Breast Cancer Screening 64.69% 71.85% 72.81% 80.91%
Chlamydia Screening in Women-all Age groups 47.00% 51.46% 50.16% 66.08%
Colorectal Cancer Screening 46.96% 65.16% 62.43% 74.72%
Preventive Care Year Plan State Avg. Natl. Avg. 90th Pctl.
Breast Cancer Screening 2016 N/A 71.80% 72.90% 80.63%
2015 N/A 72.07% 73.08% 81.53%
2014 N/A 72.22% 73.52% 81.91%
2013 N/A 72.82% 73.71% 80.78%
Chlamydia Screening in Women-all Age groups 2016 N/A 49.79% 48.98% 63.50%
2015 N/A 47.89% 52.32% 64.06%
2014 N/A 48.07% 51.65% 63.48%
2013 N/A 47.46% 46.20% 59.63%
Colorectal Cancer Screening 2016 N/A 65.83% 61.71% 74.09%
2015 N/A 64.43% 62.32% 73.84%
2014 N/A 63.41% 64.06% 74.86%
2013 N/A 65.36% 62.85% 72.75%
Info
Spirometry Testing 2017 Plan State Avg Nat Avg 90th Pctl.
Use of Spirometry Testing in the Assessment and diagnosis of COPD 55.17% 43.12% 41.90% 50.52%
Spirometry Testing Year Plan State Avg. Natl. Avg. 90th Pctl.
Use of Spirometry Testing in the Assessment and diagnosis of COPD 2016 N/A 42.48% 42.55% 51.02%
2015 N/A 46.31% 42.44% 51.66%
2014 N/A 42.48% 42.16% 51.85%
2013 N/A 43.20% 42.08% 50.99%
Info
Weight Assessment and Counseling 2017 Plan State Avg Nat Avg 90th Pctl.
Adult BMI Assessment 61.32% 79.49% 79.78% 93.20%
Children/Adolescents BMI Assessment - Total 61.56% 70.41% 70.59% 88.08%
Counseling for Nutrition for Children/Adolescents - Total 59.61% 69.47% 65.50% 83.21%
Counseling for Physical Activity for Children/Adolescents - Total 51.58% 64.30% 59.96% 77.32%
Weight Assessment and Counseling Year Plan State Avg. Natl. Avg. 90th Pctl.
Adult BMI Assessment 2016 N/A 77.87% 76.17% 91.85%
2015 N/A 75.90% 74.19% 91.76%
2014 N/A 76.28% 75.36% 91.20%
2013 N/A 72.78% 74.24% 90.00%
Children/Adolescents BMI Assessment - Total 2016 N/A 69.07% 65.62% 88.08%
2015 N/A 60.49% 60.37% 83.78%
2014 N/A 61.63% 61.08% 85.37%
2013 N/A 52.14% 54.90% 83.13%
Counseling for Nutrition for Children/Adolescents - Total 2016 N/A 66.76% 61.76% 83.68%
2015 N/A 63.88% 58.94% 80.79%
2014 N/A 65.02% 60.64% 80.05%
2013 N/A 61.17% 56.48% 79.32%
Counseling for Physical Activity for Children/Adolescents - Total 2016 N/A 60.41% 55.96% 79.44%
2015 N/A 59.53% 54.50% 78.85%
2014 N/A 62.13% 57.09% 77.30%
2013 N/A 56.47% 53.16% 74.70%
Health Plan Stability/Descriptive
Info
Administrative Data 2017 Plan State Avg Nat Avg 90th Pctl.
Administrative Ratio 0.17 0.12 86.39 93.13
Medical Cost Ratio 0.82 0.83 93.13 96.59
Number of Enrollees 21,040 133,992 92 97
Number of Physicians 79,982 81,926 87 95
Premium Per Member Per Month $352 $370 N/A N/A
Profit/Loss Ratio 0.01 0.05 79.44 89.14
Administrative Data Year Plan State Avg. Natl. Avg. 90th Pctl.
Administrative Ratio 2016 0.19 0.15 N/A N/A
2015 0.19 0.14 N/A N/A
2014 0.23 0.14 N/A N/A
2013 0.47 0.14 N/A N/A
Medical Cost Ratio 2016 0.88 0.83 N/A N/A
2015 0.73 0.82 N/A N/A
2014 0.73 0.81 N/A N/A
2013 0.72 0.83 N/A N/A
Number of Enrollees 2016 27,510 136,796 N/A N/A
2015 22,874 124,097 N/A N/A
2014 18,580 115,428 N/A N/A
2013 3,945 98,253 N/A N/A
Number of Physicians 2016 72,651 73,426 N/A N/A
2015 65,263 90,027 N/A N/A
2014 50,861 63,157 N/A N/A
2013 45,711 64,207 N/A N/A
Premium Per Member Per Month 2016 $313 $370 N/A N/A
2015 $318 $375 N/A N/A
2014 $335 $412 N/A N/A
2013 $2,042 $544 N/A N/A
Profit/Loss Ratio 2016 -0.07 0.03 N/A N/A
2015 0.07 0.04 N/A N/A
2014 0.02 0.06 N/A N/A
2013 -0.26 0.03 N/A N/A
Info
Board Certification Rates for Providers 2017 Plan State Avg Nat Avg 90th Pctl.
Board Certification for Geriatricians 63.00% 71.38% N/A N/A
Board Certification for Pediatricians 84.00% 85.50% N/A N/A
Board Certification Rate for Family Medicine Physicians 81.00% 81.38% N/A N/A
Board Certification Rate for Internal Medicine Physicians 74.00% 81.00% N/A N/A
Board Certification Rate for OB/GYN Providers 82.00% 83.00% N/A N/A
Board Certification Rate for Other Specialists 74.00% 81.88% N/A N/A
Board Certification Rates for Providers Year Plan State Avg. Natl. Avg. 90th Pctl.
Board Certification for Geriatricians 2016 N/A 73.44% N/A N/A
2015 N/A 71.06% N/A N/A
2014 N/A 74.73% 64.82% 87.50%
2013 N/A 71.19% 63.29% 83.33%
Board Certification for Pediatricians 2016 N/A 87.02% N/A N/A
2015 N/A 88.14% N/A N/A
2014 N/A 88.13% 83.89% 91.52%
2013 N/A 86.01% 81.01% 90.29%
Board Certification Rate for Family Medicine Physicians 2016 N/A 80.32% N/A N/A
2015 N/A 82.53% N/A N/A
2014 N/A 82.93% 77.41% 89.90%
2013 N/A 81.36% 76.60% 88.80%
Board Certification Rate for Internal Medicine Physicians 2016 N/A 81.15% N/A N/A
2015 N/A 82.59% N/A N/A
2014 N/A 83.98% 79.07% 88.73%
2013 N/A 80.80% 78.18% 87.44%
Board Certification Rate for OB/GYN Providers 2016 N/A 83.36% N/A N/A
2015 N/A 83.51% N/A N/A
2014 N/A 83.71% 79.30% 88.80%
2013 N/A 80.44% 76.89% 87.80%
Board Certification Rate for Other Specialists 2016 N/A 83.25% N/A N/A
2015 N/A 82.88% N/A N/A
2014 N/A 84.44% 78.09% 89.67%
2013 N/A 79.95% 74.88% 88.36%
Info
Financial Data 2017 Plan State Avg Nat Avg 90th Pctl.
Income $277,269 $34,422,501 N/A N/A
Net Worth $22,523,667 $263,890,874 N/A N/A
Premiums Earned $104,799,970 $645,600,589 N/A N/A
Financial Data Year Plan State Avg. Natl. Avg. 90th Pctl.
Income 2016 $-4,890,121 $38,212,136 N/A N/A
2015 $3,438,659 $19,029,685 N/A N/A
2014 $1,088,809 $50,732,622 N/A N/A
2013 $-2,262,863 $44,817,532 N/A N/A
Net Worth 2016 $18,427,637 $267,217,323 N/A N/A
2015 $17,645,367 $237,291,717 N/A N/A
2014 $12,139,629 $250,764,247 N/A N/A
2013 $5,845,934 $222,343,959 N/A N/A
Premiums Earned 2016 $95,876,576 $644,862,921 N/A N/A
2015 $79,978,908 $552,705,214 N/A N/A
2014 $42,248,104 $470,221,984 N/A N/A
2013 $8,832,350 $403,549,832 N/A N/A
Info
Years in Business 2017 Plan State Avg Nat Avg 90th Pctl.
Years in Business N/A 35 N/A N/A
Years in Business Year Plan State Avg. Natl. Avg. 90th Pctl.
Years in Business 2016 N/A 34 N/A N/A
2015 N/A 33 N/A N/A
2014 N/A 32 N/A N/A
2013 N/A 31 N/A N/A
Member Satisfaction
Info
Member Satisfaction 2017 Plan State Avg Nat Avg 90th Pctl.
Getting Care Quickly N/A 87.22% 85.34% 89.83%
Getting Needed Care N/A 87.44% 86.71% 90.37%
How Well Doctors Communicate N/A 94.74% 95.10% 96.91%
Members highly rating their HMO (8 to 10 on a 0-10 scale) 50.39% 61.26% 62.44% 75.00%
Members highly rating their most often seen specialist (8 to 10 on a 0-10 scale) 77.94% 83.86% 84.62% 88.77%
Members highly rating their overall health care (8 to 10 on a 0-10 scale) 75.00% 76.98% 77.27% 82.99%
Members highly rating their personal doctor (8 to 10 on a 0-10 scale) 78.64% 83.95% 84.60% 89.86%
Member Satisfaction Year Plan State Avg. Natl. Avg. 90th Pctl.
Getting Care Quickly 2016 N/A 85.81% 85.14% 90.00%
2015 N/A 85.61% 85.00% 89.71%
2014 N/A 86.12% 85.79% 90.17%
2013 N/A 86.65% 86.84% 90.75%
Getting Needed Care 2016 N/A 86.38% 87.25% 91.54%
2015 N/A 86.51% 86.79% 91.23%
2014 N/A 88.34% 87.95% 92.13%
2013 N/A 87.20% 88.05% 92.37%
How Well Doctors Communicate 2016 N/A 95.22% 95.39% 97.21%
2015 N/A 94.90% 95.20% 97.10%
2014 N/A 95.30% 95.26% 97.16%
2013 N/A 94.13% 94.94% 96.97%
Members highly rating their HMO (8 to 10 on a 0-10 scale) 2016 N/A 62.47% 62.27% 74.92%
2015 N/A 62.71% 62.65% 74.57%
2014 N/A 58.77% 64.71% 76.75%
2013 N/A 65.03% 66.21% 78.29%
Members highly rating their most often seen specialist (8 to 10 on a 0-10 scale) 2016 N/A 83.44% 84.72% 88.74%
2015 N/A 83.49% 83.85% 89.05%
2014 N/A 85.38% 84.24% 88.27%
2013 N/A 83.04% 84.52% 89.47%
Members highly rating their overall health care (8 to 10 on a 0-10 scale) 2016 N/A 77.49% 77.19% 83.29%
2015 N/A 76.25% 76.99% 82.76%
2014 N/A 79.49% 78.26% 83.66%
2013 N/A 76.64% 78.14% 84.28%
Members highly rating their personal doctor (8 to 10 on a 0-10 scale) 2016 N/A 84.65% 84.57% 88.37%
2015 N/A 83.85% 84.24% 88.77%
2014 N/A 84.37% 84.70% 88.96%
2013 N/A 83.92% 84.96% 89.71%
Overuse/Appropriateness
Info
Antipsychotics 2017 Plan State Avg Nat Avg 90th Pctl.
Antipsychotics Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Cervical Cancer Screening in Adolescent Females 2017 Plan State Avg Nat Avg 90th Pctl.
Cervical Cancer Screening in Adolescent Females Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Lower Back Pain 2017 Plan State Avg Nat Avg 90th Pctl.
Use of Imaging for Low Back Pain 70.73% 73.85% 75.16% 82.29%
Lower Back Pain Year Plan State Avg. Natl. Avg. 90th Pctl.
Use of Imaging for Low Back Pain 2016 N/A 73.58% 72.67% 80.11%
2015 N/A 74.11% 74.57% 81.25%
2014 N/A 72.44% 74.82% 81.95%
2013 N/A 73.66% 74.48% 81.27%
Info
Respiratory 2017 Plan State Avg Nat Avg 90th Pctl.
Appropriate Treatment for Children With Upper Respiratory Infection 93.88% 90.92% 89.19% 94.59%
Respiratory Year Plan State Avg. Natl. Avg. 90th Pctl.
Appropriate Treatment for Children With Upper Respiratory Infection 2016 N/A 88.81% 88.51% 94.80%
2015 N/A 87.71% 88.11% 94.26%
2014 N/A 87.19% 87.39% 94.57%
2013 N/A 82.80% 85.30% 92.63%
Utilization
Info
Antibiotic Utilization 2017 Plan State Avg Nat Avg 90th Pctl.
Antibiotic Utilization Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Child and Adolescent Well Child Visits 2017 Plan State Avg Nat Avg 90th Pctl.
Well Child Visits in the First 15 Months of Life 81.14% 85.68% 80.53% 90.78%
Well Child Visits in the 3rd - 6th Years 81.21% 83.18% 79.11% 91.03%
Adolescent Well-Care Visits 50.26% 53.24% 50.46% 70.44%
Child and Adolescent Well Child Visits Year Plan State Avg. Natl. Avg. 90th Pctl.
Well Child Visits in the First 15 Months of Life 2016 N/A 83.40% 80.76% 90.36%
2015 N/A 84.01% 79.35% 89.12%
2014 N/A 82.63% 79.12% 89.64%
2013 N/A 83.44% 79.34% 89.83%
Well Child Visits in the 3rd - 6th Years 2016 N/A 82.50% 78.30% 90.11%
2015 N/A 80.48% 77.75% 89.74%
2014 N/A 80.03% 77.37% 88.75%
2013 N/A 78.43% 75.89% 88.25%
Adolescent Well-Care Visits 2016 N/A 50.35% 49.68% 67.70%
2015 N/A 49.34% 48.26% 64.50%
2014 N/A 48.09% 47.51% 64.76%
2013 N/A 46.84% 46.27% 63.82%
Info
Mental Health Utilization 2017 Plan State Avg Nat Avg 90th Pctl.
Mental Health Utilization Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Plan All-Cause Readmissions 2017 Plan State Avg Nat Avg 90th Pctl.
Plan All-Cause Readmissions Year Plan State Avg. Natl. Avg. 90th Pctl.