| 2021 | |
|---|---|
| Number of Enrollees: | 126,386 |
| PMPM: | $716 |
| Number of Physicians: | 42,012 |
| NCQA Accreditation: | |
*The data elements noted with an asterisk (*) contain regional-specific values whereas those not noted with an asterisk (*) contain Virginia specific values.
None in Virginia
None in Virginia
Information provided by HMOs to State Corporation Commission Bureau of Insurance.
| 2021 | 2020 | 2019 | 2018 | 2017 | |
|---|---|---|---|---|---|
| Number of Enrollees | 126,386 | NA | NA | NA | NA |
| PMPM | $716 | NA | NA | $582 | NA |
| Medical Cost Ratio | 82% | NA | NA | 24% | NA |
| Administrative Ratio | 11% | NA | NA | -158% | NA |
| Profit/Loss Ratio | 7% | NA | NA | 443% | NA |
| Number of Physicians | 42,012 | NA | NA | NA | NA |
*The data elements noted with an asterisk (*) contain regional-specific values whereas those not noted with an asterisk (*) contain Virginia specific values.
| 2021 | 2020 | 2019 | 2018 | 2017 | |
|---|---|---|---|---|---|
| Premiums Earned | $1,014,499,665 | NA | NA | $16,891 | NA |
| Income | $56,935,303 | NA | NA | $115,947 | NA |
| Net Worth | $157,717,385 | NA | NA | $4,584,154 | NA |
*The data elements noted with an asterisk (*) contain regional-specific values whereas those not noted with an asterisk (*) contain Virginia specific values.
| Adult Access To Preventive/Ambulatory Health Services | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Adult Access To Preventive/Ambulatory Health Services | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Alcohol and Other Drug Dependence Treatment | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Alcohol and Other Drug Dependence Treatment | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Prenatal and Postpartum Care | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Prenatal and Postpartum Care | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Adherence to Antipsychotic Medications for Individuals with Schizophrenia | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Adherence to Antipsychotic Medications for Individuals with Schizophrenia | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Antidepressant Medication Management | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Antidepressant Medication Management | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Attention-Deficit/Hyperactivity Disorder (ADHD) Medication | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Attention-Deficit/Hyperactivity Disorder (ADHD) Medication | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Follow-Up After Emergency Department Visit for Mental Illness | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Follow-Up After Emergency Department Visit for Mental Illness | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Follow-up After Hospitalization For Mental Illness | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Follow-up After Hospitalization For Mental Illness | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Asthma Medication Ratio | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Asthma Medication Ratio | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Cardiovascular Disease Management | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Cardiovascular Disease Management | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Cervical Cancer Screening | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Cervical Cancer Screening | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Common Childhood Illnesses | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Common Childhood Illnesses | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Diabetes Care and Management | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Diabetes Care and Management | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Immunizations | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Immunizations | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Pharmacotherapy of COPD Exacerbation | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Pharmacotherapy of COPD Exacerbation | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Preventive Care | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Preventive Care | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Spirometry Testing | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Spirometry Testing | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Statin Therapy | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Statin Therapy | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Weight Assessment and Counseling | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Weight Assessment and Counseling | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Administrative Data | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Administrative Data | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Financial Data | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Financial Data | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Years in Business | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Years in Business | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Member Satisfaction | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Member Satisfaction | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Antipsychotics | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Antipsychotics | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Cervical Cancer Screening in Adolescent Females | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Cervical Cancer Screening in Adolescent Females | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Lower Back Pain | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Lower Back Pain | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Respiratory | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Respiratory | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Use of Opiods | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Use of Opiods | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Acute Hospital Utilization Rate | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Acute Hospital Utilization Rate | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Emergency Department Utilization | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Emergency Department Utilization | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Plan All-Cause Readmissions | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Plan All-Cause Readmissions | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Antibiotic Utilization | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Antibiotic Utilization | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|
| Mental Health Utilization | 2021 Plan | State Avg | Nat Avg | 90th Pctl. |
|---|
| Mental Health Utilization | Year | Plan | State Avg. | Natl. Avg. | 90th Pctl. |
|---|