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.
Child Access to Primary Care Practitioners Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Prenatal and Postpartum Care 2017 Plan State Avg Nat Avg 90th Pctl.
Timeliness of Prenatal Care 81.01% 87.01% N/A N/A
Prenatal and Postpartum Care Year Plan State Avg. Natl. Avg. 90th Pctl.
Timeliness of Prenatal Care 2016 N/A 86.52% N/A N/A
2015 N/A 86.91% N/A N/A
2014 N/A 85.85% N/A N/A
2013 N/A 91.58% N/A N/A
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.
Common Childhood Illnesses Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Diabetes Care and Management 2017 Plan State Avg Nat Avg 90th Pctl.
Diabetes Care and Management Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Drug Therapy in Rheumatoid Arthritis 2017 Plan State Avg Nat Avg 90th Pctl.
Drug Therapy in Rheumatoid Arthritis Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Immunizations 2017 Plan State Avg Nat Avg 90th Pctl.
Immunizations Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Mental Health: Care and Follow-up 2017 Plan State Avg Nat Avg 90th Pctl.
Mental Health: Care and Follow-up Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Persistent Medications 2017 Plan State Avg Nat Avg 90th Pctl.
Persistent Medications Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Pharmacotherapy of COPD Exacerbation 2017 Plan State Avg Nat Avg 90th Pctl.
Pharmacotherapy of COPD Exacerbation Year Plan State Avg. Natl. Avg. 90th Pctl.
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%
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%
Info
Spirometry Testing 2017 Plan State Avg Nat Avg 90th Pctl.
Spirometry Testing Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Weight Assessment and Counseling 2017 Plan State Avg Nat Avg 90th Pctl.
Counseling for Physical Activity for Children/Adolescents - Total 51.58% 59.44% N/A N/A
Weight Assessment and Counseling Year Plan State Avg. Natl. Avg. 90th Pctl.
Counseling for Physical Activity for Children/Adolescents - Total 2016 N/A 54.14% N/A N/A
2015 N/A 54.38% N/A N/A
2014 N/A 58.06% N/A N/A
2013 N/A 52.85% N/A N/A
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.
Financial Data Year Plan State Avg. Natl. Avg. 90th Pctl.
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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 Needed Care N/A 88.46% N/A N/A
Members highly rating their most often seen specialist (8 to 10 on a 0-10 scale) 77.94% 94.34% 95.10% 96.91%
Member Satisfaction Year Plan State Avg. Natl. Avg. 90th Pctl.
Getting Needed Care 2016 N/A 87.23% N/A N/A
2015 N/A 87.33% N/A N/A
2014 N/A 88.88% N/A N/A
2013 N/A 87.29% N/A N/A
Members highly rating their most often seen specialist (8 to 10 on a 0-10 scale) 2016 N/A 94.88% 95.39% 97.21%
2015 N/A 94.63% 95.20% 97.10%
2014 N/A 94.87% 95.26% 97.16%
2013 N/A 93.94% 94.94% 96.97%
Overuse/Appropriateness
Info
Antipsychotics 2017 Plan State Avg Nat Avg 90th Pctl.
Antipsychotics Year Plan State Avg. Natl. Avg. 90th Pctl.
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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.
Lower Back Pain Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Respiratory 2017 Plan State Avg Nat Avg 90th Pctl.
Respiratory Year Plan State Avg. Natl. Avg. 90th Pctl.
Utilization
Info
Antibiotic Utilization 2017 Plan State Avg Nat Avg 90th Pctl.
Antibiotic Utilization Year Plan State Avg. Natl. Avg. 90th Pctl.
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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% 85.55% N/A N/A
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 82.77% N/A N/A
2015 N/A 83.06% N/A N/A
2014 N/A 81.95% N/A N/A
2013 N/A 82.08% N/A N/A
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%
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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.