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Innovation Health Plan, Inc.

Company Information

  • Company Providing Plan:Inova and Aetna
  • Address:151 Farmington Avenue, RT21
    Hartford, CT 06156
  • Telephone :860-273-7305
  • Website:www.innovation-health.com
2016
Number of Enrollees: 27,510
PMPM: $313
Number of Physicians: 72,651
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

2016 2015 2014 2013 2012
Number of Enrollees 27,510 22,874 18,580 3,945 NA
PMPM $313 $318 $335 $2,042 NA
Medical Cost Ratio 88% 73% 73% 72% NA
Administrative Ratio 19% 19% 23% 47% NA
Profit/Loss Ratio -7% 7% 2% -26% NA
Number of Physicians 72,651 65,263 50,861 45,711 NA

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

Financial Data

2016 2015 2014 2013 2012
Premiums Earned $95,876,576 $79,978,908 $42,248,104 $8,832,350 NA
Income ($4,890,121) $3,438,659 $1,088,809 ($2,262,863) NA
Net Worth $18,427,637 $17,645,367 $12,139,629 $5,845,934 NA

*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 2016 Plan State Avg Nat Avg 90th Pctl.
Adult Access (Age 20-44) To Preventive/Ambulatory Health Services N/A 92.81% 92.73% 95.55%
Adult Access (Age 45-64) To Preventive/Ambulatory Health Services N/A 95.78% 95.78% 97.61%
Adult Access (Age 65 and Older) To Preventive/Ambulatory Health Services N/A 97.30% 97.19% 98.61%
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 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%
2012 N/A 93.53% 93.40% 95.86%
Adult Access (Age 45-64) To Preventive/Ambulatory Health Services 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%
2012 N/A 95.88% 95.84% 97.42%
Adult Access (Age 65 and Older) To Preventive/Ambulatory Health Services 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%
2012 N/A 97.38% 97.27% 98.74%
Info
Alcohol and Other Drug Dependence Treatment 2016 Plan State Avg Nat Avg 90th Pctl.
Initiation of Alcohol and Other Drug Dependence Treatment - Total N/A 35.69% 32.93% 40.24%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 13-17 N/A 40.15% 40.47% 51.96%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 18 plus N/A 35.55% 32.64% 40.33%
Engagement of Alcohol and Other Drug Dependence Treatment - Total N/A 12.51% 11.46% 16.72%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 13-17 N/A 11.28% 15.68% 23.73%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 18 plus N/A 12.57% 11.32% 16.09%
Alcohol and Other Drug Dependence Treatment Year Plan State Avg. Natl. Avg. 90th Pctl.
Initiation of Alcohol and Other Drug Dependence Treatment - Total 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%
2012 N/A 37.48% 40.13% 51.23%
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 13-17 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%
2012 N/A N/A N/A N/A
Initiation of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 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%
2012 N/A N/A N/A N/A
Engagement of Alcohol and Other Drug Dependence Treatment - Total 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%
2012 N/A 11.95% 14.33% 20.35%
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 13-17 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%
2012 N/A N/A N/A N/A
Engagement of Alcohol and Other Drug Dependence Treatment - Ages 18 plus 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%
2012 N/A N/A N/A N/A
Info
Child Access to Primary Care Practitioners 2016 Plan State Avg Nat Avg 90th Pctl.
12-24 month old Child Access to Primary Care Practitioners N/A 98.34% 98.09% 99.72%
25 month to 6 year old Child Access to Primary Care Practitioners N/A 94.33% 92.60% 96.46%
7-11 year old Child Access to Primary Care Practitioners N/A 94.38% 93.25% 98.25%
12-19 year old Child Access to Primary Care Practitioners N/A 91.45% 90.76% 96.39%
Child Access to Primary Care Practitioners Year Plan State Avg. Natl. Avg. 90th Pctl.
12-24 month old Child Access to Primary Care Practitioners 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%
2012 N/A 97.87% 97.94% 99.58%
25 month to 6 year old Child Access to Primary Care Practitioners 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%
2012 N/A 93.16% 92.31% 96.13%
7-11 year old Child Access to Primary Care Practitioners 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%
2012 N/A 93.54% 92.93% 97.72%
12-19 year old Child Access to Primary Care Practitioners 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%
2012 N/A 90.02% 90.01% 95.97%
Info
Prenatal and Postpartum Care 2016 Plan State Avg Nat Avg 90th Pctl.
Postpartum Care N/A 74.50% 73.95% 88.85%
Timeliness of Prenatal Care N/A 86.71% 85.57% 96.28%
Prenatal and Postpartum Care Year Plan State Avg. Natl. Avg. 90th Pctl.
Postpartum Care 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%
2012 N/A 81.20% 80.22% 90.25%
Timeliness of Prenatal Care 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%
2012 N/A 91.51% 89.70% 96.97%
Effectiveness of Care
Info
Asthma Medication Management 2016 Plan State Avg Nat Avg 90th Pctl.
Asthma Medication Management Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Asthma Medication Ratio 2016 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 2016 Plan State Avg Nat Avg 90th Pctl.
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Initiation N/A 41.91% 38.93% 48.61%
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Continuation N/A 46.92% 45.82% 56.86%
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 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%
2012 N/A 36.75% 38.72% 48.58%
Follow-up care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication-Continuation 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%
2012 N/A 38.87% 45.07% 54.05%
Info
Cardiovascular Disease Management 2016 Plan State Avg Nat Avg 90th Pctl.
Controlling High Blood Pressure N/A 56.91% 60.31% 74.43%
Persistence of Beta-Blockers N/A 90.70% 83.61% 90.83%
Cardiovascular Disease Management Year Plan State Avg. Natl. Avg. 90th Pctl.
Controlling High Blood Pressure 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%
2012 N/A 59.78% 61.63% 72.94%
Persistence of Beta-Blockers 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%
2012 N/A 82.94% 83.03% 92.98%
Info
Common Childhood Illnesses 2016 Plan State Avg Nat Avg 90th Pctl.
Appropriate Testing for Children With Pharyngitis N/A 90.38% 84.50% 93.75%
Common Childhood Illnesses Year Plan State Avg. Natl. Avg. 90th Pctl.
Appropriate Testing for Children With Pharyngitis 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%
2012 N/A 87.53% 81.22% 91.58%
Info
Diabetes Care and Management 2016 Plan State Avg Nat Avg 90th Pctl.
Comprehensive Diabetes Care-Rate of Eye Exams N/A 60.88% 61.06% 78.35%
Comprehensive Diabetes Care-Rate of Medical Attention for Diabetic Nephropathy N/A 58.36% 56.62% 66.39%
Comprehensive Diabetes Care-Rate of Poor HbA1c control N/A 58.46% 52.96% 72.04%
Comprehensive Diabetes Care-Testing for HbA1c N/A 90.56% 90.03% 92.71%
Diabetes Care and Management Year Plan State Avg. Natl. Avg. 90th Pctl.
Comprehensive Diabetes Care-Rate of Eye Exams 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%
2012 N/A N/A N/A N/A
Comprehensive Diabetes Care-Rate of Medical Attention for Diabetic Nephropathy 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%
2012 N/A N/A N/A N/A
Comprehensive Diabetes Care-Rate of Poor HbA1c control 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%
2012 N/A 57.24% 55.70% 74.09%
Comprehensive Diabetes Care-Testing for HbA1c 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%
2012 N/A 85.74% 83.70% 89.54%
Info
Drug Therapy in Rheumatoid Arthritis 2016 Plan State Avg Nat Avg 90th Pctl.
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis N/A 89.05% 87.87% 93.92%
Drug Therapy in Rheumatoid Arthritis Year Plan State Avg. Natl. Avg. 90th Pctl.
Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis 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%
2012 N/A 88.39% 87.47% 93.70%
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Immunizations 2016 Plan State Avg Nat Avg 90th Pctl.
Childhood Immunization for Multiple diseases including Chicken Pox N/A 84.29% 78.93% 89.03%
Childhood Immunization for Multiple diseases including pneumovax N/A 82.08% 77.04% 87.50%
Flu Vaccinations for Adults Ages 18–64 N/A 47.13% N/A N/A
Immunizations Year Plan State Avg. Natl. Avg. 90th Pctl.
Childhood Immunization for Multiple diseases including Chicken Pox 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%
2012 N/A 82.72% 79.83% 88.00%
Childhood Immunization for Multiple diseases including pneumovax 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%
2012 N/A 78.74% 77.05% 86.00%
Flu Vaccinations for Adults Ages 18–64 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%
2012 N/A N/A N/A N/A
Info
Mental Health: Care and Follow-up 2016 Plan State Avg Nat Avg 90th Pctl.
Antidepressant Medication Management-Acute Phase Treatment N/A 70.29% 66.56% 74.77%
Antidepressant Medication Management-Continuation Phase Treatment N/A 53.51% 50.69% 58.60%
Follow-up After Hospitalization For Mental Illness within 7 days after hospital discharge N/A 52.99% 52.06% 67.31%
Follow-up After Hospitalization For Mental Illness within 30 days after hospital discharge N/A 73.85% 71.36% 84.17%
Mental Health: Care and Follow-up Year Plan State Avg. Natl. Avg. 90th Pctl.
Antidepressant Medication Management-Acute Phase Treatment 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%
2012 N/A 69.62% 69.03% 77.57%
Antidepressant Medication Management-Continuation Phase Treatment 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%
2012 N/A 52.80% 53.51% 61.69%
Follow-up After Hospitalization For Mental Illness within 7 days after hospital discharge 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%
2012 N/A 61.69% 57.57% 73.88%
Follow-up After Hospitalization For Mental Illness within 30 days after hospital discharge 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%
2012 N/A 77.74% 75.42% 86.45%
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Persistent Medications 2016 Plan State Avg Nat Avg 90th Pctl.
Annual Monitoring for Patients on Persistent Medications N/A 84.90% 83.34% 87.04%
Persistent Medications Year Plan State Avg. Natl. Avg. 90th Pctl.
Annual Monitoring for Patients on Persistent Medications 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%
2012 N/A 83.30% 82.11% 86.32%
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Pharmacotherapy of COPD Exacerbation 2016 Plan State Avg Nat Avg 90th Pctl.
Pharmacotherapy of COPD Exacerbation - Bronchodilator N/A 84.12% 76.30% 85.98%
Pharmacotherapy of COPD Exacerbation - Corticosteroid N/A 79.54% 70.70% 81.82%
Pharmacotherapy of COPD Exacerbation Year Plan State Avg. Natl. Avg. 90th Pctl.
Pharmacotherapy of COPD Exacerbation - Bronchodilator 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%
2012 N/A 80.97% 80.45% 87.50%
Pharmacotherapy of COPD Exacerbation - Corticosteroid 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%
2012 N/A 73.69% 73.65% 81.32%
Info
Preventive Care 2016 Plan State Avg Nat Avg 90th Pctl.
Breast Cancer Screening N/A 71.80% 72.90% 80.63%
Chlamydia Screening in Women-all Age groups N/A 49.79% 48.98% 63.50%
Colorectal Cancer Screening N/A 65.83% 61.71% 74.09%
Preventive Care Year Plan State Avg. Natl. Avg. 90th Pctl.
Breast Cancer Screening 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%
2012 N/A N/A N/A N/A
Chlamydia Screening in Women-all Age groups 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%
2012 N/A 46.98% 45.16% 57.69%
Colorectal Cancer Screening 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%
2012 N/A 64.80% 62.63% 73.86%
Info
Spirometry Testing 2016 Plan State Avg Nat Avg 90th Pctl.
Use of Spirometry Testing in the Assessment and diagnosis of COPD N/A 42.48% 42.55% 51.02%
Spirometry Testing Year Plan State Avg. Natl. Avg. 90th Pctl.
Use of Spirometry Testing in the Assessment and diagnosis of COPD 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%
2012 N/A 45.42% 43.34% 55.44%
Info
Weight Assessment and Counseling 2016 Plan State Avg Nat Avg 90th Pctl.
Adult BMI Assessment N/A 77.87% 76.17% 91.85%
Children/Adolescents BMI Assessment - Total N/A 69.07% 65.62% 88.08%
Counseling for Nutrition for Children/Adolescents - Total N/A 66.76% 61.76% 83.68%
Counseling for Physical Activity for Children/Adolescents - Total N/A 60.41% 55.96% 79.44%
Weight Assessment and Counseling Year Plan State Avg. Natl. Avg. 90th Pctl.
Adult BMI Assessment 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%
2012 N/A 60.89% N/A N/A
Children/Adolescents BMI Assessment - Total 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%
2012 N/A 43.29% 49.34% 78.51%
Counseling for Nutrition for Children/Adolescents - Total 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%
2012 N/A 51.32% 54.19% 75.00%
Counseling for Physical Activity for Children/Adolescents - Total 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%
2012 N/A 45.42% 49.91% 70.66%
Health Plan Stability/Descriptive
Info
Administrative Data 2016 Plan State Avg Nat Avg 90th Pctl.
Administrative Ratio 0.19 0.15 N/A N/A
Medical Cost Ratio 0.88 0.83 N/A N/A
Number of Enrollees 27,510 136,796 N/A N/A
Number of Physicians 72,651 73,426 N/A N/A
Premium Per Member Per Month $313 $370 N/A N/A
Profit/Loss Ratio -0.07 0.03 N/A N/A
Administrative Data Year Plan State Avg. Natl. Avg. 90th Pctl.
Administrative Ratio 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
2012 N/A 0.10 N/A N/A
Medical Cost Ratio 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
2012 N/A 0.84 N/A N/A
Number of Enrollees 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
2012 N/A 111,525 N/A N/A
Number of Physicians 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
2012 N/A 62,436 N/A N/A
Premium Per Member Per Month 2015 $318 $375 N/A N/A
2014 $335 $412 N/A N/A
2013 $2,042 $544 N/A N/A
2012 N/A $378 N/A N/A
Profit/Loss Ratio 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
2012 N/A 0.07 N/A N/A
Info
Board Certification Rates for Providers 2016 Plan State Avg Nat Avg 90th Pctl.
Board Certification for Geriatricians N/A 73.44% N/A N/A
Board Certification for Pediatricians N/A 87.02% N/A N/A
Board Certification Rate for Family Medicine Physicians N/A 80.32% N/A N/A
Board Certification Rate for Internal Medicine Physicians N/A 81.15% N/A N/A
Board Certification Rate for OB/GYN Providers N/A 83.36% N/A N/A
Board Certification Rate for Other Specialists N/A 83.25% N/A N/A
Board Certification Rates for Providers Year Plan State Avg. Natl. Avg. 90th Pctl.
Board Certification for Geriatricians 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%
2012 N/A 73.37% 65.21% 87.23%
Board Certification for Pediatricians 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%
2012 N/A 86.06% 83.97% 91.65%
Board Certification Rate for Family Medicine Physicians 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%
2012 N/A 81.09% 77.40% 89.19%
Board Certification Rate for Internal Medicine Physicians 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%
2012 N/A 81.93% 79.29% 88.24%
Board Certification Rate for OB/GYN Providers 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%
2012 N/A 80.51% 79.23% 86.38%
Board Certification Rate for Other Specialists 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%
2012 N/A 79.00% 75.49% 87.62%
Info
Financial Data 2016 Plan State Avg Nat Avg 90th Pctl.
Income $-4,890,121 $38,212,136 N/A N/A
Net Worth $18,427,637 $267,217,323 N/A N/A
Premiums Earned $95,876,576 $644,862,921 N/A N/A
Financial Data Year Plan State Avg. Natl. Avg. 90th Pctl.
Income 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
2012 N/A $57,195,463 N/A N/A
Net Worth 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
2012 N/A $232,468,936 N/A N/A
Premiums Earned 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
2012 N/A $442,669,442 N/A N/A
Info
Years in Business 2016 Plan State Avg Nat Avg 90th Pctl.
Years in Business N/A 34 N/A N/A
Years in Business Year Plan State Avg. Natl. Avg. 90th Pctl.
Years in Business 2015 N/A 33 N/A N/A
2014 N/A 32 N/A N/A
2013 N/A 31 N/A N/A
2012 N/A 30 N/A N/A
Member Satisfaction
Info
Member Satisfaction 2016 Plan State Avg Nat Avg 90th Pctl.
Getting Care Quickly N/A 85.81% 85.14% 90.00%
Getting Needed Care N/A 86.38% 87.25% 91.54%
How Well Doctors Communicate N/A 95.22% 95.39% 97.21%
Members highly rating their HMO (8 to 10 on a 0-10 scale) N/A 62.47% 62.27% 74.92%
Members highly rating their most often seen specialist (8 to 10 on a 0-10 scale) N/A 83.44% 84.72% 88.74%
Members highly rating their overall health care (8 to 10 on a 0-10 scale) N/A 77.49% 77.19% 83.29%
Members highly rating their personal doctor (8 to 10 on a 0-10 scale) N/A 84.65% 84.57% 88.37%
Member Satisfaction Year Plan State Avg. Natl. Avg. 90th Pctl.
Getting Care Quickly 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%
2012 N/A 85.74% 85.81% 90.18%
Getting Needed Care 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%
2012 N/A 86.83% 87.88% 91.65%
How Well Doctors Communicate 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%
2012 N/A 94.08% 94.39% 96.44%
Members highly rating their HMO (8 to 10 on a 0-10 scale) 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%
2012 N/A 64.01% 63.16% 74.19%
Members highly rating their most often seen specialist (8 to 10 on a 0-10 scale) 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%
2012 N/A 84.35% 83.55% 88.27%
Members highly rating their overall health care (8 to 10 on a 0-10 scale) 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%
2012 N/A 75.50% 76.51% 82.08%
Members highly rating their personal doctor (8 to 10 on a 0-10 scale) 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%
2012 N/A 84.23% 83.62% 87.92%
Overuse/Appropriateness
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Antipsychotics 2016 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 2016 Plan State Avg Nat Avg 90th Pctl.
Cervical Cancer Screening in Adolescent Females Year Plan State Avg. Natl. Avg. 90th Pctl.
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Lower Back Pain 2016 Plan State Avg Nat Avg 90th Pctl.
Use of Imaging for Low Back Pain N/A 73.58% 72.67% 80.11%
Lower Back Pain Year Plan State Avg. Natl. Avg. 90th Pctl.
Use of Imaging for Low Back Pain 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%
2012 N/A 72.73% 74.28% 81.82%
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Respiratory 2016 Plan State Avg Nat Avg 90th Pctl.
Appropriate Treatment for Children With Upper Respiratory Infection N/A 88.81% 88.51% 94.80%
Respiratory Year Plan State Avg. Natl. Avg. 90th Pctl.
Appropriate Treatment for Children With Upper Respiratory Infection 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%
2012 N/A 81.66% 84.23% 92.25%
Utilization
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Antibiotic Utilization 2016 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 2016 Plan State Avg Nat Avg 90th Pctl.
Well Child Visits in the First 15 Months of Life N/A 83.40% 80.76% 90.36%
Well Child Visits in the 3rd - 6th Years N/A 82.50% 78.30% 90.11%
Adolescent Well-Care Visits N/A 50.35% 49.68% 67.70%
Child and Adolescent Well Child Visits Year Plan State Avg. Natl. Avg. 90th Pctl.
Well Child Visits in the First 15 Months of Life 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%
2012 N/A 83.14% 78.67% 91.43%
Well Child Visits in the 3rd - 6th Years 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%
2012 N/A 76.56% 74.36% 86.52%
Adolescent Well-Care Visits 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%
2012 N/A 44.66% 44.76% 63.11%
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Mental Health Utilization 2016 Plan State Avg Nat Avg 90th Pctl.
Mental Health Utilization Year Plan State Avg. Natl. Avg. 90th Pctl.
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Plan All-Cause Readmissions 2016 Plan State Avg Nat Avg 90th Pctl.
Plan All-Cause Readmissions Year Plan State Avg. Natl. Avg. 90th Pctl.