1997 DIRECTORY OF MANAGED CARE PROVIDERS (CALIFORNIA)

CorVel Corp.*
1920 Main St., Suite 1090, Irvine, Calif. 92714; 714-851-1473; fax: 714-851-1469
Staff/Facilities
Primary practitioners64,000
Board-certified95%
Specialists**240,000
Hospitals3,188
Pharmacies39,000
Users: Group Health
Employees & dependents75,000
Users: Workers Compensation
Employer/payer groups1,063
Single coverage6,700,000
Total Users6,775,000
Operational date: May 1992.
For profit.
AAHC/URAC accreditation status: Health Utilization Management Standards.
Service area: Contracts with Beech Street for general services in Illinois, Kansas, Montana, Nevada, New Jersey, New Mexico, New York, Ohio, Oregon, Texas, Utah and Washington; CCN for workers compensation in California; Consumer Health Network for workers compensation in New Jersey; Interplan for general services in California; Med Comp USA for general services and workers compensation in Louisiana; MedView for general services in Alabama, Colorado, Connecticut, Florida, Kentucky, Michigan, New Hampshire, North Carolina, Pennsylvania, Rhode Island, South Carolina, Tennessee, West Virginia and Wisconsin; MedView for workers compensation in Colorado, Connecticut, Illinois, Indiana, Massachusetts, Michigan, Texas and Wisconsin; Ohio Comp Network for workers compensation in Ohio; Ohio Health Choice for workers compensation in Ohio; PPO Oklahoma for general services and workers compensation in Oklahoma; Preferred Plan for general services in Arizona, District of Columbia, Georgia, Indiana, Iowa, Maryland, Massachusetts, Missouri, Nebraska and Virginia; Preferred Plan for workers compensation in Arizona.
Services: General medical, vision, mental health, workers compensation. Services available unbundled. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem, discount off customary rates, DRGs, case rates, capitated rates; is compensated by employers/payers, insurers, TPAs; charges flat fee per employee, by percent of savings.
UR: Standard procedures, excluding precertification. UR provided by the PPO.
Officers: Gordon Clemons, CEO/president; Daniel Davis, vp-marketing/product development; Don Mcfarlane, vp-information technology; Richard Schweppe, CFO/secretary; Louis Silverman, vp-operations.
Contact: Boni Vinter, 703-385-5646.
**Figures are consolidated, including all PPO plans in this organization.
***Includes ancillary providers.
CorVel Corp.
1920 Main St., Suite 1090, Irvine, Calif. 92714; 714-851-1473; fax: 714-851-1469
Staff/Facilities
Primary practitioners4,965
Board-certified95%
Specialists29,173*
Hospitals450
Service area: California.
**Includes ancillary providers.
See CorVel Corp. consolidated listing under California.
DeltaPreferred Option
100 First St., San Francisco, Calif. 94105; 415-972-8300; fax: 415-972-8366
Specialty: dental
Staff/Facilities
Primary practitioners5,394
Specialists3,460
Users
Employer/payer groups401
Single coverage282,791
Employees & dependents494,884
Total Users777,675
Operational date: January 1987.
Not for profit.
Service area: California: statewide.
Services: Dental. Services available unbundled. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by combination of methods; is compensated by employers/payers; charges flat fee per employee.
UR: Retrospective review, outpatient service predetermination, dental office audits. UR provided by the PPO.
Officers: William T. Ward, president/CEO; Dr. R. Steven Ball, vp-public/professional services; Don B. Conling, senior vp-marketing/underwriting/actuarial; Jerry R. Holcombe, senior vp/chief administrative officer; Elizabeth Russell, senior vp/CFO.
Contact: Jeff Album, 415-972-8418.
FOCUS Healthcare Management Inc.
7101 Executive Center Drive, Suite 375, Brentwood, Tenn. 37207; 800-873-0055 or 615-377-9936; fax: 615-661-4042
Specialty: workers compensation
Staff/Facilities*
Primary practitioners6,136
Specialists24,812
Hospitals394
Total Users747,171
Operational date: December 1990.
Service area: California: 60 counties.
**Includes leased providers/facilities.
See FOCUS Healthcare Management Inc. consolidated listing under Tennessee.
Foundation Health Systems Inc.*
21600 Oxnard St., Woodland Hills, Calif. 91367; 800-474-6676; fax: 818-676-8591
Staff/Facilities
Primary practitioners25,749
Specialists56,684
Hospitals1,130
Pharmacies10,523
Primary care locations6,361
Users
Employer/payer groups19,568
Single coverage397,577
Family coverage514,595
Employees & dependents1,841,211
Medicare228,445
Medicaid104,819
Total2,174,475
Revenues
First-half 1997$1,221,052,497**
1996$3,116,829,223Licensed in: Arizona, California, Colorado, Connecticut, Florida, Idaho, Louisiana, New Jersey, New Mexico, Ohio, Oklahoma, Oregon, Pennsylvania, Texas, Utah, Washington, West Virginia.
For profit.
Service area: Arizona, California, Colorado, Connecticut, Florida, Louisiana, New Mexico, Oklahoma, Oregon, Pennsylvania, Texas, Utah, Washington.
Contracts with Advantage Dental HealthPlans for dental in Florida; Access One for home health care and durable medical equipment in Connecticut; Benecare for dental for Medicare/Medicaid in Connecticut; Business Insurance Co. for workers compensation in Arizona; Boston Mutual for life and disability in Connecticut; Catalina Health Service for mental health in Arizona; Combined Dental for commercial dental in Connecticut; Integrated Pharmaceutical Services for prescription drugs in Arizona, Florida and Utah; Intergroup Vision Services for vision in Arizona; Managed Health Network for mental health in Utah; Mental Health Network for mental health/substance abuse in Florida; Merck-Medco for prescription drugs in Connecticut; PRO Behavioral Health for mental health/chemical dependency in Colorado, Connecticut, New Mexico and Washington; Review Co. for workers compensation in Connecticut; San Luis Valley HMO for general services in Colorado; United Dental for dental in Arizona; Vision 21 for vision in Florida.
Officers: Dr. Malik M. Hasan, chairman/CEO; Jay M. Gellert, president/COO; Jeffrey L. Elder, senior vp/CFO; Dr. Dale T. Berkbigler, executive vp-medical affairs/chief medical officer; B. Curtis Westen, senior vp/general counsel/secretary.
Contact: David Olson, vp-investor relations, 818-676-6978.
**Figures are consolidated, including all HMO/POS plans in this organization.
***Does not include second-quarter 1997 gross revenues for Health Net/Select in California.
Foundation Health Systems*
21600 Oxnard St., Woodland Hills, Calif. 91367; 800-474-6676; fax: 818-676-8591
Staff/Facilities
Primary practitioners21,507
Specialists51,936
Hospitals809
Pharmacies7,793
Users
Employer/payer groups660
Single coverage3,580
Family coverage2,573
Employees & dependents17,095
Total Users13,328
For profit.
Service area: Arizona, California, Colorado, Florida, Louisiana, New Mexico, Oklahoma, Oregon, Pennsylvania, Texas, Utah, Washington.
Contracts with Advantage Dental HealthPlans for dental in Florida; Business Insurance Co. for workers compensation in Arizona; Catalina Health Service for mental health in Arizona; Integrated Pharmaceutical Services for prescription drugs in Arizona and Florida; Intergroup Vision Service for vision in Arizona; Mental Health Network for mental health/substance abuse in Florida; Pro America for general services in Texas; United Dental for dental in Arizona.
Officers: Dr. Malik M. Hasan, chairman, CEO; Jay M. Gellert, president/COO; Jeffrey L. Elder, senior vp/CFO; Dr. Dale T. Berkbigler, executive vp-medical affairs/chief-medical officer; B. Curtis Westen, senior vp/general counsel/secretary.
Contact: David Olson, vp-investor relations, 818-676-6978.
**Figures are consolidated, including all PPO plans in this organization.
Foundation for Medical Care of Kern County
2603 G St., Bakersfield, Calif. 93301; 805-327-0770
Staff/Facilities
Primary practitioners210
Board-certified90%
Patients/practitioner11,000
Specialists340
Hospitals10
Pharmacies147
Users: Group Health
Employer/payer groups410
Single coverage13,000
Family coverage28,800
Employees & dependents85,000
Users: Workers Compensation
Employer/payer groups103
Single coverage17,000
Total Users102,000
Operational date: 1983.
Not for profit.
Service area: California: Inyo, Kern, Mono and Santa Barbara counties.
Contracts with California Care Network in California.
Services: General medical, dental, vision, prescription drug, mental health, workers compensation. Services available unbundled. May be customized to meet employer specifications. Individual enrollment is allowed.
Compensation: Negotiates hospital charges by per diem; is compensated by employers/payers, insurers, TPAs, PPPs; charges flat fee per employee, by percent of savings.
UR: Standard procedures excluding hospital bill audits. UR provided by the PPO and outside contractors.
Officers: Dr. Brian C. Brenner, president; Dr. Richard O'Reilly, vp; Dr. Gerhard Schmidt, secretary; Dr. James E. Anhalt, treasurer; Cliff Harmel, executive director.
Contact: Cliff Harmel.