New York
AnciCare PPO
3700 Lakeside Drive, Suite 401, Miramar, Fla. 33027-3225; 800-414-4674; fax: 305-826-7482
Specialty: workers compensation/medical diagnostic imaging
Staff/Facilities
Primary practitioners63
Hospitals28
Service area: New York: Albany, Bronx, Kings, Nassau, New York, Onondaga, Queens, Richmond, Saratoga, Suffolk and Westchester counties.
See AnciCare PPO consolidated listing under Florida.
Anthem Health Network
1200 South Ave., Staten Island, N.Y. 10314; 718-370-5380; fax: 718-370-6090
Staff/Facilities
Primary practitioners3,158
Board-certified100%
Specialists10,303
Hospitals72Parent: Anthem Health & Life Insurance Co. of New York.
Operational date: October 1997.
Licensed in: New York.
Model type: Network.
For profit.
Service area: New York: Bronx, Kings, Nassau, New York, Orange, Putnam, Queens, Richmond, Rockland, Suffolk and Westchester counties.
Services: General medical, dental, mental health. Services available unbundled. May be customized to meet employer specifications.
Rating options: Community rating; adjusted community rating.
Offers self-insured products.
Officers: Carmine Morano, senior vp; Linda Farren, vp/chief administrative officer; Dr. Susan Beane, medical director.
Contact: Linda Farren, 718-370-6066.
Anthem Health Network
1200 South Ave., Staten Island, N.Y. 10314; 718-370-5380; fax: 718-370-6090
Staff/Facilities
Primary practitioners3,158
Board-certified100%
Specialists10,303
Hospitals72
Users: Group Health
Employer/payer groups1,000
Single coverage11,000*
Family coverage26,700*
Employees & dependents79,170*
Ownership: Anthem Health & Life Insurance Co. of New York.
Operational date: March 1997.
For profit.
Service area: New York: Bronx, Kings, Nassau, New York, Orange, Putnam, Queens, Richmond, Rockland, Suffolk and Westchester counties.
Contracts with Medchoice in New Jersey.
Services: General medical, dental, mental health. Services available unbundled.
Compensation: Negotiates hospital charges by per diem, discount off customary rates; is compensated by employers/payers, insurers; charges flat fee per employee.
UR: Standard procedures excluding outpatient service predetermination. UR provided by the PPO.
Officers: Carmine Morano, senior vp; Linda Farren, vp/chief administrative officer; Dr. Susan Beane, medical director.
Contact: Linda A. Farren, 718-370-6066.
**Estimate.
Beech Street Corp.
173 Technology, Irvine, Calif. 92618; 800-233-2478 or 714-727-1353; fax: 714-727-1319
Staff/Facilities
Primary practitioners3,495
Specialists13,324
Hospitals100
Users: Group Health
Single coverage16,116
Family coverage56,692
Employees & dependents146,506
Users: Workers Compensation
Single coverage11,705
Total Users158,212
Operational date: 1992.
Service area: New York: 59 counties.
See Beech Street Corp. consolidated listing under California.
Blue Choice
150 E. Main St., Rochester, N.Y. 14647; 716-454-1700; fax: 716-238-4557
Staff/Facilities
Primary practitioners1,101
Board-certified75%
Specialists1,783
Hospitals15
Pharmacies244
Primary care locations4
Users
Employer/payer groups5,377
Single coverage102,990
Family coverage124,553
Employees & dependents513,057
Medicare28,250
Medicaid22,537
Total563,844
Revenues
First-half 1997$387,126,981
1996$734,760,558Parent: FingerLakes Health Insurance Co.
Operational date: January 1985.
Licensed in: New York.
NCQA fully accredited.
Model type: Group/IPA.
Not for profit.
Service area: New York: Genesee, Livingston, Monroe, Ontario, Orleans, Seneca, Wayne, Wyoming and Yates counties.
Member of HMO Blue USA.
Services: General medical, vision, prescription drug, mental health, workers compensation. Services available unbundled. May be customized to meet employer specifications.
Rating options: Community rating: $146.39 single, $370.12 family (HMO); $151.17 single, $383.18 family (POS).
Offers self-insured products.
Point-of-service contracts: 3% of members are enrolled.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual enrollment is allowed.
Officers: Howard Berman, president/CEO; David Klein, vp/COO; Jonathan Kaplan, medical director; Kevin Hill, vp-marketing; Rosanne Mills, director-managed care.
Blue Choice HMO/POS
622 Third Ave., New York, N.Y. 10017; 212-476-1000
Staff/Facilities
Primary practitioners5,175
Board-certified77%
Patients/practitioner45
Specialists14,926
Hospitals108
Pharmacies4,200
Primary care locations21,300
Users
Single coverage13,878
Family coverage11,654
Employees & dependents52,077
Revenues
First-half 1997$55,400,000
1996$50,300,000Operational date: December 1995.
Licensed in: New York.
NCQA one year accredited.
Model type: IPA.
Not for profit.
Service area: New York: 28 counties.
Member of HMO Blue USA.
Contracts with Davis Vision for vision in New York; Express Pharmacy Services for prescription drug in New York; Med Impact for prescription drug in New York.
Services: General medical, dental, vision, prescription drug, mental health. Services available unbundled. May be customized to meet employer specifications.
Rating options: Community rating: $125.30 single, $325.79 family.
Point-of-service contracts: 19% of members are enrolled.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual enrollment is allowed.
Officers: Dr. Michael A. Stocker, president/CEO; Dr. William Osheroff, vp/chief medical officer; Gloria McCarthy, senior vp-operations, managed care, sales; Patricia Sabella, vp-medical management; Connie Poirier, vp-network development.
Blue Choice PPO
622 Third Ave., New York, N.Y. 10017; 212-476-1000
Staff/Facilities
Primary practitioners7,901
Board-certified77%
Patients/practitioner45
Specialists22,189
Hospitals148
Pharmacies4,200
Users: Group Health
Employer/payer groups3,719
Single coverage65,002
Family coverage76,904
Employees & dependents313,814
Total Users313,814
Not for profit.
Service area: New York: 28 counties.
Contracts with Express Pharmacy Services for prescription drug in New York; Med Impact for prescription drug in New York; Merit Behavioral Care for mental health in New York.
Services: General medical, dental, vision, prescription drug, mental health, vision, workers compensation. Services available unbundled*. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem, fee for service; is compensated by employers/payers; charges by fee schedule.
UR: Standard procedures. UR provided by the PPO.
Officers: Dr. Michael Stocker, president/CEO; Dr. William Osheroff, vp/chief medical director; Gloria McCarthy, senior vp-operations, managed care, sales; Patricia Sabella, vp-medical management; Connie Poirier, vp-network development.
**Dependent upon contract with provider.
CCN
5251 Viewridge Court, San Diego, Calif. 92123; 800-247-2898; 619-278-1262
Staff/Facilities
Primary practitioners186
Board-certified89.8%
Specialists727
Hospitals64
Users: Group Health
Employer/payer groups1
Employees & dependents13,750
Users: Workers Compensation
Employer/payer groups50
Total Users*13,750
Service area: New York: 64 counties.
Services: General medical, mental health, workers compensation, ancillary services.
**Does not include workers compensation users.
See CCN consolidated listing under California.
CNA Managed Care-Central New York
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners624
Hospitals3
Service area: New York: Central New York.
See CNA Managed Care PPO consolidated listing under Illinois.
CNA Managed Care-Eastern New York
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners627
Hospitals5
Service area: New York: Eastern New York.
See CNA Managed Care PPO consolidated listing under Illinois.
CNA Managed Care-New York City
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners12,447
Hospitals56
Service area: New York: New York City.
See CNA Managed Care PPO consolidated listing under Illinois.
CNA Managed Care-Western New York
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners458
Hospitals6
Service area: New York: Western New York.
See CNA Managed Care PPO consolidated listing under Illinois.
Capital District Physicians' Health Plan Inc.
17 Columbia Circle, Albany, N.Y. 12203; 518-862-3700; fax: 518-452-0003
Staff/Facilities
Primary practitioners636
Board-certified77%
Specialists1,752
Hospitals20
Pharmacies250
Primary care locations402
Users
Employer/payer groups3,200
Single coverage44,749
Family coverage45,494
Employees & dependents191,790
Medicaid10,807
Total202,597
Revenues
First-half 1997$154,928,299
1996$301,558,032Operational date: April 1984.
Licensed in: New York, Vermont.
NCQA fully accredited.
Model type: IPA.
Not for profit.
Service area: New York: Albany, Columbia, Fulton, Greene, Montgomery, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington counties.
Services: General medical, dental, vision, prescription drug, mental health. May be customized to meet employer specifications.
Rating options: Community rating: $142.03 single, $368.86 family.
Officers: Diane E. Bergman, president; Mary Connolly, vp-finance; Dr. Richard Adler, vp-medical affairs; Pamela Wilkes, vp-health services management; Dan Colacino, vp-marketing.
Capital District Physicians' Healthcare Network
17 Columbia Circle, Albany, N.Y. 12203; 518-862-3750; fax: 518-862-9395
Staff/Facilities
Primary practitioners605
Board-certified79%
Specialists1,263
Hospitals20
Pharmacies250
Users
Employer/payer groups6
Single coverage1,350
Family coverage1,158
Employees & dependents5,026
Total Users5,026
Operational date: June 1991.
For profit.
Service area: New York: Albany, Columbia, Fulton, Greene, Montgomery, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington counties.
Services: General medical, vision, prescription drug, mental health. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by discount off customary rates; is compensated by employers/payers; charges flat fee per employee.
UR: Standard procedures, excluding outpatient service predetermination. UR provided by the PPO.
Officers: Dr. John H. Carter, president; Thomas P. Collins, vp/treasurer; Dr. John A. Ferraro, secretary; Diane E. Bergman, executive director.
ChiroSource Inc.
P.O. Box 130, Clayton, Calif. 94517; 510-672-5333; fax: 510-672-6657
Specialty: chiropractic
Staff/Facilities
Primary practitioners64
Service area: New York: statewide.
See ChiroSource Inc. consolidated listing under California.
CIGNA HealthCare of New York Inc.
195 Broadway, Eighth Floor, New York, N.Y. 10007; 212-618-4200; 212-618-4258
Staff/Facilities
Primary practitioners3,540
Board-certified85.2%
Patients/practitioner34.6
Specialists8,218
Hospitals74
Pharmacies2,934
Users
Employer/payer groups777
Medicare2,702
Total125,286Operational date: April 1985.
Licensed in: New York.
Model type: IPA.
Service area: New York: Bronx, Dutchess, Kings, Nassau, New York, Orange, Putnam, Queens, Richmond, Rockland, Suffolk and Westchester counties.
Point-of-service contracts: 61.8% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Kurt Wiemer, general manager; Patrick Wormser, assistant vp-business decision support; Karen Lerner, assistant vp-marketing; Charlene Renollet, director/manager-operations; Charlie Catalano-market manager.
Contact: Diane Padweski, 201-442-6330.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA Managed Care Network of Central New York
440 S. Warren St., Suite 601, Syracuse, N.Y. 13202; 315-477-6150; fax: 315-477-6180
Staff/Facilities
Primary practitioners232
Board-certified89.6%
Patients/practitioner50.2
Specialists513
Hospitals7
Pharmacies187
Users
Employer/payer groups382
Total11,666Operational date: January 1994.
Licensed in: New York.
Model type: IPA.
Service area: New York: Cayuga, Madison, Onondaga and Oswego counties.
Point-of-service contracts: 70% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Jeanne McCarthy, general manager; Ron E. Dziedzicki, executive director; Dr. David Cogan, medical director; Cathy Eck, UM health services manager; Myra Malone, provider relations manager.
Contact: Lisa McCormick.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA PPO-Central New York
440 S. Warren St., Suite 601; Syracuse, N.Y. 13202; 315-477-6150; fax: 315-477-6180
Staff/Facilities
Primary practitioners224
Board-certified88.8%
Patients/practitioner20.2
Specialists448
Hospitals8
Users: Group Health
Employer/payer groups107
Total Users4,530
Operational date: January 1994.
Service area: New York: Cayuga, Madison, Onondaga and Oswego counties.
Officers: Ron Dziedzicki, executive director; Jeanne McCarthy, general manager; Dr. David Cogan, medical director; Myra Malone, provider relations manager; Lisa McCormick, planning/analysis-medical economics.
Contact: Andrew Green, 820-726-3586.
See CIGNA HealthCare PPO consolidated listing under Connecticut.
CIGNA PPO-New York
195 Broadway, Eighth Floor, New York, N.Y. 10007; 212-618-4200; 212-618-4258
Staff/Facilities
Primary practitioners2,946
Board-certified87.1%
Patients/practitioner39.8
Specialists7,188
Hospitals85
Users: Group Health
Employer/payer groups628
Total Users117,520
Operational date: January 1993.
Service area: New York: Bronx, Dutchess, Kings, Nassau, New York, Orange, Putnam, Queens, Richmond, Rockland, Suffolk and Westchester counties.
Officers: Tom Garvey, assistant vp-network management; Karen Lerner, assistant vp-marketing; Patrick Wormser, assistant vp-business decision support; Kurt Weimer, general manager; Charlie Catalano, sales director/manager.
Contact: Michael Kelly, 860-726-3794.
See CIGNA HealthCare PPO consolidated listing under Connecticut.
Community Blue
1901 Main St., P.O. Box 80, Buffalo, N.Y. 14240; 716-884-2800; fax: 716-887-6958
Staff/Facilities
Primary practitioners910
Board-certified76%
Specialists3,023
Hospitals31
Pharmacies366
Primary care locations1,409
Users
Employer/payer groups3,869
Single coverage41,690
Family coverage49,593
Employees & dependents208,688
Medicare8,836
Medicaid14,389
Total231,913
Revenues
First-half 1997$136,315,675
1996$255,815,489Parent: New York Care Plus Insurance Co. Inc.
Operational date: August 1985.
Licensed in: New York.
NCQA fully accredited.
Model type: IPA.
Not for profit.
Service area: New York: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans and Wyoming counties. Member of HMO Blue USA.
Services: General medical, vision, mental health.
Rating options: Community rating: $101.50 single, $273.04 family.
Offers self-insured products.
Point-of-service contracts: 17% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Thomas P. Hartnett, president/CEO; John G. Anderson, senior vp/COO; Alphonso O'Neil-White, senior vp/general counsel/corporate secretary; Harris S. Topel, senior vp-operational support services/CFO.
Contact: Member services, 800-544-2583.
Community Blue Advantage
1901 Main St., P.O. Box 80, Buffalo, N.Y. 14240; 716-884-2800; fax: 716-887-6958
Staff/Facilities
Primary practitioners741
Board-certified78%
Specialists2,631
Hospitals26
Pharmacies366
Primary care locations1,118
Users
Employer/payer groups3,424
Single coverage41,690
Family coverage49,593
Employees & dependents208,688
Medicare8,836
Medicaid14,389
Total231,913
Revenues
First-half 1997$136,315,675
1996$255,815,489Parent: New York Care Plus Insurance Co. Inc.
Operational date: January 1997.
Licensed in: New York.
NCQA fully accredited.
Model type: IPA.
Not for profit.
Service area: New York: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagra, Orleans and Wyoming counties. Member of HMO Blue USA.
Services: General medical, vision, mental health.
Rating options: Community rating: $101.50 single, $273.04 family.
Offers self-insured products.
Point-of-service contracts: 17% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Thomas P. Hartnett, president/CEO; John G. Anderson, senior vp/COO; Robert J. Boden, chief marketing executive-New York Care Plus Insurance Co. Inc.; Alphonso O'Neil-White, senior vp/general counsel/corporate secretary; Harris S. Topel, senior vp-operational support services/CFO.
Contact: Member services, 800-544-2583 or 716-884-2800.
CorVel Corp.
1920 Main St., Suite 1090, Irvine, Calif. 92714; 714-851-1473; fax: 714-851-1469
Staff/Facilities
Primary practitioners 2,937
Board-certified95%
Specialists7,622*
Hospitals90
Service area: New York.
**Includes ancillary providers.
See CorVel Corp. consolidated listing under California.