1997 DIRECTORY OF MANAGED CARE PROVIDERS

California
Admar Med Network*
1551 N. Tustin Ave., Suite 300, Santa Ana, Calif. 92705; 714-953-9600; fax: 714-953-6309
Staff/Facilities**
Primary practitioners48,228
Board-certified80%
Specialists110,922
Hospitals1,791
Users
Employer/payer groups150
Single coverage3,075,500
Employees & dependents6,980,000
Ownership: The Principal Financial Group.
Operational date: February 1987.
For profit.
Service area: Alabama, Arkansas, Arizona, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Illinois, Indiana, Kansas, Louisiana, Maine, Maryland, Massachusetts, Mississippi, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, Tennessee, Texas, Vermont, Virginia.
Contracts with American Life Care in Alabama, Arkansas, Louisiana, Mississippi; Dimension in Florida; Dona Ana in New Mexico; Focus in Tennessee, Health Care's Finest Network in Illinois, Ohio, West Virginia; HealthStar Inc. in Florida, Georgia, Illinois, Indiana, Ohio; Intergroup in Delaware, New Jersey, Pennsylvania; Medical Care Referral in Texas; Northern Nevada Health Network in Nevada; Primera in Colorado; Universal Health in Nevada.
Services: General medical, mental health.
Services available unbundled. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem, discount off customary rates, case rates; is compensated by employers/payers, insurers, TPAs; charges flat fee per employee, by percent of savings.
UR: Standard procedures including maternity care.
UR provided by the PPO.
Officers: Richard Toral, CEO/chairman; Kraig Boysen, vp-managed care services; Virginia Pascual, chief administrative officer; Stephen Ashley, vp-network services; Edward Evans, CFO/vp-finance.
Contact: Jody Bays, marketing supervisor.
**Figures are consolidated, including all PPO plans in this organization. ***Includes leased providers/facilities.
Admar Med Network
1551 N. Tustin Ave., Suite 300, Santa Ana, Calif. 92705; 714-953-9600; fax: 714-953-6309
Staff/Facilities
Primary practitioners14,250
Specialists31,815
Hospitals370
Users
Employees & dependents3,596,308
Operational date: June 1979.
Service area: California: 54 counties.
See Admar Med Network consolidated listing under California.
American Specialty Health Plans Inc.
8989 Rio San Diego Drive, Suite 250, San Diego, Calif. 92108; 619-686-5990; fax: 619-297-8189
Specialty: chiropractic
Staff/Facilities
Primary practitioners2,100
Primary care locations1,500
Users
Employer/payer groups400
Single coverage2,300,000
Medicare700,000
Total3,000,000
Revenues
First-half 1997$45,000,000
1996$26,000,000Operational date: September 1994.
Licensed in: California.
Model type: Network.
For profit.
Service area: California: statewide.
Services: Chiropractic. Services available unbundled. May be customized to meet employer specifications.
Rating options: Adjusted community rating.
Offers self-insured products.
Officers: George DeVries, president/CEO; Dr. R. Douglas Metz, vp-health services; Eric Leaver, vp-product development; Jerry Parker, vp-operations support.
Contact: Eric Leaver.
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 practitioners84
Hospitals36
Service area: Alameda, Butte, Contra Costa, Kings, Los Angeles, Mapera, Monterey, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, Santa Clara, Santa Cruz and Tulare counties.
See AnciCare PPO consolidated listing under Florida.
BPS HMO
888 S. Figueroa St., Suite 1400, Los Angeles, Calif. 90017; 213-489-2694; 213-489-7973
Staff/Facilities
Primary practitioners12,000
Specialists27,800
Hospitals154
Pharmacies2,700
Users
Employer/payer groups325
Employees & dependents9,000
Total9,000Parent: BPS Healthcare.
Operational date: November 1994.
Licensed in: California.
Model type: Group/IPA.
For profit.
Service area: California: Alameda, Contra Costa, Los Angeles, Marin, Merced, Orange, Riverside, San Bernardino, San Francisco, San Joaquin, San Mateo, Santa Clara, Santa Cruz, Stanislaus and Ventura counties.
Services: General medical, prescription drug, mental health, chiropractic. Services available unbundled. May be customized to meet employer specifications.
Rating options: Community rating by class; adjusted community rating.
Officers: Barbara E. Rodin, president/CEO; Asim A. Ashary, senior vp/CFO; Edward N. Stevens, vp-marketing; Dr. Jeffrey A. Wolf, vp-medical affairs; Patricia Stanton, vp.
BPS Healthcare
888 S. Figueroa St., Suite 1400, Los Angeles, Calif. 90017; 213-489-2694; fax: 213-489-7973
Staff/Facilities
Primary practitioners11,400
Specialists19,600
Hospitals200
Users: Group Health
Employer/payer groups4,000
Employees & dependents208,400
Total Users208,400
Ownership: NYLCare Health Plans/The Anthem Health Cos.
Operational date: 1982.
For profit.
Service area: California: 44 counties.
Services: General medical, mental health. Services available unbundled. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem; is compensated by providers, insurers; charges flat fee per employee.
UR: Preadmission review, concurrent review, length of stay determination, discharge planning, second surgical opinion. UR provided by the PPO.
Officers: Barbara E. Rodin, president/CEO; Asim A. Ashary, senior vp/CFO; Edward N. Stevens, vp-marketing; Dr. Jeffrey A. Wolf, vp-medical affairs; Patricia Stanton, vp.
Bakersfield Memorial Physicians' Independent Practice Assn.
P.O. Box 81265, Bakersfield, Calif. 93380; 805-327-0770
Staff/Facilities
Primary practitioners111
Board-certified90%
Patients/practitioner11,000
Specialists142
Hospitals1
Pharmacies147
Users: Group Health
Employer/payer groups78
Single coverage1,100
Family coverage14,500
Employees & dependents32,000
Total Users33,100
Operational date: February 1987.
Not for profit.
Service area: California: Kern County.
Services: General medical, vision, prescription drug, mental health. May be customized to meet employer specifications. Individual enrollment is allowed.
Compensation: Negotiates hospital charges by per diem; is compensated by insurers; charges by percent of savings.
UR: UR provided by outside contractors.
Officers: Dr. David P. Schale, president; Dr. H.C. Amin, secretary; Dr. Randall Jacobs, treasurer; Cliff Harmel, manager.
Contact: Cliff Harmel.
Beech Street Corp.*
173 Technology, Irvine, Calif. 92618; 800-233-2478 or 714-727-1353; fax: 714-727-1319
Staff/Facilities**
Primary practitioners62,409
Board-certified85%
Specialists193,685
Hospitals2,180
Users: Group Health
Employer/payer groups7,560
Single coverage809,428
Family coverage3,167,325
Employees & dependents8,094,276
Users: Workers Compensation
Employer/payer groups723
Single coverage10,641,136
Total Users18,735,413
Operational date: October 1984.
For profit.
Service area: Alaska, Arizona, California, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Vermont, West Virginia, Wyoming.
Contracts with Ethix in Michigan; First Choice in Washington; Health Choice in Alabama, Tennessee; Health Net PPO, Preferred in Tennessee; Health Network in Indiana, Wisconsin; Managed Healthcare Northwest in Oregon; Mountain Medical Affiliates in Colorado; One Source in Utah; Preferred Health Partnership in Tennessee; Preferred Health Plan in Kentucky; Southeast Medical Alliance in Arkansas, Louisiana, Mississippi; Virginia Health Network in Virginia.
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, daily rate caps; is compensated by employers/payers, insurers, TPAs; charges flat fee per employee, by percent of savings, by percent of charges.
UR: Standard procedures, including demand management. UR provided by the PPO and by outside contractors.
Officers: George J. Bregante, president/COO; Sue Christofferson, vp-network development; Dr. William Thompson, vp-medical affairs; Michael Lombardi, vp-sales/marketing/account management; Sheila Rankin, vp-operations; Norman Werthwein, CFO.
Contact: Lauree Landis.
**Figures are consolidated, including all PPO plans in this organization. ***Includes leased providers/facilities
Beech Street Corp.
173 Technology, Irvine, Calif. 92618; 800-233-2478 or 714-727-1353; fax: 714-727-1319
Staff/Facilities
Primary practitioners9,971
Specialists27,557
Hospitals255
Users: Group Health
Single coverage168,450
Family coverage624,276
Employees & dependents1,604,286
Users: Workers Compensation
Single coverage9,420,598
Total Users11,024,883
Operational date: 1984.
Service area: California: 56 counties.
See Beech Street Corp. consolidated listing under California.