Maryland
Admar Med Network
1551 N. Tustin Ave., Suite 300, Santa Ana, Calif. 92705; 714-953-9600; fax: 714-953-6309
Staff/Facilities
Primary practitioners1,292
Specialists3,743
Hospitals52
Users
Employees & dependents2,632
Operational date: June 1991.
Service area: Maryland: 22 counties.
See Admar Med Network consolidated listing under California.
Alliance PPO Inc.
4 Taft Court, Rockville, Md. 20850; 301-330-6807; fax: 301-762-6132
Staff/Facilities
Primary practitioners8,142
Board-certified80%
Specialists11,432
Hospitals205
Users: Group Health
Employer/payer groups30,000
Employees & dependents1,004,000
Users: Workers Compensation
Employer/payer groups11*
Total Users1,004,000
Ownership: Mid Atlantic Medical Services Inc.
Operational date: April 1988.
For profit.
Service area: Delaware: statewide; District of Columbia; Maryland: statewide; North Carolina: 65 counties; Pennsylvania: Adams, Bedford, Berks, Cumberland, Dauphin, Franklin, Fulton, Lancaster, Montgomery, Philadelphia, Somerset and York counties; Virginia: statewide; West Virginia: 75 counties.
Services: General medical, dental, 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, fee maximums; is compensated by employers/payers, insurers, TPAs; charges flat fee per employee, by percent of savings.
UR: Standard procedures excluding hospital bill audits and outpatient service predetermination. UR provided by the PPO.
Officers: George T. Jochum, CEO; Dr. Mark D. Groban, president; Frank W. Noone, vp; Janice Dade, senior director.
Contact: Frank W. Noone.
**Excludes workers comp enrollment.
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 practitioners15
Hospitals9
Service area: Maryland: Baltimore, Bristol, Frederick, Harford, Montgomery and Prince George's counties.
See AnciCare PPO consolidated listing under Florida.
Beech Street Corp.
173 Technology, Irvine, Calif. 92618; 800-233-2478 or 714-727-1353; fax: 714-727-1319
Staff/Facilities
Primary practitioners501
Specialists1,698
Hospitals12
Users: Group Health
Single coverage10,506
Family coverage36,959
Employees & dependents95,512
Users: Workers Compensation
Single coverage35,116
Total Users130,628
Operational date: 1992.
Service area: Maryland: Allegany, Anne Arundel, Baltimore, Calvert, Carroll, Cecil, Charles, Dorchester, Frederick, Harford, Howard, Montgomery, Prince George's, Queen Anne's, St. Mary's, Talbot, Washington and Wicomico counties and the city of Baltimore.
See Beech Street Corp. consolidated listing under California.
Blue Cross
& Blue Shield
of Maryland Inc.
10455 Mill Run Circle, Owings Mills, Md. 21117; 410-581-3000; fax: 410-998-5576
Staff/Facilities
Primary practitioners1,903
Board-certified70%
Patients/practitioner52
Specialists11,939
Hospitals50
Pharmacies1,023
Primary care locations1,100
Users
Employer/payer groups40,978
Single coverage17,749
Family coverage19,265
Employees & dependents52,317
Total89,331Operational date: January 1992.
Licensed in: Maryland.
Model type: IPA.
Not for profit.
Service area: Maryland: 23 counties.
Member of Blue Card.
Contracts with Advance Paradigm for prescription drug in Maryland; Green Spring for mental health/substance abuse in Maryland.
Services: General medical, dental, vision, prescription drug, mental health. Services available unbundled. May be customized to meet employer specifications.
Rating options: Adjusted community rating.
Offers self-insured products.
Officers: Dr. Eric R. Baugh, senior vp-managed care/medical systems; William L. Jews, president/CEO; Gregory A. Devou, executive vp/chief medical officer; David D. Wolf, executive vp/COO; David Kowalczyk, vp-audit.
Contact: Robert Wern, 410-998-5048.
CCN
5251 Viewridge Court, San Diego, Calif. 92123; 800-247-2898; 619-278-1262
Staff/Facilities
Primary practitioners1,080
Board-certified82.3%
Specialists2,620
Hospitals36
Users: Group Health
Employer/payer groups85
Employees & dependents4,353
Users: Workers Compensation
Employer/payer groups15
Total Users*4,353
Service area: Maryland: 27 counties.
Services: General medical, mental health, workers compensation, ancillary services.
**Does not include workers compensation users.
See CCN consolidated listing under California.
ChiroSource Inc.
P.O. Box 130, Clayton, Calif. 94517; 510-672-5333; fax: 510-672-6657
Specialty: chiropractic
Staff/Facilities
Primary practitioners9
Service area: Maryland: statewide.
See ChiroSource Inc. consolidated listing under California.
CIGNA HealthCare Mid-Atlantic Inc.
9700 Patuxent Woods Drive, Suite 200, Columbia, Md. 21046; 410-720-5800;
fax: 410-720-5860
Staff/Facilities
Primary practitioners1,600
Board-certified....78%
Patients/practitioner 86.1
Specialists3,634
Hospitals55
Pharmacies*1,464
Users
Employer/payer groups*1,736
Total*137,881Operational date: December 1986.
Licensed in: Maryland, Virginia, Washington D.C.
NCQA fully accredited.
Model type: IPA.
Service area: District of Columbia; Maryland: Allegany, Anne Arundel, Baltimore, Calvert, Carroll, Charles, Frederick, Garrett, Harford, Howard, Montgomery, Prince George's, St. Mary's and Washington counties and the city of Baltimore; Virginia: Arlington, Fairfax, Fauquier, Frederick, Loudoun, Prince William, Stafford and Warren counties and the cities of Alexandria, Fairfax, Falls Church, Manassas, Manassas Park and Winchester.
Point-of-service contracts*: 65.1% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: John Wider, general manager; Dr. James Springrose, medical director; Jennifer Teeter, provider relations manager; Jenine Woodward, quality assurance manager; Mary Lawson, UM health services.
Contact: Dave Wilson.
**Figures reflect total for the mid-Atlantic region.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut
CIGNA Managed Care
Network Mid-Atlantic/
Shenandoah Valley
9700 Patuxent Woods Drive, Suite 200, Columbia, Md. 21046; 410-720-5860;
fax: 410-720-5260
Staff/Facilities
Primary practitioners19
Board-certified87.5%
Specialists27
Hospitals1
Pharmacies*1,464
Users*
Employer/payer groups1,736
Total137,881Operational date: January 1996.
Licensed in: Maryland, Virginia.
Model type: IPA.
Service area: District of Columbia; Maryland: Allegany, Anne Arundel, Baltimore, Calvert, Caroline, Carroll, Charles, Dorchester, Frederick, Garrett, Harford, Howard, Montgomery, Prince George's, Queen Anne's, Saint Mary's, Talbot and Washington counties and the city of Baltimore; Virginia: Arlington, Caroline, Fairfax, Fauquier, Frederick, Loudoun, Prince William, Stafford andWarren counties and the cities of Alexandria, Fairfax, Falls Church, Manassas, Manassas Park and Winchester; West Virginia: Berkely and Morgan counties.
Point-of-service contracts*: 65.1% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: John Wider, general manager; Dr. James Springrose, medical director; Steven Dillman, sales director/manager; Jennifer Teeter, provider relations manager; Jenine Woodward, quality assurance manager.
Contact: Eric Strother.
**Figures reflect total for the mid-Atlantic region.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut
CIGNA PPO-Baltimore/
Washington
9700 Patuxent Woods Drive, Suite 200, Columbia, Md. 21046; 410-720-5800; fax: 410-720-5860
Staff/Facilities
Primary practitioners2,441
Board-certified80.8%
Patients/practitioner30.5
Specialists6,274
Hospitals68
Users: Group Health
Employer/payer groups566
Total Users74,514
Operational date: January 1991.
Service area: District of Columbia; Maryland: Allegany, Anne Arundel, Baltimore, Calvert, Caroline, Carroll, Charles, Dorchester, Frederick, Garrett, Harford, Howard, Montgomery, Prince George's, Queen Anne's, St. Mary's, Talbot and Washington counties and the city of Baltimore; Virginia: Arlington, Fairfax, Fauquier, Frederick, Loudoun, Prince William, Stafford, Warren and the cities of Alexandria, Fairfax, Falls Church, Manassas, Manassas Park and Winchester; West Virginia: Berkeley and Morgan counties.
Officers: John Wider, general manager; Dr. James Springrose, medical director; Steve Dillman, sales director/manager; Jennifer Teeter, provider relations manager; Eric Strother, planning/analysis-medical economics.
Contact: Andrew Green, 860-726-3586.
See CIGNA HealthCare PPO consolidated listing under Connecticut.
CNA Managed Care-Baltimore
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners4,213
Hospitals27
Service area: Maryland: Baltimore.
See CNA Managed Care PPO consolidated listing under Illinois.
CNA Managed Care-Washington, D.C.
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners6,582
Hospitals33
Service area: Maryland.
See CNA Managed Care PPO consolidated listing under Illinois.
CAPP CARE Inc.
West Tower, 4000 MacArthur Blvd., Suite 10000, Newport Beach, Calif. 92660; 800-937-2277; fax: 714-251-2222
Staff/Facilities
Primary practitioners*501
Board-certified56.1%
Patients/practitioner129.6
Hospitals10
Service area: Maryland: Anne Arundel, Howard, Montgomery and Prince George's counties.
**Includes specialists.
See CAPP CARE Inc. consolidated listing under California.
CorVel Corp.
1920 Main St., Suite 1090, Irvine, Calif. 92714; 714-851-1473; fax: 714-851-1469
Staff/Facilities
Primary practitioners1,545
Board-certified84%
Specialists5,726*
Hospitals22
Service area: Maryland.
**Includes ancillary providers.
See CorVel Corp. consolidated listing under California.
Dental Benefit Providers Inc.
7200 Wisconsin Ave., Suite 800, Bethesda, Md. 20814; 301-654-6900;
fax: 301-986-7965
Specialty: dental
Staff/Facilities
Primary practitioners4,922
Patients/practitioner325
Specialists1,658
Primary care locations3,264
Users
Employer/payer groups105
Single coverage225,568
Family coverage60,023
Employees & dependents318,533
Medicare202,500
Medicaid330,000
Total851,033Operational date: January 1984.
Licensed in: California Colorado, Illinois, Maryland, Massachusetts, New Jersey, New York, Ohio, Virginia.
Model type: IPA/Network.
For profit.
Service area: California: 32 counties; Colorado; Adams, Arapahoe, Boulder, Denver, Douglas, El Paso, Elbert, Jefferson, Larimer, Pueblo and Weld counties; Connecticut: Fairfield, Hartford, Litchfield, Middlesex, New Haven, New London, Tolland and Windham counties; Dictrict of Columbia; Florida; Hillsborough, Pasco and Pinellas counties; Georgia: Carroll, Clayton, Cobb, Coweta, Dekalb, Fulton, Hall, Muscogee and Twiggs counties; Iowa: Clarke, Dallas, Polk and Woodbury counties; Idaho: Ada and Boise counties; Illinois: Bureau, Cook, Dupage, Kane, LaSalle, Lake, McHenry, Peoria and Will counties; Indiana: Allen, Dearborn, Elkhart, Floyd, Hamilton, Hancock, Hendricks, Henry, Howard, Johnson, Lake, Lawrence, Madison, Marion, Monroe, Porter, St. Joseph, Shelby, Vanderburgh, Vigo, Warrick and Wayne counties; Kansas: Johnson, Leavenworth and Wyandotte counties; Kentucky: Boone, Campbell and Kenton counties; Massachusetts: Barnstable, Berkshire, Bristol, Essex, Franklin, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk and Worcester counties; Maryland: Allegany, Anne Arundel, Baltimore, Calvert, Caroline, Carroll, Cecil, Charles, Dorchester, Frederick, Garrett, Harford, Howard, Kent, Montgomery, Prince Goerge's, Queen Anne's Somerset, St. Mary's, Talbot, Washington, Wicomico and Worcester counties and the city of Baltimore; Michigan: Genesee, Isabella, Macomb, Oakland, Saginaw, St. Clair, Shiawassee, Tuscola, Washtenaw and Wayne counties; Minnesota: Hennepin County; Missouri: Buchanan, Cass, Clay, Jackson and Platte counties; New Hampshire: Hillsborough County; New Jersey: Bergen, Camden, Essex, Hudson, Hunterdon, Middlesex, Monmouth, Ocean, Passaic, Somerset and Union counties; New Mexico: Bernalillo, Los Alamos, Santa Fe and Valencia counties; New York: Bronx, Kings, Nassau, New York, Putnam, Queens, Richmond, Rockland, Suffolk and Westchester counties; Ohio: 31 counties; Oregon: Benton, Clackamas and Multnomah counties; Pennsylvania: Allegheny, Beaver, Berks, Bucks, Butler, Chester, Delaware, Erie, Lancaster, Lehigh, Montgomery, Philadelphia, Washington and Westmoreland counties; Rhode Island: Kent, Newport, Providence and Washington counties; Texas: Brazos, Collin, Dallas, Denton, Hays, McLennan, Tarrant and Travis counties; Virginia: 31 counties; Washington: Clark, King, Snohomish and Spokane counties.
Services: Dental. Services available unbundled. May be customized to meet employer specifications.
Point-of-service contracts: 1% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Ralph Foxman, chairman; Edward A. Murphy, CEO; Jeffrey W. Ulanet, COO; Fred Horowitz, executive vp; Dennis Cahill, CFO.
Contact: Fred Horowitz.
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 practitioners24
Specialists362
Total Users13,526
Operational date: June 1997.
Service area: Maryland: 22 counties.
See FOCUS Healthcare Management Inc. consolidated listing under Tennessee.
FreeState
Health Plan Inc.
100 S. Charles St., Baltimore, Md. 21201; 410-528-7000; fax: 410-528-7017
Specialty: dental
Staff/Facilities
Primary practitioners1,965
Board-certified82%
Patients/practitioner127
Specialists4,000
Hospitals50
Pharmacies1,023
Primary care locations139
Users
Employer/payer groups5,379
Single coverage56,071
Family coverage67,522
Employees & dependents249,796
Medicaid10,174
Total259,970
Revenues
First-half 1997$206,443,601
1996$370,800,484Parent: Blue Cross & Blue Shield of Maryland Inc.
Operational date: November 1983.
Federally qualified.
Licensed in: Maryland.
NCQA fully accredited.
Model type: IPA/Network.
For profit.
Service area: Maryland: 23 counties.
Member of HMO Blue USA. Contracts with Advance Paradigm for prescription drug in Maryland; GreenSpring for mental health/substance abuse in Maryland; Maryland Eye Care for vision in Maryland; United Concordia Co. for dental in Maryland.
Services: General medical, dental, vision, prescription drug, mental health. May be customized to meet employer specifications.
Rating options: Community rating by class; adjusted community rating.
Offers self-insured products.
Point-of-service contracts: 27% of members are enrolled.
Non-federally qualified programs.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual enrollment is allowed.
Officers: Dr. Eric R. Baugh, senior vp-managed care/medical systems; William L. Jews, president/CEO; Gregory A. Devou, executive vp/chief marketing officer; David D. Wolf, executive vp/COO; David Kowalczyk, vp-audit.
Contact: Robert Wern, 410-998-5048.
HealthCare COMPARE Corp.
3200 Highland Ave., Downers Grove, Ill. 60515; 630-241-7900; fax: 630-241-7856
Staff/Facilities
Primary practitioners*592
Specialists1,744
Hospitals**11
Service area: Maryland: statewide.
**Includes some specialists. ***Includes specialty hospitals.
See HealthCare COMPARE Corp./The AFFORDABLE Medical Networks consolidated listing under Illinois.
Kaiser Foundation Health Plan of Mid-Atlantic States Inc.
2101 E. Jefferson St., Rockville, Md. 20852; 301-816-2424; fax: 301-816-7471
Staff/Facilities
Primary practitioners 303
Patients/practitioner1,761
Specialists376
Hospitals5
Pharmacies4,000
Primary care locations22
Users
Medicare24,372
Total537,897
Revenues
First-half 1997$352,530,634
1996$592,839,000Operational date: November 1972.
Federally qualified.
Licensed in: District of Columbia, Maryland, Virginia.
NCQA fully accredited.
Model type: Group.
Service area: District of Columbia; Maryland: Anne Arundel, Baltimore, Calvert, Carroll, Charles, Frederick, Hartford, Howard, Montgomery and Prince George's counties and the city of Baltimore.
Services: General medical, vision, prescription drug, mental health, durable medical equipment, hospitalization, lab, x-ray, preventive medicine, health education, substance abuse. Services available unbundled. May be customized to meet employer specifications.
Rating options: Adjusted community rating.
Point-of-service contracts: 4.5% of members are enrolled.
Officers: Cleve L. Killingsworth, president; Robert Pfotenhauer, vp/executive director-Washington D.C and Northern Virginia; Robert Essink, vp/executive director-Baltimore market; Michael Wise, CFO; Dr. Adrian Long, medical director.
See Kaiser Permanente consolidated listing under California.