Maine
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 practitioners2
Hospitals1
Service area: Maine: Androscoggin County.
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 practitioners1
Specialists15
Hospitals1
Users: Group Health
Single coverage3,715
Family coverage16,333
Employees & dependents41,281
Users: Workers Compensation
Single coverage147,912
Total Users189,193
Operational date: 1994.
Service area: Maine: Androscoggin, Aroostook, Cumberland, Franklin, Kennebec, Knox, Lincoln, Oxford, Penobscot, Sagadhoc, Washington and York counties.
See Beech Street Corp. consolidated listing under California.
Blue Cross & Blue Shield of Maine
2 Gannett Drive, South Portland, Maine 04106; 207-822-7000; fax: 207-822-7375
Staff/Facilities
Primary practitioners833
Board-certified84%
Patients/practitioner142
Specialists1,438
Hospitals42
Pharmacies256
Users
Employer/payer groups636
Single coverage26,099
Family coverage27,127
Employees & dependents112,022
Total112,022
Revenues
First-half 1997$158,509,613
1996$88,856,538Operational date: December 1985.
Licensed in: Maine.
NCQA fully accredited.
Model type: IPA.
Not for profit.
Service area: Maine.
Member of HMO Blue USA.
Services: General medical, prescription drug, mental health. May be customized to meet employer specifications.
Rating options: Community rating: $204.82 single, $614.46 family; community rating by class; adjusted community rating.
Offers self-insured products.
Point-of-service contracts: 71% of members are enrolled.
Officers: Andrew W. Greene, chairman/CEO; Keith W. Vangeison, president/COO; Elizabeth O. Shorr, senior vp-corporate affairs; Francis G. McGinty, senior vp-health care policy; Sheila Hanley, senior managed care executive.
Contact: Maggie Franco 207-822-7338.
CNA Managed Care-Lewiston/
Portland
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners605
Hospitals8
Service area: Maine: Lewiston/Portland.
See CNA Managed Care PPO consolidated listing under Illinois.
ChiroSource Inc.
P.O. Box 130, Clayton, Calif. 94517; 510-672-5333; fax: 510-672-6657
Specialty: chiropractic
Staff/Facilities
Primary practitioners2
Service area: Maine: statewide.
See ChiroSource Inc. consolidated listing under California.
CIGNA Managed Care Network of Maine
3 Newton Executive Park, 2223 Washington St., Suite 200, Newton, Mass. 02162; 617-630-4300; fax: 617-630-4380
Staff/Facilities
Primary practitioners234
Board-certified90%
Patients/practitioner15.6
Specialists475
Hospitals17
Pharmacies29
Users
Employer/payer groups56
Total3,668Operational date: January 1994.
Licensed in: Maine, Massachusetts.
Model type: IPA.
Service area: Maine: Androscoggin, Aroostook, Cumberland, Hancock, Kennebec, Knox, Oxford, Penobscot, Piscataquis, Sagadahoc, Somerset, Waldo and York counties.
Point-of-service contracts: 86.2% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Brian Wells, general manager; Dr. Imre Toth, medical director; Carla Bettano, provider relations manager; Donna McCabe, quality asurance manager; Yvonne Menzolan, UM health services manager.
Contact: Merry Simpson.
See CIGNA HealthCare HMO/POS consolidated listing under Connecticut.
CIGNA PPO-Maine
3 Newton Executive Park, 2223 Washington St., Suite 200, Newton, Mass. 02162; 617-630-4300; fax: 617-630-4380
Staff/Facilities
Primary practitioners229
Board-certified91.6%
Patients/practitioner10
Specialists392
Hospitals14
Users: Group Health
Employer/payer groups63
Total Users2,728
Operational date: January 1994.
Service area: Maine: Androscoggin, Aroostook, Cumberland, Hancock, Kennebec, Knox, Oxford, Penobscot, Piscataquis, Sagadahoc, Somerset, Waldo and York counties.
Officers: Brian Wells, general manager; Dr. Imre Toth, medical director; Carla Bettano, director-provider relations; Linda Schneider, planning/analysis-medical economics.
Contact: Andrew Green, 860-726-3586.
See CIGNA HealthCare PPO consolidated listing under Connecticut.
CorVel Corp.
1920 Main St., Suite 1090, Irvine, Calif. 92714; 714-851-1473; fax: 714-851-1469
Staff/Facilities
Primary practitioners1
Board-certified90%
Specialists45*
Service area: Maine.
**Includes ancillary providers.
See CorVel Corp. consolidated listing under California.
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 practitioners71
Specialists235
Hospitals5
Total Users4,508
Operational date: September 1996.
Service area: Maine: Adroscoggin, Aroostook, Cumberland, Franklin, Hancock, Kennebec, Knox, Lincoln, Oxford, Penobscot, Piscataquis, Sagadahoc, Somerset, Waldo, Washington and York counties.
See FOCUS Healthcare Management Inc. consolidated listing under Tennessee.
HealthCare COMPARE Corp.
3200 Highland Ave., Downers Grove, Ill. 60515; 630-241-7900; fax: 630-241-7856
Staff/Facilities
Specialists1
Hospitals**1
Service area: Maine: Androscoggin, Aroostook, Cumberland, Franklin, Hancock, Kennebec, Knox, Lincoln, Oxford, Penobscot, Somerset, Waldo, Washington and York counties.
**Includes some specialists. ***Includes specialty hospitals.
See HealthCare COMPARE Corp./The AFFORDABLE Medical Networks consolidated listing under Illinois.
Healthcare Value Management Inc.
100 River Ridge Drive, Suite 101, Norwood, Mass., 02062; 617-762-5511; fax: 617-762-5318
Staff/Facilities
Primary practitioners35
Specialists68
Hospitals3
Users: Group Health
Employees & dependents1,000
Service area: Maine: Androscobbin, Cumberland, Franklin and York to be served by end of 1998.
See Healthcare Value Management Inc. consolidated listing under Massachusetts.
MultiPlan Inc.
115 Fifth Ave., New York, N.Y. 10003; 212-780-2000; fax: 212-843-3517
Staff/Facilities
Primary practitioners*NA
Specialists*NA
Hospitals7
Users: Group Health
Employer/payer groups5
Employees & dependents79,534
Service area: Maine: statewide.
**Practitioner network not yet established.
See MultiPlan Inc. consolidated listing under New York.
National Ear Care Plan
6825 E. Tennessee Ave., Suite 415, Denver, Colo. 80224-1632; 303-399-1212; fax: 303-399-7719
Specialty: hearing
Staff/Facilities
Primary practitioners2
Service area: Maine: cities of Farmington and Yarmouth.
See National Ear Care Plan consolidated listing under Colorado.
National Preferred Provider Network Inc.
419 E. Main St., Middletown, N.Y. 10940; 914-343-1600; fax: 914-343-6113
Staff/Facilities
Primary practitioners2
Specialists34
Hospitals1
Users: Group Health
Employer/payer groups7
Employees & dependents32,269
Total Users32,269
Service area: Maine.
See National Preferred Provider Network Inc. consolidated listing under New York.
NYLCare Health Plans of Maine Inc.
1 Monument Square, Fifth Floor, Portland, Maine 04101; 207-879-1995; fax; 207-879-7951
Staff/Facilities
Primary practitioners637
Board-certified75%
Patients/practitioner20
Specialists1,167
Hospitals31
Pharmacies250
Primary care locations331
Users
Employees & dependents7,850
Medicaid3,000
Total10,850
Revenues
First-half 1997$5,300,000
Second-half 1996$400,000Parent: NYLCare Health Plans Inc.
Operational date: June 1996.
Licensed in: Maine.
Service area: Maine: statewide.
Services: General medical. Services available unbundled. May be customized to meet employer specifications.
Offers self-insured products.
Point-of-service contracts: 20% of members are enrolled.
Enrollment options: Individual enrollment is allowed.
Officers: Dr. Daniel Fishbein, CEO; Kathy Edelman, vp-operations; Walter Munsen, vp-sales/marketing; Ted Tinson, CFO/vp-network development; Dr. Jeff Holmstrom, medical director.
See NYLCare Health Plans Inc. consolidated listing under New York.
NYLCare PPO
1 Monument Square, Portland, Maine 04101; 207-879-1995; fax: 207-879-7951
Staff/Facilities
Primary practitioners629
Board-certified75%
Specialists1,067
Hospitals31
Pharmacies250
Ownership: NYLCare Health Plans Inc.
Operational date: November 1996.
For profit.
Service area: Maine: statewide.
Contracts with PHCS for general services in Connecticut, New Hampshire, Massachusetts, upstate New York and Rhode Island.
Services: General medical. Services available unbundled. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem, discount off customary rates; is compensated by employers/payers; charges flat fee per employee.
Officers: Dr. Daniel Fishbein, CEO; Kathy Edelman, vp-operations; Walter Munsen, vp-sales/marketing; Ted Tinson, CFO/vp-network development; Dr. Jeff Holmstrom, medical director.
Private Healthcare Systems
1100 Winter St., Waltham, Mass. 02154; 781-895-7500; fax: 781-895-3455
Staff/Facilities
Primary practitioners249
Board-certified94%
Specialists327
Hospitals8
Pharmacies239
Users: Group Health
Employees & dependents10,490
Total Users10,490
Operational date: April 1985.
Service area: Maine: cities of Auburn, Lewiston and Portland.
See Private Healthcare Systems PPO consolidated listing under Massachusetts.