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1997 DIRECTORY OF MANAGED CARE PROVIDERS

Reprints

Oregon
CNA Managed Care-Eugene
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners282
Hospitals6
Service area: Oregon: Eugene.
See CNA Managed Care PPO consolidated listing under Illinois.
CNA Managed Care-Portland
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners2,425
Hospitals21
Service area: Oregon: 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 practitioners11
Service area: Oregon: statewide.
See ChiroSource 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 practitioners959
Board-certified85%
Specialists3,626*
Hospitals32
Service area: Oregon.
**Includes ancillary providers.
See CorVel Corp. consolidated listing under California.
HealthCare COMPARE Corp.
3200 Highland Ave., Downers Grove, Ill. 60515; 630-241-7900; fax: 630-241-7856
Staff/Facilities
Primary practitioners*1,125
Specialists1,583
Hospitals**28
Service area: Oregon: 30 counties.
**Includes some specialists.
***Includes specialty hospitals.
See HealthCare COMPARE Corp./The AFFORDABLE Medical Networks consolidated listing under Illinois.
KMSB Health Plans
2500 Daggett St., Klamath Falls, Ore. 97601; 800-422-6557; fax: 541-884-0406
Staff/Facilities
Primary practitioners725
Board-certified75%
Patients/practitioner55
Specialists1,402
Hospitals21
Pharmacies110
Users: Group Health
Employer/payer groups8,550
Single coverage26,850
Family coverage15,682
Employees & dependents47,185
Ownership: KMSB Health Plans.
Operational date: 1978.
Not for profit.
Service area: Oregon: Baker, Deschutes, Grant, Harney, Jackson, Jefferson, Josephine, Klamath, Lake, Malheur, Morrow, Umatilla, Union and Wallowa counties.
Services: General medical, dental, vision, prescription drug, mental health. Services available unbundled. May be customized to meet employer specifications. Individual enrollment is allowed.
Compensation: Negotiates hospital charges by per diem, discount off customary rates, DRGs; is compensated by employers/payers; charges by percent of savings.
UR: Preadmission review, precertification, concurrent review, case management. UR provided by the PPO.
Officers: Tim Bailey, president; Jeanette Gansberg, executive vp; Helen Noonan-Harnsberger, medical director; Terry Sweeney, director-sales; Rob Kerman, director-provider contracting.
Contact: Terry Sweeney.
Kaiser Foundation Health Plan of the Northwest
500 N.E. Multnomah St., Suite 100, Portland, Ore. 97232; 503-813-2800; fax: 503-813-4636
Staff/Facilities
Primary practitioners213
Board-certified95%
Patients/practitioner1,958
Specialists349
Hospitals8
Pharmacies37
Primary care locations13
Users
Employer/payer groups4,472
Single coverage108,579
Family coverage50,711
Employees & dependents340,503
Medicare47,204
Medicaid28,682
Total415,560
Revenues
First-half 1997$388,645,026
1996$751,735,741Federally qualified.
Licensed in: Idaho, Oregon, Washington.
NCQA fully accredited.
Model type: Group.
Service area: Oregon: Benton, Clackamas, Columbia, Lane, Linn, Marion, Multnomah, Polk, Washington and Yamhill counties; Washington: Clark, Cowlitz, Lewis, Skamania and Wahkiakum.
Services: General medical, dental, vision, prescription drug, mental health, workers compensation, 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.
Offers self-insured products.
Point-of-service contracts: 1.5% of members are enrolled.
Non-federally qualified programs.
Officers: Michael Katcher, executive director-Kaiser/Group Health; Dr. Allan Weiland, medical director-Northwest Permanente; Barbara A. West, senior vp-Kaiser/Group Health and executive director-Kaiser Permanente NW division; Denise Honzel, marketing director-Kaiser/Group Health; Wade J. Overgaard, manager sales/marketing-Kaiser/Group Health.
Contact: Lynn Bonner, 503-813-4826.
See Kaiser Permanente consolidated listing under California.
Managed HealthCare Northwest Inc.
2701 N.W. Vaughn, Suite 710, Portland, Ore. 97210; 503-224-0409; fax: 503-224-0116
Staff/Facilities
Primary practitioners745
Board-certified60%
Specialists1,918
Hospitals17
Users: Group Health
Employer/payer groups51
Employees & dependents281,704
Users: Workers Compensation
Employer/payer groups9
Single coverage283,642
Ownership: Legacy Health System/Adventist Health.
Operational date: December 1983.
For profit.
Service area: Oregon: Clackamas, Columbia, Hood River, Lane, Multnomah, Wasco and Washington counties; Washington: Clark, Klickitat and Skamania counties.
Contracts with Beech Street and PPO Alliance in California; First Choice Health in Washington.
Services: General medical, chiropractic, mental health/substance abuse. 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, providers, insurers, TPAs; charges flat fee per employee.
UR: Standard procedures excluding discharge planning and hospital bill audits. UR provided by the PPO.
Officers: Robert Pallari, CEO; Dolores Russell, COO/director-payer/provider relations; Dr. Frank Wong, medical director; Scott Clement, director-sales; Pam Chritton, director-medical management.
Contact: Robin Mack.
MultiPlan Inc.
115 Fifth Ave., New York, N.Y. 10003; 212-780-2000; fax: 212-843-3517
Staff/Facilities
Primary practitioners*NA
Specialists*NA
Hospitals19
Users: Group Health
Employer/payer groups9
Employees & dependents156,021
Service area: Oregon: 21 counties.
**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 practitioners14
Service area: Oregon: cities of Albany, Brookings, Eugene, Grants Pass, King City, Klamath Falls, Lake Oswego, Lakeview, McMinnville, Medford, Portland, Salem, Tualatin and West Linn.
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 practitioners959
Specialists2,665
Hospitals32
Users: Group Health
Employer/payer groups18
Employees & dependents17,003
Total Users17,003
Service area: Oregon.
See National Preferred Provider Network Inc. consolidated listing under New York.
Northwest Therapy Alliance Corp.
10700 S.W. Beaverton Hillsdale Highway, Suite 622, Beaverton, Ore. 97005; 503-626-7724; fax: 503-526-8734
Specialty: physical therapy, occupational therapy, speech therapy
Staff/Facilities
Primary practitioners185
Specialists50
Hospitals2
Users: Group Health
Employer/payer groups11
Employees & dependents657,333
Total Users657,333
Ownership: Therapeutic Associates Inc.
Operational date: June 1994.
Not for profit.
Service area: Oregon: 25 counties; Washington: Clark County.
Contracts with AFFORDABLE, CorVel, Klamath Medical Service Bureau, LIFEWISE, ODS and PacificSource for physical therapy; Oregon Health Systems for physical and occupational therapy; CHAMPUS/TRICARE, CareOregon, PHCS and QualMed for physical, occupational and speech therapy.
Services: Workers compensation, physical therapy, occupational therapy, speech therapy. Services available unbundled. May be customized to meet employer specifications.
Compensation: Negotiates charges by per diem, discount off customary rates, DRGs, capitation; is compensated by employers/payers, providers, insurers, TPAs.
UR: Precertification, retrospective review, outpatient service predetermination, case management. UR provided by the PPO.
Officers: Daniel Jones, president; Rick Costain, vp; Steve Jones, secretary; Richard Katz, executive director.
Contact: Richard Katz.
PacifiCare of Oregon
5 Centerpointe Drive, Suite 600, Lake Oswego, Ore. 97035; 800-922-1444;
fax: 503-603-7377
Staff/Facilities
Primary practitioners1,243
Board-certified85%
Patients/practitioner160
Specialists1,106
Hospitals32
Pharmacies508
Primary care locations482
Users
Employer/payer groups4,124
Single coverage32,474
Family coverage31,920
Employees & dependents135,871
Medicare46,487
Total191,729
Revenues
First-half 1997$157,586,922
1996$150,824,957Operational date: February 1987.
Federally qualified.
Licensed in: Oregon.
NCQA one year accredited.
Model type: Network.
Service area: Oregon: Benton, Clackamas, Columbia, Jackson, Josephine, Lane, Linn, Marion, Multnomah, Polk, Washington and Yamhill counties; Washington: Clark County. Member of Covantage. Contracts with PacifiCare Behavioral Health for mental health/substance abuse in Oregon; Prescription Solutions for mail-order drug in Oregon.
Services: General medical, dental. May be customized to meet employer specifications.
Rating options: Community rating by class.
Offers self-insured products.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual enrollment is allowed.
Officers: Leeba Lessin, acting president; Paul Poon, acting director-finance; Patty Tucker, vp-operations; Shannon Burke, vp-sales/marketing; Don Costa, CFO.
See PacifiCare Health Systems HMO/POS consolidated listing under California.
Preferred Provider Plan
100 S.W. Market St., Portland, Ore. 97201; 503-225-5406; fax: 503-273-4136
Staff/Facilities
Primary practitioners1,921
Specialists4,024
Hospitals45
Users: Group Health
Employer/payer groups4,977
Single coverage77,750
Family coverage88,311
Employees & dependents377,829
Total Users377,829
Ownership: Regence Blue Cross & Blue Shield of Oregon.
Operational date: October 1986.
Not for profit.
Service area: Oregon: statewide; Washington: Clark, Klickitat and Skamania counties.
Services: General medical, vision, mental health. May be customized to meet employer specifications. Individual enrollment is allowed.
Compensation: Negotiates hospital charges by per diem, discount off customary rates, DRGs; is compensated by employers/payers; charges by administration fee negotiated per contract.
UR: Precertification, concurrent review, retrospective review, hospital bill audits, case management. UR provided by the PPO.
Officers: Donald Sacco, president/CEO; Dan Mallea, senior vp-finance; William Hoveke, senior vp-marketing; Arnold Holloway, senior vp-benefit services; Roger Lyman, senior vp-health care delivery/contracts.
Private Healthcare Systems
777 108th Ave. N.E., Suite 2260, Bellevue, Wash. 98004; 206-450-5558; fax: 206-450-5559
Staff/Facilities
Primary practitioners1,263
Board-certified85%
Specialists1,432
Hospitals27
Pharmacies515
Users: Group Health
Employees & dependents17,800
Total Users17,800
Operational date: May 1987.
Service area: Oregon: cities of Eugene, Medford, Pendleton, Portland, Salem and Springfield.
See Private Healthcare Systems PPO consolidated listing under Massachusetts.
Private Healthcare Systems Inc.
777 108th Ave. N.E., Suite 2260, Bellevue, Wash. 98004; 206-450-5558; fax: 206-450-5559
Staff/Facilities
Primary practitioners843
Board-certified85%
Specialists1,432
Hospitals27
Pharmacies515
Users
Employees & dependents1,104
Total1,104Service Area: Oregon: cities of Eugene, Medford, Pendleton, Portland, Salem and Springfield.
See Private Healthcare Systems POS consolidated listing under Massachusetts.
QualMed Health & Life Insurance Co.
225 N. Main St., Pueblo, Colo. 81003; 800-847-1528; fax: 719-585-8291
Staff/Facilities
Primary practitioners1,829
Board-certified74%
Patients/practitioner32
Specialists5,006
Hospitals55
Pharmacies475
Ownership: Foundation Health Systems Inc.
Operational date: January 1993.
Service area: Oregon: 31 counties; Washington: Clark, Cowlitz, Klickitat and Skamania counties.
Services: General medical, prescription drug, mental health. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem, discount off customary rates, DRGs; is compensated by employers/payers; charges flat fee per employee.
UR: Standard procedures. UR provided by the PPO.
Officers: Darnell Dent, president/CEO; Brian Crary, treasurer; Kevin Staab, secretary/director-finance; Kathleen McCafferty, director-medical management; Michael Tullos, director, legal affairs.
Contact: Ginny Salomon.
See Foundation Health Systems consolidated listing under California.
QualMed Oregon Health Plan Inc.
4800 S.W. Macadam, Suite 400, Portland, Ore. 97201; 503-222-5217; fax: 503-796-6399
Staff/Facilities
Primary practitioners1,829
Board-certified74%
Patients/practitioner32
Specialists5,006
Hospitals55
Pharmacies475
Primary care locations1,091
Users
Employer/payer groups1,180
Single coverage14,269
Family coverage16,043
Medicaid3,358
Total67,712Parent: Foundation Health Systems Inc.
Operational date: July 1989.
Federally qualified.
Licensed in: Oregon, Washington.
Model type: IPA.
Service area: Oregon: 31 counties; Washington: Clark, Cowlitz, Klickitat, Shamania.
Services: General medical, vision, prescription drug. Services available unbundled. May be customized to meet employer specifications.
Rating options: Community rating by class; adjusted community rating.
Offers self-insured products.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Officers: Christopher F. du Laney, president; Randy McEvers, vp; Dr. Eric Wall, secretary; Dale C. Ahlskog, CFO.
Contact: C. Fred Roberts, vp-sales, 503-796-6302.
See Foundation Health Systems consolidated listing under California.
Regence HMO Oregon
100 S.W. Market St., Portland, Ore. 97201; 503-225-5406; fax: 503-273-4136
Staff/Facilities
Primary practitioners1,733
Specialists4,420
Hospitals53
Users
Employer/payer groups8,847
Single coverage223,834
Family coverage81,416
Employees & dependents476,992
Medicare56,242
Medicaid92,768
Total626,002
Revenues
First-half 1997$360,643,000
1996$723,803,000Parent: Regence Blue Cross & Blue Shield of Oregon.
Operational date: April 1988.
Federally qualified.
Licensed in: Oregon, Washington.
NCQA one year accredited.
Model type: IPA.
Not for profit.
Service area: Oregon; Washington: Clark County.
Member of HMO Blue USA.
Services: General medical, vision, mental health.
Rating options: Community rating by class; adjusted community rating.
Point-of-service contracts: 7.6% of members are enrolled.
Non-federally qualified programs.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual enrollment is allowed.
Officers: Donald Sacco, president/CEO; Don Mallea, senior vp-finance; William Hoveke, senior vp-marketing; Arnold Holloway, senior vp-benefit services; Roger Lyman, senior vp-health care delivery/contracts.
USA H&W Network
7301 N. 16th St., Suite 201, Phoenix, Ariz. 85020; 602-371-3860; fax: 602-371-3889
Staff/Facilities
Primary practitioners366
Specialists749
Hospitals17
Users: Group Health
Single/family coverage20,235
Employees & dependents46,540
Total Users46,540
Operational date: February 1989.
Service Area: Oregon: 23 counties.
See USA H&W Network consolidated listing under Arizona.
USA Workers' Injury Network
916 S. Capital of Texas Highway, Austin, Texas 78746; 512-306-0201; fax: 512-328-6785
Specialty: workers compensation
Staff/Facilities
Primary practitioners237
Specialists714
Hospitals2
Users: Workers Compensation
Single coverage23,247
Total Users23,247
Operational date: February 1989.
Service area: Oregon: 23 counties.
See USA Workers' Injury Network consolidated listing under Texas.
United HealthCare Insurance Co.
Harrison Square Building, Suite 650, 1800 S.W. First Ave., Portland, Ore. 97201; 503-220-1030; fax: 503-221-2260
Staff/Facilities
Primary practitioners1,064
Board-certified73%
Specialists1,926
Hospitals10
Pharmacies202
Licensed in: Oregon.
Model type: Network.
Service area: Oregon: Clackamas, Columbia, Marion, Multnomah and Washington counties.
Services: General medical, prescription drug, mental health/substance abuse.
Rating options: Adjusted community rating, experience rating.
Contact: Beth Sobert, sales manager.
See United HealthCare Corp. HMO consolidated listing under Minnesota.
United HealthCare Insurance Co.
Harrison Sqare Building, Suite 650, 1800 S.W. First Ave., Portland, Ore. 97201; 503-220-1030; fax: 503-221-2260
Staff/Facilities
Primary practitioners1,064
Board-certified73%
Specialists1,905
Hospitals22
Pharmacies283
Users:
Employer/payer groups323
Total Users18,726
Service area: Oregon: Benton, Clackamas, Clark, Clatsop, Columbia, Hood River, Jackson, Josephine, Lane, Linn, Marion, Multnomah, Wasco, Washington and Yamhill counties.
Services: General medical, prescription drug, mental health/substance abuse.
Contact: Beth Sobert, sales manager.
See United HealthCare Corp. PPO consolidated listing under Minnesota.