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Health insurance
Reference
Blue Cross Blue Shield plans: http://www.bluecares.com/listing/index.html
Managed care organizations
America 's Health Insurance Plans (AHIP), Washington , DC
Description: national health insurance trade association.
Tel number: 202/778-3200
Web site: http://www.aahp.org/template.cfm
Blue Cross Blue Shield Association (BCBSA), Chicago , IL
Description: the national trade association Blue Cross and Blue Shield Plans.
Tel number: 312/297-5954
Web site: http://ww w .bluecares.com/
Council for Affordable Health Insurance, Alexandria , VA
Description: association of small to medium-sized insurance companies.
Tel number: 703/836-6200
Web site: http://users.worldweb.net/~cahi
Integrated Healthcare Association, Walnut Creek , CA
Description: association of California HMOs and IPAs and groups, pharmaceutical companies, aiming to make managed care more responsive.
Tel number: 925/746-5105
Web site: http://www.iha.org/
Healthcare Leadership Council, Washington , DC
Description: group composed of chief executives from a broad range of healthcare organizations, from HMOs and hospitals to drugmakers and medical device manufacturers.
Tel number: 202-452-8700
Web site: http://www.hlc.org/
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Managed care oversight
National Committee for Quality Assurance (NCQA), Washington , DC
Definition: evaluates a health plan's performance using the Health Plan Employer Data and Information Set (HEDIS).
Tel number: 202/955-3500
Web site: http://www.ncqa.org/
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Managed care information
Healthcare Financial Management Association (HFMA), Westchester , IL
Description: Information and meetings on managed care and other health care issues.
Tel number: 800/252-4362
Web site: http://www.hfma.org/
National Research Corp., Lincoln , NE
Description: provider of ongoing survey-based performance measurement, analysis and tracking services to the healthcare industry
Tel number: 402/475-2525
Web site: http://www.nationalresearch.com
InterStudy Publications, St. Paul , MN
Description: provides data on the managed care industry.
Tel number: 800/844-3351
Web site: http://w w w.hmodata.com
Mathematica Policy Research, Princeton , NJ
Description: studies on health care, welfare, education, employment, nutrition, and early childhood policies and programs.
Tel number: 609/799-3535
Web site: http://www.mathematica-mpr.com
National Managed Health Care Congress (NMHCC), Waltham , MA
Description: sponsors yearly meeting, conferences and expositions
Tel number: 781/663-6549
Web site: www.nmhcc.org
Mark Farrah Associates, Kennebunk , ME
Description: a managed care market research firm.
Tel number: 207/985-8484
Web site: http://www.markfarrah.com/
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Managed care consultants
Ki Health Inc. Bellevue , WA
Description: clients are hospitals, integrated delivery networks, health plans, and multi-hospital health systems.
Tel number: 425/646-5121
Web site: http://www.kihealth.com
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Managed care policy groups
Center for Studying Health System Change (HSC), Washington , DC
Description: analyzes effects of health system change.
Main number: 202/484-5261
Web site: http://ww w .hschange.org
Health Leadership Council, Washington , DC
Description: a forum to develop policies, plans and programs.
Tel number: 202/452-8700
Web site: http://www.hlc.org/
National Institute of Health Care Management Research and Educational Foundation, Washington , DC
Description: Established by 10 leading health care companies to build expertise in managed care topics.
Tel number: 202/296-4426
Web site: http://www.nihcm.org
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Managed care physicians
National Association of Managed Care Physicians. Glen Allen, VA
Description: run by physicians for physicians.
Tel number: 804/527-1905
Web site: http://www.namcp.com/
American College of Managed Care Medicine. Richmond , VA
Description: offers courses.
Tel number: 804/527-1905
Web site: http://www.acmcm.org
American College of Physician Executives, Tampa , FL
Description: represents physicians in executive and other management positions; hosts educational and career development programs.
Tel number: 800/562-8088
Web site: http://www.acpe.org
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Disease management
Disease Management Association of America (DMAA), Washington , DC
Description: seeks to advance disease management through standardization of definitions, program components and outcome measures.
Tel number: 202/861-1490
Web site: http://www.dmaa.org/
Disease Management Purchasing Consortium & Advisory Council (DMC2), Wellesley , MA
Description: membership group of health plans and employers that assists in disease and population management.
Tel number: 781/237-7208
Web site: http://www.dismgmt.com/
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Managed behavioral health
American Managed Behavioral Health Association (AMBHA), Washington DC
Description: association of managed behavioral healthcare companies, which manage mental health benefits separately in “carve outs.”
Tel number: 202/756-7308
Web site: http://www.ambha.org/
ValueOptions, Norfolk , VA
Description: a behavioral health managed care company that provides mental health, substance abuse and EAP services; a subsidiary of FHC Health Services Inc.
Tel number: 757/459-5100
Web site: http://www.valueoptions.com/
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Independent practice associations (IPAs)
The IPA Association of America (TIPAAA), Oakland , CA
Description: represents independent practice associations, loose groupings of physicians that come together to negotiate with managed care companies.
Tel number: 510/569-6561
Web site: http://www.tipaaa.org/index.html
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Preferred provider organizations (PPOs)
American Association of Preferred Provider Organizations (AAPPO), Louisville , KY
Description: association of PPOs, network-based healthcare entities and affiliated organizations.
Tel number: 502/403-1122
Web site: www.aappo.org
Beech Street Corporation. Lake Forest , CA
Description: a large PPO.
Tel number: 800/877-1666
Web site: http://www.beechstreet.com/
CCN, San Diego , CA
Description: subsidiary of First Health Group Corp., is one of the nation's largest PPO network.
Tel number: 301/581-0600
Web site: www.ccnusa.com
First Health Group Corp., Downers Grove , IL
Description: PPO network and our other products
Tel number: 630/737-7900
Web site: http://www.firsthealth.com/
Provider Healthcare Systems (PHCS), Waltham , MA
Description: it has a large PPO network.
Tel number: 781/895-7500
Web site: http://www.phcs.com/
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Managed care plans
Aetna Inc., Hartford , CT
Description: provides health care, dental, pharmacy, group life, disability and long-term care benefits.
Tel number: 860/273-0123
Web site: http://www.aetna.com
Blue Shield of California , San Francisco , CA
Description: one of largest plans in California .
Tel number: 415/445-5000
Web site: www.blueshieldca.com
CIGNA HealthCare, Philadelphia , PA
Description: bills itself as “an employee benefits company”; provides other types of insurance. as well as health insurance.
Tel number: 215/761-4450
Web site: www.cigna.com/ h ealthcare
Coventry Health Care, Bethesda , MD
Description: provides HMO, PPO, POS, Medicare+Choice and Medicaid products.
Tel number: 301/581-0600
Web site: http://www.cvty.com
Harvard Pilgrim Health Care. Dedham , MA
Description: a nonprofit health plan mainly in Massachusetts , Maine and New Hampshire .
Tel number: 888/888-4742
Web site: www.harvardpilgrim.org
Health Care Service Corp. Chicago , IL
Description: owns the Blue Cross Blue Shield plans in Illinois , Texas and New Mexico and subsidiaries in other states.
Tel number: 312/653-6000
Web site: http://www.hcsc.net/
Health Net. Woodland Hills , CA
Description: Operations in California , Oregon , Arizona and the Northeast.
Tel number: 818/676-6000
Web site: http://www.health.net/
HIP -- Health Insurance Plan of Greater New York . New York , NY
Description: operates in New York , Connecticut and Massachusetts .
Tel number: 800-447-8255
Web site: www.hipusa.com
Highmark. Pittsburgh , PA
Description: runs Blues plans in western Pennsylvania .
Tel number: 412/544-7000
Web site: http://www.highmark.com
Humana Inc. Louisville , KY
Description: operates in 15 states and Puerto Rico .
Tel number: 502/580-3683
Web site: www.humana.com
Kaiser Foundation Health Plan, Oakland , CA
Description: a staff/group model HMO in California , Colorado , Georgia , Hawaii , Maryland , Ohio and Washington . DC.
Tel number: 510/271-6489
Web site: www.kaiserpermanente.org
Medical Mutual, Cleveland OH
Description: Provides group and personal health insurance plans and third-party administrative services to self-insured group customers in Ohio .
Tel number: 216/687-7000
Web site: www.mmoh.com
Oxford Health Plans, Trumbull , CT
Description: operates in New York and Connecticut ; it is part of UnitedHealthcare.
Tel number: 952/992-4775
Web site: http://www.oxf o rdhealth.com
PacifiCare Health Systems, Santa Ana , CA
Description: coverage for individuals, employers and Medicare beneficiaries; operations in behavioral health, dental and vision, life insurance and pharmacy and medical management.
Tel number: 714/226-3530
Web site: www.phs.com
Premera Blue Cross. Spokane , WA
Description: operates in Washington state and Alaska .
Tel number: 800/722-1471
Web site: http://www.premera.com
Regence BlueShield, Seattle , WA
Description: Part of multi-state Regence Group.
Tel number: 800/458-3523
Web site: http://www.wa.regence.com
Sierra Health Services, Las Vegas , NV
Description: operates in Nevada , Texas and other states.
Tel number: 702/242-7156
Web site: www.sierrahealth.com
UnitedHealthcare, Minnetonka , MN
Description: operates medical, life, vision, disability and pharmacy plans.
Tel number: 952/992-4775
Web site: www.unit e d healthcare.com
WellPoint Health Networks, Indianapolis , IN
Description: operates Anthem Blue Cross and Blue Shield, Blue Cross of California, Blue Cross Blue Shield of Georgia, Blue Cross Blue Shield of Missouri, Blue Cross Blue Shield of Wisconsin, HealthLink and UniCare.
Tel number: 317/532-6000
Web site : www.wellpoint.com
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Managed care regulators
National Association of Managed Care Regulators, Buckingham , PA
Description: members are mainly from the federal purchasing sector and state insurance or health departments.
Web site: http://www.namcr.org/
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Employers
National Business Coalition on Health (NBCH), Washington , DC
Description: national group representing local business coalitions.
Tel number: 202/775-9300
Web site: http://www.nbch.org/
Pacific Business Group on Health, San Francisco , CA
Description: a business coalition of 50 purchasers, seeks to improve the quality and availability of health care while moderating cost.
Tel number: 415/281-8660
Web site: http://www.pbgh.org/
National Business Group on Health Washington , DC
Description: an association representing large employers devoted to finding innovative solutions to health care and related benefits issues. It was called the Washington Business Group on Health.
Tel number: 202/628-9320
Web site: http://www.wbgh.org
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Employee benefits
American Benefits Council, Washington , DC
Description: Lobbyist for employer-sponsored benefit programs.
Tel number: 202/289-6700
Web site: http://www.appwp.org/
Buck Consultants, New York , NY
Description: specializes in the strategy, process, systems and finance of human resources; a subsidiary of Mellon Financial Corporation.
Tel number: 212/330-1000
Web site: www.buckconsultants.com
Ernst & Young. New York , NY
Description: provides accounting and auditing, tax reporting and operations, tax advisory, business risk services, technology and security risk services, transaction advisory, and human capital services.
Tel number: 212/773-5299
Web site: http://www.ey.com/global/gcr.nsf/International/International_Home
The Hay Group, Philadelphia , PA
Description: a management consulting firm. Measures increases in health insurance premiums.
Tel number: 215/861-2000
Web site: http://www.haygroup.com/default.asp
Hewitt Associates, Lincolnshire IL
Description: a human resources outsourcing and consulting firm.
Tel number: 847/771-2500
Web site: www.hewitt.com
The Lewin Group, Fairfax , VA
Description: Part of Quintiles Transnational.
Tel number: 703/218-5500
Web site: http://www.quintiles.com/products_and_services/integrated_strategic_solutions/the_lewin_group
Mercer Human Resources Consulting, Chicago , IL
Description: part of Marsh and McClennan Companies (MMC).
Tel number: 312/902-7500
Web site: www.mercerHR.com
PricewaterhouseCoopers , New York , NY
Description: professional services organization with a health care division.
Tel number: 800/211-5131
Web site: http://www.pwchealth.com
The Segal Company, New York , NY
Description: compensation and human resources consulting company.
Tel number: 212/251-5000
Web site: http://www.segalco.com
Towers Perrin, Stamford , CT
Description: its HR services sector helps organizations effectively manage their investment in people. We offer our clients services in areas such as employee benefits, compensation, communication, change management, employee research and the delivery of HR services.
Tel number: 914/745-4175
Web site: http://www.towersperrin.com/hrservices/global/default.htm
Watson Wyatt Worldwide, Bethesda , MD
Description: its benefits consulting practice works with clients to design and manage cost-effective retirement and group benefits and health care programs that help attract, retain and motivate a talented workforce.
Tel number: 301/581-4600
Website: www.watsonw y att.com
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