The Centers for Medicaid and Medicare Services (CMS) and California Department of Healthcare Services (DHCS) have also made it increasingly clear that plans are ultimately accountable for fulfilling the terms and conditions of their contracts and are held responsible for the actions and failures of their downstream providers to comply with these requirements. LOS ANGELES--(BUSINESS WIRE)--Prospect Medical Group (Prospect), a Southern California-based independent physician association (IPA), will acquire certain assets of CalCare IPA and Los Angeles Medical Center IPA, both of which serve Los Angeles County, and Vantage Medical Group in Riverside, San Bernardino, and San Diego. MultiCultural Medical Group, Inc. My Family Medical Group. Your care should be, too. lives and talents to the pursuit of excellence in the field of health care. A compliance officer with supporting staff should review all policies, reports, audit findings and any other issues with the Audit and Finance committees and with the entirety of the Board. controlled and directed organization. The physicians and staff in California IPA and MSO SoCal are dedicated to assisting you with your healthcare concerns. We focus on Medi-Cal/Medicaid, Commercial, and Medicare and Dual Eligible (Medi-Medi) members in the Riverside and San Bernardino counties. The following physician group clients are currently available through Southern California Physicians Managed Care Services. Associated Hispanic Physicians of Southern California IPA Bella Vista Medical Group IPA Centinela Valley Medical Group Central Valley Medical Providers/MedPRO Community Care IPA El Proyecto del Barrio, Inc. Emanate Health IPA Family Care Specialists IPA Global Care Medical Group IPA Health Care LA, IPA Integrated Health Partners Whether you have questions or are experiencing difficulties with your insurance, you may contact our Member Services representative. access to a patients complete health record. The MSO INC. team commits to always deliver services in the spirit of collegiality and cooperation. California, 94954. - Director of IPA Services at Universal Care Health Plan managing 11 IPAs with multiple payor contracts of 150,000 patients in Los Angeles and Orange Counties. Our independent network of over 450 primary care and specialty physicians live and practice medicine in your community. is linked through technology allowing all providers across our network Co-payment for services varies greatly. The physicians and staff in California IPA and MSO SoCal are dedicated to assisting you with your healthcare concerns. Serving over 90,000 members of major HMOs, PPOs, and Medicare Of all of the issues arising from the downfall of this prominent medical group and its MSO, it is the policy concerns relating to economic profiling cited in the DMHC order that is causing heart palpitations in the California delegated model and resounding across other states utilizing a Medicaid Managed Care model. With more than 7 years in business, Alliance Health Systems, IPA is an Independent Practice Association (IPA) committed to providing patient-centered quality medical care through an extensive and accessible network of healthcare providers. Sulmeyer, Kupetz, Baumann Rothman and Elissa D. Miller for Defendant and Respondent Southern California IPA Medical Group, Inc. Solomon, Saltsman Jamieson and Stephen Allen Jamieson for Defendants and . Independent Local Network of Physicians A complete list of winners can be found, Directory of HMOs, PPOs and Medical Groups. Associated Hispanic Physicians of Southern California IPA c/o Medpoint Management P.O. She served as Gov. Your local doctor is focused on making sure Health Care LA, IPA. Our members health and well being are our top priority. Founded in 1999, MSO Inc. and MMSE Inc. provides meaningful advice and efficient management to the best in healthcare. Medical Group Ratings -- Select a County - California community. the network. Our local doctors take your health care needs personally. As part of our medical group, you will have access to over 1000 doctors in Santa Clara . Value-based and Risk Transfer Payment Arrangements, Managed Care / Risk Readiness Gap Assessment, Managed Care Contract Revenue Optimization, Post-Acute Network Assessment and Optimization, Primary Care Provider Network Empanelment Assessment and Optimization, Quality and Provider Performance Improvement, Care Management Assessment, Optimization and Implementation, Managed Services Organization (MSO) Development and Optimization, Analytics for Risk Contracting (ARC) Suite, Managed Services Organization Development and Optimization, Value-Based and Risk Transfer Payment Arrangements. Noble AMA IPA. Mid County Physicians Medical Group. Joint audits by DHCS and California Department of Managed Health Care (DMHC) for contractual and regulatory compliance have increased over time and are expected to continue. IPA Medical Group, Inc., 86 Cal.App.4th 919, see flags on bad law, and search Casetext's comprehensive legal database . CALIIPA Physicians Choice Medical Group of San Luis Obispo. Palomar Health Medical Group. Optum - Formerly . They are passionate about Enforcement of existing requirements is likely a better starting place. - Consultant in strategy, business development, facilities, operations planning and regulatory compliance for clients such as: L.A. Care Health Plan, Cedars Sinai Medical Center, St. Joseph Hospital Orange, St Jude, Heritage Foundation, Antelope Valley Medical Center, Kaiser Permanente, Mount Diablo Medical Center, Kern Medical Center, Los Angeles Medical Center IPA, Arta Health Care, United Care Medical Group, Alliance of Premier Hospitals, Care Medical Group, Accountable Health Plan IPA, Optometric Alliance of California and Crown City Medical Group. Health care value is a function of quality divided by cost. Our independent network To earn this recognition, medical groups must have scores that rank in the top 50% for 'Quality of Care' and 'Patient's Rate Overall Experience' as well as 'Total Cost of Care'. Health Plans. About Us Alpha Care Medical Group It is owned and sponsored by experienced and traditional Medicare Advantage and Medi-Cal Managed Care providers and administrators who wish to . We are a full service MSO that provides comprehensive and personalized insights to improve our client's operations and profitability. We are independent and OmniCare Medical Group. About Us. participating specialists for an initial consultation. Connecting patients to independent doctors who are passionate about providing For Enrollment Information call: (323) 657-0003. Physician Group Clients. SCCIPA's network includes more than 1000 physicians practicing in over trained, board certified, and experienced physicians in Silicon Valley We deliver quality care in While the need for higher scrutiny and stronger accountability of delegated providers and MSOs may be highlighted by this collapse, the alleged wrongdoing of one medical group should not overshadow the large-scale success of Californias delegated model. Expanded the health plan from one county (Los Angeles) to four counties (Los Angeles, Orange, Riverside and San Bernardino) in three years, with membership growing from 0 at start up to almost 17,000 Medicare members when it sold. Physicians Medical Group of San Jose. Imperial County Physicians Medical Group (ICPMG) Southern California Children's Healthcare Network (SCCHN) Hospital . - Vice President of Networking Operations and Marketing at Care 1st Health Plan serving 200,000 patients. Alliance Health Systems, IPA | Alliance Health Systems, IPA Health plans must take a more active role in better oversight of MSOs, and possibly other key vendor relationships. PDF 2023 Insurance/Payers Currently Filed in California (Southern) - Labcorp (805) 705-2586 List of Medical Groups by HMO - California convenient access to physicians, hospitals, urgent care clinics, radiology Conclusion Cindy Ehnes is an Executive Vice President at COPE Health Solutions and can be reached atcehnes@copehealthsolutions.com and (916) 599-5490. participating major health plans to provide you with the information and You have kindly supported us and offered much appreciated resources and assistance. Medical Groups Directory Last Update: 07/26/2023. Los Angeles County, and is continually expanding. Global Care Medical Group IPA Inc The San Diego Physicians Medical Group/Scripps Physicians Medical Group works with The subject of managed care is one that makes physicians and health care professionals very uncomfortable. delivering high quality, comprehensive care. Happy New Year. We understand that peace of mind is important and if medical attention is needed, your personal issues will be addressed by experts in a timely and hassle free manner. Access IPA (Los Angeles - Eastern L.A. County); Access Managed Care/Access Medical Group (Los Angeles - Torrance and South Bay); Access Managed Care/Access Medical Group (Los Angeles - West); Accountable Healthcare IPA (aka Accountable Healthplan Medical) (Los Angeles) Accountable Healthcare IPA (aka Accountable Healthplan Medical) (Los Angeles - Eastern L.A. County) We founded the company in 2001. Global Care IPA is a large group comprised of professional men and women who have dedicated their Global Care Medical Group IPA 2020-2021. Board Governance . Southern California Physicians Managed Care Services - Web Site - SCPMCS The computer can warn your doctor(s) if they are trying to prescribe a drug that could cause an interaction with another drug you are taking. 1129 S. San Gabriel Boulevard, San Gabriel, CA 91776 Tel: (626) 287-6746. Call our office, your doctor, or your health plan advice line to explore the options you have in order to start feeling better as soon as possible. In the last 20 years, the managed care landscape has changed drastically with positive evolutions in policies, procedures and processes to improve quality of care and quality of services and increase accountability. Fax (916)323-5400. Phone: (818) 461-5000, Report site errors here|Privacy| Terms & Conditions, Fast and efficient service with the goal to make seeing a Doctor easier. Greater Tri- Cities IPA Medical Group, Inc. California IPA has Alignment Health Plan, CareMore Health, Anthem Blue Cross Cal Medi-Connect Plan, Santa Clara Family Health Plan and Valley Health Plan (active from 2016-2021) as its primary affiliated health plans. UnitedHealthcare of California - HMO. Otherwise, products must offer the same essential benefits. Southern California Medical Group Taking Care of Business Since 1990. SCCIPA members have You can choose one of the 39 counties listed. The state pays premiums to the health plan on a per member per month basis. The topics provide information on important quality care for the topic and what your doctor or health plan and you should or could be doing so that you get the best care. These compliance functions, including hotline, can also be outsourced. gary@blancohopkins.com. Clients - Easy Care MSO 3320 South Hill St Los Angeles, CA, 90007 United States (213)749-5386 [email protected] Occupational Medicine | Industrial Medicine | Orthopedic | Physical Therapy | Acupuncture | Chiropractic | . University of Southern California's Bronny James - AllSides The acquisition complements Prospects focus on providing care through the lifespan continuum for all members, across all products. Associated Hispanic Physicians of Southern California IPA - AHPSCIPA As regulators contemplate additional, new bold actions, it is imperative to consider that increasing oversight increases cost and shrinks the already tight margins of the Medi-Cal managed care dollar going to providers. As Counties where Santa Clara County IPA (SCCIPA) provides services: Many medical groups also serve patients who live in neighboring counties. Schwarzeneggers Director of the CA Department of Managed Health Care for seven years, overseeing health insurance services for 21 million Californians, and regulating the operations, clinical and financial performance for 105 health plans and 220 delegated medical groups. This acquisition advances our goals of supporting independent physicians and helping them succeed in managed care environments, said Dr. Mitchell Lew, President, Prospect Medical Holdings. Number of mental health practitioners: 10, Lucile Salter Packard Children's Hosp. You're one of a kind. Associated Hispanic Physicians of Southern California IPA. SCPMCS - For Members Centinela Valley IPA Medical Group, Inc. Citrus Valley Physician Group Community Family Care - San Fernando Valley Community Family Care IPA - Antelope Valley . 10153 Global Care Medical Group IPA 6400 Canoga Avenue, Suite 163 Woodland Hills CA 91367 10154 Golden Empire Managed Care, A Medical Group, Inc. 5080 California Ave. Bakersfield CA 93309 is just right for you. For example, Covered California, the states health care exchange with products approved by the DMHC, is an active purchaser that openly distinguishes its product prices based on the relative cost of provider networks. Call us today @ 800-708-3230. The recent high profile collapse of one of the nations more prominent risk-bearing medical group and its affiliated MSO highlights a number of potential operational, financial and regulatory dilemmas that must be carefully managed in the relationship between an MSO and one or more medical groups. Economic Profiling Narrow Networks Fax: (323) 724-6922 CLAIMS MSO Inc. Southern California Referrals to Specialists Box 571420 Tarzana, CA 91357 Global Care Headquarters 11149 South Crenshaw blvd suite D, Inglewood,CA. local physicians who practice both primary and specialty care: Megan Nguyen., Cal IPA CEO Primary Care Physician can refer you directly to many To ensure the most secure and best overall experience on our website we recommend the latest versions of, Internet Explorer is no longer supported. Leveraging its existing infrastructure, Prospect will ensure the highest quality operations and compliance for these acquired assets. With more than 11,000 PCPs and specialists in Southern California to choose from, . Independent practice Beverly Hospital . Prospect currently owns or manages 25 IPAs across six states, with 500,000 members accessing a variety of insurance products. CIGNA - HMO. Kaiser Permanente - Northern California - HMO. Stakeholder engagement, regulatory predictability and reasonable regulation are essential underpinnings to balance access to the best physicians and hospitals with the regrettable reality of cost. Box 571450 Tarzana, CA 91357 Ph: (818) 702-0100 Toll Free: (800) 509-8359 Member Services Department 425 W Main St., Suite 202 Alhambra, CA 91801 Tel: (626) 828-9292 Email: info@ahpscipa.com 2023 California (Southern) Insurance/Payers Currently Filed in Provider TIN #: 27-3267315 Provider Name: Esoterix Genetic Laboratories, LLC Esoterix Genetic Laboratories, LLC will file claims for insured patients directly to Medicare, Medicaid, and many insurance companies and managed care plans. Southern; California and St Joseph Health, June 21, 2016. Omni IPA Medical Group, Inc. dba Medcore Medical Group. AHS was founded by a healthcare visionary who focused on change and innovation. Associated Hispanic Physicians of Southern California, IPA can help you make better health decisions. 1. Linkedin Profile. a timely manner with a minimum of paperwork and no delays. Associated Hispanic Physicians of Southern California IPA, AHP, AHPSCIPA In large provider organizations, the Board of Directors have Audit and Finance sub-committees in addition to organizational compliance and internal audit functions. Following the closing of the transaction, the three additional IPAs, representing more than 10,000 providers, will join Prospects existing networks, becoming one of the largest IPAs in the country with more than 20,000 providers in its network. California IPA includes primary care physicians and specialists in the South Bay Area who share the same philosophy of personalized medicine. Global Care is a strategically savvy, large multi-site, multi-specialty Independent Physician Blue Shield of California - HMO. There are, however, increasingly challenging compliance demands and regulatory requirements.
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