Medica 2019 Annual Report

THE POWER OF Performance

As a nonprofit health plan, we’re committed to understanding and responding to community needs. In 2019, we offered new health insurance products in every market segment and extended our reach to more people and places than ever before.

Case Study: Medica + CHI Health

ACOs Drive Growth and Improve Health We partner with premier health systems across our service area to create Accountable Care Organization (ACO) products that deliver high-quality, affordable care with personalized service and support. In 2019, more than 150,000 Medica members were enrolled in an ACO product featuring a trusted local provider system. We’re able to deliver more effective care for these members by sharing data and working with our care system partners to encourage adherence to evidence-based best practices, reduce variation, close gaps in care, and continuously pursue improvement opportunities. It works. Members enrolled in our ACO health plans during 2019 experienced fewer hospitalizations, fewer hospital readmissions, fewer emergency room visits, and higher rates of preventive care utilization compared to members in open- access networks. When care is more appropriate, efficient and effective, member satisfaction follows. In fact, 97% of all Medica members who were enrolled in an ACO plan through an employer group during 2019 renewed it for 2020.

It’s in our DNA to partner with the health care systems our members know and trust. CHI Health — a leading health system with 14 hospitals and 400 providers across eastern Nebraska and southwestern Iowa — is a great example. With more than 30,000 members enrolled in our Medica with CHI Health SM individual and family plans by 2019, it was only natural to extend the benefits of our partnership to other market segments. We offered our first ACO-type Medicare Advantage plans to seniors in the Lincoln/ Omaha/Council Bluffs area in the fall of 2019, and are expanding the Medica with CHI Health ACO-plan portfolio to employer groups for 2021 enrollments.

Our ACO Partners Altru Health System | Ascension St. John | CHI Health | Essentia Health | LifeCare Health Services M Health Fairview | Mayo Clinic | Nebraska Health Network | North Memorial Health | Park Nicollet Health Services Ridgeview Medical Center | Saint Luke’s Health System | Stormont Vail Health | UnityPoint Health

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