Fidest – Agenzia giornalistica/press agency

Quotidiano di informazione – Anno 32 n° 259

Posts Tagged ‘health plan’

Talya Schwartz, MD, Appointed President and CEO of MetroPlus Health Plan

Posted by fidest press agency su mercoledì, 15 maggio 2019

The Board of MetroPlus Health Plan today announced the appointment of Talya Schwartz, MD, as the health plan’s President and CEO. MetroPlus is the low-cost, five-star quality health insurance plan of choice for more than 500,000 New Yorkers. As the health plan owned by NYC Health + Hospitals, MetroPlus is a vital component of Mayor de Blasio’s Guaranteed Health Care plan to ensure health care for all New Yorkers. Dr. Schwartz, currently the Chief Medical Officer of MetroPlus, assumed her new position on May 10th. The five-star rated health plan is the health insurance plan of NYC Health + Hospitals and growing and strengthening the plan is part of the public health system’s comprehensive, multi-year redesign to build a competitive, sustainable organization that will continue to offer high-quality and accessible health care to the people of New York City.
Since 2016, Dr. Schwartz has served as Chief Medical Officer at MetroPlus, leading the Medical Management division including quality, case management, utilization management, pharmacy, network relations, provider contracting, credentialing, health analytics and various lines of business. Under her leadership MetroPlus ranked among the top plans in the State for quality. She transformed the care management program into a holistic, field-based program that now also addresses social determinants of health with special focus on housing for its homeless population. Additionally, the Plan became a state-designated peer certification program for HIV peers and has made great strides in engaging patients in their own care to achieve high levels of HIV suppression, results that have been presented at medical conferences at home and abroad.Dr. Schwartz joined MetroPlus from the private sector. She has been a founding member of a behavioral health technology startup company and prior to that served in various leadership roles in regional and national health plans. Earlier in her career she worked as a strategic consultant at the Advisory Board Company, a post-doctoral researcher at the University of Pennsylvania, and served as a Fellow at the National Institute of Health.Dr. Schwartz earned her medical degree from Sackler Medical School and a graduate certificate in Health Services Management and Leadership from the George Washington University. She completed her residency in Pediatrics at Maimonides Medical Center in Brooklyn, New York, and worked as a pediatrician at Children’s National Medical Center in Washington, DC.Dr. Schwartz replaces Arnold Saperstein, MD, who served as President and CEO of MetroPlus since 2006.

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AM Best Revises Outlooks to Positive for Memorial Hermann Health Plan

Posted by fidest press agency su giovedì, 14 marzo 2019

AM Best has revised the outlooks to positive from stable and affirmed the Financial Strength Rating of B+ (Good) and the Long-Term Issuer Credit Rating of “bbb-”of Memorial Hermann Health Plan, Inc. and Memorial Hermann Health Insurance Company. Collectively, the group is herein referred to as Memorial Hermann Insurance Operations. All companies are domiciled in Houston, TX.The ratings reflect Memorial Hermann Insurance Operations’ balance sheet strength, which AM Best categorizes as adequate, as well as its weak operating performance, limited business profile, and appropriate enterprise risk management.The ratings also reflect Memorial Hermann Insurance Operations’ strategic role as the managed care subsidiary of Memorial Hermann Health System (Memorial Hermann), a fully integrated health care delivery system, as well as Memorial Hermann’s established network and overall creditworthiness, which enhances each entity’s assessment. Furthermore, the parent organization has historically demonstrated explicit financial support in the form of capital contributions to Memorial Hermann Insurance Operations.After reporting significant underwriting losses in recent years, Memorial Hermann Insurance Operations became profitable in 2018 due to several implemented performance improvement initiatives, including an exit from the individual exchange market, a shift of membership mix toward HMO products, and improved operations and medical management. These earnings were accretive to growth in absolute capital and surplus and, combined with reduced premium, strengthened projected risk-adjusted capitalization. The positive outlooks reflect this enhanced projected risk-adjusted capitalization, as well as continuing financial and operational support from its parent company.Memorial Hermann Insurance Operations continues to be challenged by a limited business profile largely reflecting its modest market share, geographically concentrated operations within the Houston, TX metro area, as well as highly competitive major medical and Medicare Advantage markets, which include larger national and regional health carriers.

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