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Aetna Inc. (/ ˈ ɛ t n ə / ET-nə) is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, primarily through employer-paid (fully or partly) insurance and benefit programs, and through Medicare.
Specifically, most ratings are determined from multivariate logistic regressions of medical outcomes at a given healthcare provider to risk-adjust the patients and 1-, 3- and 5-star awards are given to providers whose negative outcomes are worse than expected, near predicted levels, and better than expected, respectively.
CareSource was founded by Pamela Morris in 1989 in Dayton, Ohio with the goal of expanding health care for underserved populations. The plan was originally called the Dayton Area Health Plan (DAHP) which was incorporated by three hospital CEOs and located its first headquarters in the offices of the Dayton Hospital Association.
Brighter is a Santa Monica-based internet and healthcare company that connects dentists, patients, and dental insurers. The company licenses a consumer-driven dental benefits experience to insurance carriers to help them administer dental plans more efficiently and offer patient-friendly services such as online and mobile provider directories, patient reviews, and a proprietary online ...
Aetna Cited by KLAS Research as 'Transformational Partner' for Providers -- Aetna Receives Accolades from Providers in KLAS Report on Accountable Care Payers -- HARTFORD, Conn.--(BUSINESS WIRE ...
This is a list of insurance companies based in the United States. These are companies with a strong national or regional presence, having insurance as their primary business.
In the 21st century, commercial payers were increasingly using litigation against providers to combat alleged fraud or abuse. [25] Examples included litigation between Aetna and a group of surgical centers over an out-of-network overbilling scheme and kickbacks for referrals, where Aetna was ultimately awarded $37 million. [25]
WellCare began operations in 1985 in Tampa, Florida as a Medicaid provider for the State of Florida. [5] In 1992, Kiran Patel, a cardiologist and entrepreneur, purchased the company. [6] [7] In 2002, Patel sold it to a New York investment group led by George Soros and Todd Farha. [7] Also in 2002, Todd Farha joined the company as CEO. [8] [9]