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CalOptima is a publicly funded health insurance plan for low-income citizens for Orange County, CA. With an annual budget of US$4 billion serving 940,000 members as of July 2022, [ 1 ] it is also the single largest county organized health insurer in the state. [ 2 ]
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
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Sept. 2019: UnitedHealth Group announces acquisition of Equian, LLC for $3.2 billion. [12] A Payment Integrity Institution that has joined the Optum family. Jan 2021: UnitedHealth Group announces acquisition of Change Healthcare LLC, evaluated to worth $8 billion, in addition to paying off its $5 billion debt for a total of $13 billion. [13]
GEHA (Government Employees Health Association) is a self-insured, not-for-profit association providing medical and dental plans to federal employees and retirees and their families through the Federal Employees Health Benefits program and the Federal Employees Dental and Vision Insurance Program (FEDVIP).