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Organization Name and
Address:
Health Plus , Inc. |
Contact name:
Thomas Early
Contact e-mail:
tearly@healthplus-ny.org
Medical Director:
Cliff Marbut, M.D. |
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Phone / fax:
(718) 630-0133
fax: (718) 852-5785 |
CEO:
Thomas Early |
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Web site:
www.healthplus-ny.org |
COO:
Jack Essex |
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Years Operational:
19 years |
CFO:
Rolando Portocarrero |
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Enrollment level, by
payer:
FHP: 17,600
Medicaid: 119,700
CHIP: 48,900
Total: 186,200
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Percent of enrollment
served by CHC clinics:
25%
Corporate status:
501(c) 4
Certifications (JACHO,
NCQA, HMO):
PHSP |
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Governance:
Health Plus is a subsidiary of Lutheran Medical Center and its Sunset
Park Family Health Center network. The board of Health Plus consists
of 14 people. Ten of those are board members of Lutheran Medical
Center, 1 is the president of Lutheran and 1 is the executive director
of Sunset Park. The remaining 2 positions are filled by members and/or
community people, as required under State licensure. |
Reserve requirements:
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Network description:
Primary and specialty care network consists of a combination of
Community Health Centers, Hospital ambulatory care departments
and private doctor offices. There are in excess of 1,800 primary
care providers, 8,500 specialty doctors and 56 hospitals
available to serve its members. HEALTH PLUS currently operates
in all boroughs of New York City.
Pharmacy benefit and management:
Pharmacy is a carve-out under New York State Medicaid managed
care program. For Child Health Plus and Family Health Plus,
Eckherd Health Services, a pharmacy benefit manager and its
network are used.
Behavioral Health:
As of January 1, 2002 behavioral health is managed
internally.
TPA/Information systems:
HEALTH PLUS currently utilizes the Erisco Facets system.
History of the organization:
HEALTH PLUS began in 1984 under a demonstration project of the
New York State Department of Health. It concentrated on the
immediate neighborhood served by Sunset Park and was operated as
a department of the Family Health Center network of Lutheran
Medical Center. Medicaid recipients could voluntary enroll. It
was funded through a grant from the Robert Wood Johnson
Foundation.
In 1992 the southwest Brooklyn Medicaid demonstration began
requiring mandatory enrollment in the service area served by
Sunset Park. Also in 1992 New York State began an insurance
product for uninsured children called Child Health Plus. It
provided ambulatory coverage for uninsured children up to age
13. In subsequent years, the Child Health Plus program has
expanded the scope of benefits and broadened eligibility of
children up to the age of 19. In 1995 HEALTH PLUS was separately
incorporated and expanded its network to all of Brooklyn and
Staten Island.
Today, HEALTH PLUS has a total enrollment exceeding 186,000
members. It is the #1 plan in government sponsored plan
enrollment in New York City and in New York State. It is also #1
in CHP enrollment in NYC. It operates in all 5 boroughs of NYC.
Three major challenges the organization faces during 2001:
The major challenge this year is the rising number of uninsured
and the budget deficits faced by the state and federal
governments. These budget deficits will result in rate
decreases, enrollment delays and eligibility freezes or
decreases.
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| Last Updated: March 2003 |
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