Network description:
Primary care: Close to 1,400 clinicians working a wide variety
of practice sites including FQHCs, non-FQHC health centers,
group practices, private offices, and hospital-based primary
care practices.
Specialty care: Over 4,200 individual specialists.
Inpatient care: Contracts with approximately 70 institutions.
Pharmacy benefit and management:
Pharmacy coverage only in Child Health Plus, Family Health Plus,
UniCare and Sunrise programs; State directly covers pharmacy for
Medicaid clients, i.e., carved out of Medicaid managed care
benefit package. Third party administrator under contract to
administer this benefit.
TPA/Information systems:
No outsourcing of MIS or operations, except for claims data
entry.
History of the organization:
1982: Initial funding provided by private foundation grant,
followed in 1984 by State contracts for development and
operating subsidies.
1986: Corporation established as The Bronx Health Plan (TBHP).
Began Medicaid managed care enrollment as of 2/87. Governing
Board comprised of four “founding” FQHCs, i.e., the initial four
practices that contracted with TBHP as participating providers.
1990: UniCare Program (State-subsidized coverage for low-income
uninsured individuals and families) began operation.
1991: Child Health Plus (State-subsidized coverage for
low-income uninsured children) began operation.
1995: Expanded service area to include Manhattan as well as the
Bronx.
1999: Acquired GENESIS Health plan; operated as a wholly-owned,
for-profit subsidiary through December 2001, offering Medicaid
managed care and Child Health Plus programs in the New York City
boroughs of Brooklyn, Queens and Staten Island, and in the five
surrounding counties of Westchester, Rockland, Orange, Nassau
and Suffolk.
2002: Merged GENESIS Health Plan into The Bronx Health Plan
thus creating a single, not-for-profit entity serving NYC and 5
surrounding counties. Liquidated GENESIS business. Changed
corporate name to Affinity Health Plan.
Governance History:
TBHP originated in 1986 through collaboration with several
FQHC’s, four of which were considered “founding” health centers
because they were the first contractors in the primary care
network. None of those health centers (or, for that matter, any
other organization or institution) were capital investors;
capitalization was provided by private foundation and State
grants. Consequently, “provider sponsorship” derived not from
ownership or investment, but from TBHP’s early involvement with
and commitment to community health centers, and a governance
model that assured an FQHC majority on the Board of Directors.
In July, 2000, TBHP’s Board revised the By-laws to provide a
governance model that better reflects the increasing diversity,
complexity and scope of the expanding organization. Board
composition now has a provider majority (5 of 9 seats) with at
least a majority of those seats (3 of 5) reserved for FQHC
representatives. The remaining (4 of 9) seats are for “public”
representatives, which does not rule out people who are involved
in the provision of health care services.
With these revisions, the previous Board was dissolved and a new
Board was formed. Currently, seven (7) seats are filled, three
(3) with providers and four (4) public seats. All three of the
provider seats are held by FQHCs, namely, the Morris Heights
Health Center, Urban Health Plan, and the Charles B. Wang Health
Center. The Board Nominating Committee is actively seeking
additional candidates to fill the vacancies and, potentially,
expand the size of the Board. |
