health outcomes survey (hos) 2017-2019 cohort 20 ...the mao table is sorted by state. a key to the...
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Medicare HOS 2017-2019 Cohort 20 Performance Measurement Participating MAOs July 2020 Page 1
Health Outcomes Survey (HOS) 2017-2019 Cohort 20 Performance Measurement:
List of Participating MAOs In January 2020, the Centers for Medicare & Medicaid Services (CMS) updated the list of Medicare Advantage Organizations (MAOs) to identify the MAO reporting units that would be included in the HOS Cohort 20 Performance Measurement analysis. The December 2019 CMS Monthly Enrollment by Contract Report of Medicare Advantage/Part D Health Plans available at https://go.cms.gov/mapddata, and the August 2019 Health Plan Management System (HPMS) Contract List were used to create the following table, in order to accurately reflect the organization and product names associated with the Cohort 20 Performance Measurement reporting. Information in the table may have changed since December 2019. The MAO table is sorted by state. A key to the table is included at the end of the section.
Reporting Unit
MAO Organization Name
MAO Product Name
MAO State
Medicare Plan Type
H0104 BLUE CROSS AND BLUE SHIELD OF ALABAMA
BLUE CROSS AND BLUE SHIELD OF ALABAMA AL Local PPO
H0154 VIVA HEALTH, INC. VIVA MEDICARE AL HMO/HMOPOS
H6528 CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.
UNITEDHEALTHCARE AR Local PPO
H9699 HMO PARTNERS, INC. HEALTH ADVANTAGE AR HMO/HMOPOS
H0302 MEDISUN, INC. BLUE CROSS BLUE SHIELD OF ARIZONA ADVANTAGE AZ HMO/HMOPOS
H0321 ARIZONA PHYSICIANS IPA, INC. UNITEDHEALTHCARE AZ HMO/HMOPOS
H0351 HEALTH NET OF ARIZONA, INC. ALLWELL AZ HMO/HMOPOS
H0354 CIGNA HEALTHCARE OF ARIZONA, INC. CIGNA AZ HMO/HMOPOS
H2593 AMERIGROUP TEXAS, INC. AMERIGROUP AZ HMO/HMOPOS
H4931 BANNER - UNIVERSITY CARE ADVANTAGE
BANNER - UNIVERSITY CARE ADVANTAGE AZ HMO/HMOPOS
H5430 ONECARE BY CARE1ST HEALTH PLAN ARIZONA INC. WELLCARE AZ HMO/HMOPOS
H5580 MERCY CARE MERCY CARE ADVANTAGE AZ HMO/HMOPOS
H5587 HEALTH CHOICE ARIZONA, INC. STEWARD HEALTH CHOICE ARIZONA AZ HMO/HMOPOS
H0148 BLUE SHIELD OF CALIFORNIA PROMISE HEALTH PLAN
BLUE SHIELD OF CALIFORNIA PROMISE HEALTH PLAN CA
Medicare Medicaid Plan
HMO/HMOPOS
Medicare HOS 2017-2019 Cohort 20 Performance Measurement Participating MAOs July 2020 Page 2
Reporting Unit
MAO Organization Name
MAO Product Name
MAO State
Medicare Plan Type
H0504 CALIFORNIA PHYSICIANS' SERVICE BLUE SHIELD OF CALIFORNIA CA HMO/HMOPOS
H0523 AETNA HEALTH OF CALIFORNIA INC. AETNA MEDICARE CA HMO/HMOPOS
H0524 KAISER FOUNDATION HP, INC. KAISER PERMANENTE CA HMO/HMOPOS
H0543 UHC OF CALIFORNIA UNITEDHEALTHCARE CA HMO/HMOPOS
H0544 BLUE CROSS OF CALIFORNIA ANTHEM BLUE CROSS CA HMO/HMOPOS
H0545 INTER VALLEY HEALTH PLAN, INC. INTER VALLEY HEALTH PLAN CA HMO/HMOPOS
H0562 HEALTH NET OF CALIFORNIA,INC. HEALTH NET OF CALIFORNIA CA HMO/HMOPOS
H0571 CHINESE COMMUNITY HEALTH PLAN
CHINESE COMMUNITY HEALTH PLAN CA HMO/HMOPOS
H0838 UNIVERSAL CARE, INC. BRAND NEW DAY CA HMO/HMOPOS
H2241 GOLDEN STATE MEDICARE HEALTH PLAN GOLDEN STATE CA HMO/HMOPOS
H2986 STANFORD HEALTHCARE ADVANTAGE
STANFORD HEALTH CARE ADVANTAGE CA HMO/HMOPOS
H3237 HEALTH NET COMMUNITY SOLUTIONS, INC.
HEALTH NET CAL MEDICONNECT MEDICARE MEDICAID PLAN
CA Medicare
Medicaid Plan HMO/HMOPOS
H3561 HEALTH NET COMMUNITY SOLUTIONS, INC.
HEALTH NET COMMUNITY SOLUTIONS, INC. CA HMO/HMOPOS
H3815 ALIGNMENT HEALTH PLAN ALIGNMENT HEALTH PLAN CA HMO/HMOPOS
H5087 WELLCARE OF CALIFORNIA, INC. WELLCARE CA HMO/HMOPOS
H5172 COMMUNITY HEALTH GROUP COMMUNITY HEALTH GROUP CA Medicare
Medicaid Plan HMO/HMOPOS
H5355 IEHP HEALTH ACCESS IEHP DUALCHOICE CA Medicare
Medicaid Plan HMO/HMOPOS
H5386 SHARP HEALTH PLAN SHARP HEALTH PLAN CA HMO/HMOPOS
H5425 SCAN HEALTH PLAN SCAN HEALTH PLAN CA HMO/HMOPOS
H5433 ORANGE COUNTY HEALTH AUTHORITY ONECARE CA HMO/HMOPOS
H5439 HEALTH NET LIFE INSURANCE COMPANY
HEALTH NET LIFE INSURANCE COMPANY CA Local PPO
H5649 CENTRAL HEALTH PLAN OF CALIFORNIA, INC.
CENTRAL HEALTH MEDICARE PLAN CA HMO/HMOPOS
Medicare HOS 2017-2019 Cohort 20 Performance Measurement Participating MAOs July 2020 Page 3
Reporting Unit
MAO Organization Name
MAO Product Name
MAO State
Medicare Plan Type
H5810 MOLINA HEALTHCARE OF CALIFORNIA
MOLINA HEALTHCARE OF CALIFORNIA CA HMO/HMOPOS
H5852 AIDS HEALTHCARE FOUNDATION AHF CA HMO/HMOPOS
H5928 BLUE SHIELD OF CALIFORNIA PROMISE HEALTH PLAN
BLUE SHIELD OF CALIFORNIA PROMISE HEALTH PLAN CA HMO/HMOPOS
H5943 SCAN HEALTH PLAN VILLAGEHEALTH CA HMO/HMOPOS
H6229 BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.
ANTHEM BLUE CROSS CAL MEDICONNECT CA
Medicare Medicaid Plan
HMO/HMOPOS
H7885 SAN MATEO HEALTH COMMISSION HEALTH PLAN OF SAN MATEO CA
Medicare Medicaid Plan
HMO/HMOPOS
H7890 SANTA CLARA COUNTY HEALTH AUTHORITY
SANTA CLARA FAMILY HEALTH PLAN CAL MEDICONNECT CA
Medicare Medicaid Plan
HMO/HMOPOS
H8016 ORANGE COUNTY HEALTH AUTHORITY ONECARE CONNECT CA
Medicare Medicaid Plan
HMO/HMOPOS
H8258 LOCAL INITIATIVE HEALTH AUTHORITY FOR L.A. COUNTY
L.A. CARE CAL MEDICONNECT PLAN CA
Medicare Medicaid Plan
HMO/HMOPOS
H8552 ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO. CA Local PPO
H8677 MOLINA HEALTHCARE OF CALIFORNIA
MOLINA HEALTHCARE OF CALIFORNIA CA
Medicare Medicaid Plan
HMO/HMOPOS
H8764 ASPIRE HEALTH PLAN ASPIRE HEALTH PLAN CA HMO/HMOPOS
H0602 ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION
ROCKY MOUNTAIN HEALTH PLANS CO 1876 Cost
H0609 PACIFICARE OF COLORADO, INC. UNITEDHEALTHCARE CO HMO/HMOPOS
H0624 UNITEDHEALTHCARE INSURANCE COMPANY UNITEDHEALTHCARE CO HMO/HMOPOS
H0630 KAISER FOUNDATION HP OF CO KAISER PERMANENTE CO HMO/HMOPOS
H0657 FRIDAY HEALTH PLANS OF COLORADO, INC.
FRIDAY HEALTH PLANS OF COLORADO CO 1876 Cost
H5608 DENVER HEALTH MEDICAL PLAN, INC.
DENVER HEALTH MEDICAL PLAN, INC. CO HMO/HMOPOS
H0710 SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. UNITEDHEALTHCARE CT Local PPO
Medicare HOS 2017-2019 Cohort 20 Performance Measurement Participating MAOs July 2020 Page 4
Reporting Unit
MAO Organization Name
MAO Product Name
MAO State
Medicare Plan Type
H0712 WELLCARE OF CONNECTICUT, INC. WELLCARE CT HMO/HMOPOS
H0755 OXFORD HEALTH PLANS (CT), INC. UNITEDHEALTHCARE CT HMO/HMOPOS
H3528 CONNECTICARE, INC. CONNECTICARE CT HMO/HMOPOS
H5793 AETNA HEALTH INC. (CT) AETNA MEDICARE CT HMO/HMOPOS
H5854 ANTHEM HEALTH PLANS, INC. ANTHEM BLUE CROSS AND BLUE SHIELD CT HMO/HMOPOS
H1016 AVMED, INC. AVMED MEDICARE FL HMO/HMOPOS
H1019 CAREPLUS HEALTH PLANS, INC. CAREPLUS HEALTH PLANS, INC. FL HMO/HMOPOS
H1032 WELLCARE OF FLORIDA, INC. WELLCARE FL HMO/HMOPOS
H1035 FLORIDA BLUE MEDICARE, INC. FLORIDA BLUE HMO FL HMO/HMOPOS
H1036 HUMANA MEDICAL PLAN, INC. HUMANA FL HMO/HMOPOS
H1045 PREFERRED CARE PARTNERS, INC. UNITEDHEALTHCARE FL HMO/HMOPOS
H1099 HEALTH FIRST HEALTH PLANS HEALTH FIRST HEALTH PLANS, INC. FL HMO/HMOPOS
H2758 BEHEALTHY FLORIDA, INC. FLORIDA BLUE PREFERRED HMO FL HMO/HMOPOS
H2962 ULTIMATE HEALTH PLANS, INC. ULTIMATE HEALTH PLANS FL HMO/HMOPOS
H3132 AHF MCO OF FLORIDA, INC. AHF FL HMO/HMOPOS
H5190 SUNSHINE STATE HEALTH PLAN, INC. ALLWELL FL HMO/HMOPOS
H5410 HEALTHSPRING OF FLORIDA CIGNA FL HMO/HMOPOS
H5420 MEDICA HEALTHCARE PLANS, INC. UNITEDHEALTHCARE FL HMO/HMOPOS
H5427 FREEDOM HEALTH, INC. FREEDOM HEALTH, INC. FL HMO/HMOPOS
H5431 HEALTHSUN HEALTH PLANS, INC.
HEALTHSUN HEALTH PLANS, INC. FL HMO/HMOPOS
H5434 BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. FLORIDA BLUE FL Local PPO
H5471 SIMPLY HEALTHCARE PLANS, INC.
SIMPLY HEALTHCARE PLANS, INC. FL HMO/HMOPOS
H5594 OPTIMUM HEALTHCARE, INC. OPTIMUM HEALTHCARE, INC. FL HMO/HMOPOS
H5938 CAPITAL HEALTH PLAN CAPITAL HEALTH PLAN FL HMO/HMOPOS
H8130 MOLINA HEALTHCARE OF FLORIDA, INC.
MOLINA HEALTHCARE OF FLORIDA FL HMO/HMOPOS
Medicare HOS 2017-2019 Cohort 20 Performance Measurement Participating MAOs July 2020 Page 5
Reporting Unit
MAO Organization Name
MAO Product Name
MAO State
Medicare Plan Type
H0439 CIGNA HEALTHCARE OF GEORGIA, INC. CIGNA GA HMO/HMOPOS
H1109 AETNA HEALTH INC.(GA) AETNA MEDICARE GA HMO/HMOPOS
H1111 UNITEDHEALTHCARE OF GEORGIA, INC. UNITEDHEALTHCARE GA HMO/HMOPOS
H1112 WELLCARE OF GEORGIA, INC. WELLCARE GA HMO/HMOPOS
H1170 KAISER FOUNDATION HP OF GA, INC. KAISER PERMANENTE GA HMO/HMOPOS
H4141 HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC. HUMANA GA HMO/HMOPOS
H5422 BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA
ANTHEM BLUE CROSS AND BLUE SHIELD GA HMO/HMOPOS
H1230 KAISER FOUNDATION HP, INC. KAISER PERMANENTE HI HMO/HMOPOS
H2491 WELLCARE HEALTH INSURANCE OF ARIZONA, INC. WELLCARE HI HMO/HMOPOS
H3832 HAWAII MEDICAL SERVICE ASSOCIATION HMSA AKAMAI ADVANTAGE HI Local PPO
H5969 ALOHACARE ALOHACARE HI HMO/HMOPOS
H0028 CHA HMO, INC. HUMANA IA HMO/HMOPOS
H1608 COVENTRY HEALTH AND LIFE INSURANCE COMPANY AETNA MEDICARE IA Local PPO
H1609 AETNA HEALTH INC. (FL) AETNA MEDICARE IA HMO/HMOPOS
H1651 MEDICAL ASSOCIATES HEALTH PLAN, INC.
MEDICAL ASSOCIATES HEALTH PLAN, INC. IA 1876 Cost
H1737 HEALTH ALLIANCE - MIDWEST, INC. HEALTH ALLIANCE MEDICARE IA HMO/HMOPOS
H1302 BLUE CROSS OF IDAHO CARE PLUS, INC. BLUE CROSS OF IDAHO ID Local PPO
H1304 REGENCE BLUESHIELD OF IDAHO
REGENCE BLUESHIELD OF IDAHO ID Local PPO
H1350 BLUE CROSS OF IDAHO CARE PLUS, INC. BLUE CROSS OF IDAHO ID HMO/HMOPOS
H1969 REGENCE BLUESHIELD OF IDAHO
REGENCE BLUESHIELD OF IDAHO ID HMO/HMOPOS
H4754 PACIFICSOURCE COMMUNITY HEALTH PLANS PACIFICSOURCE MEDICARE ID Local PPO
H0281 ILLINICARE HEALTH PLAN ILLINICARE HEALTH IL Medicare
Medicaid Plan HMO/HMOPOS
Medicare HOS 2017-2019 Cohort 20 Performance Measurement Participating MAOs July 2020 Page 6
Reporting Unit
MAO Organization Name
MAO Product Name
MAO State
Medicare Plan Type
H0336 HUMANA HEALTH PLAN, INC. HUMANA IL Medicare
Medicaid Plan HMO/HMOPOS
H0927 HEALTH CARE SERVICE CORPORATION BLUE CROSS COMMUNITY MMAI IL
Medicare Medicaid Plan
HMO/HMOPOS
H1415 HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. CIGNA IL HMO/HMOPOS
H1416 HARMONY HEALTH PLAN, INC. WELLCARE IL HMO/HMOPOS
H1463 HEALTH ALLIANCE CONNECT, INC. HEALTH ALLIANCE MEDICARE IL HMO/HMOPOS
H1468 HUMANA BENEFIT PLAN OF ILLINOIS, INC. HUMANA IL HMO/HMOPOS
H2506 AETNA BETTER HEALTH, INC. (IL)
AETNA BETTER HEALTH PREMIER PLAN IL
Medicare Medicaid Plan
HMO/HMOPOS
H3071 COMMUNITY CARE ALLIANCE OF ILLINOIS, NFP
COMMUNITY CARE ALLIANCE OF ILLINOIS IL HMO/HMOPOS
H3822 HEALTH CARE SERVICE CORPORATION
BLUE CROSS AND BLUE SHIELD OF IL, NM IL HMO/HMOPOS
H5525 HUMANA BENEFIT PLAN OF ILLINOIS, INC. HUMANA IL Local PPO
H5779 MERIDIAN HEALTH PLAN OF ILLINOIS, INC. WELLCARE IL HMO/HMOPOS
H6080 MERIDIAN HEALTH PLAN OF ILLINOIS, INC. MERIDIANCOMPLETE IL
Medicare Medicaid Plan
HMO/HMOPOS
H7301 COVENTRY HEALTH CARE OF ILLINOIS, INC. AETNA MEDICARE IL Local PPO
H8046 MOLINA HEALTHCARE OF ILLINOIS, INC.
MOLINA HEALTHCARE OF ILLINOIS IL
Medicare Medicaid Plan
HMO/HMOPOS
H8634 HEALTH CARE SERVICE CORPORATION
BLUE CROSS AND BLUE SHIELD OF IL, NM IL Local PPO
H1607 ANTHEM INSURANCE COMPANIES, INC.
ANTHEM BLUE CROSS AND BLUE SHIELD IN Local PPO
H7220 INDIANA UNIVERSITY HEALTH PLANS NFP, INC.
INDIANA UNIVERSITY HEALTH PLANS - MEDICARE IN HMO/HMOPOS
H9730 WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC WELLCARE KY HMO/HMOPOS
H9870 UNIVERSITY HEALTH CARE, INC. PASSPORT ADVANTAGE KY HMO/HMOPOS
Medicare HOS 2017-2019 Cohort 20 Performance Measurement Participating MAOs July 2020 Page 7
Reporting Unit
MAO Organization Name
MAO Product Name
MAO State
Medicare Plan Type
H1951 HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC. HUMANA LA HMO/HMOPOS
H1961 PEOPLES HEALTH, INC. PEOPLES HEALTH LA HMO/HMOPOS
H3928 AETNA HEALTH, INC. (LA) AETNA MEDICARE LA HMO/HMOPOS
H5576 VANTAGE HEALTH PLAN, INC. VANTAGE HEALTH PLAN, INC. LA HMO/HMOPOS
H6453 HMO LOUISIANA, INC. BLUE CROSS AND BLUE SHIELD OF LOUISIANA HMO LA HMO/HMOPOS
H0137 COMMONWEALTH CARE ALLIANCE, INC.
COMMONWEALTH CARE ALLIANCE, INC. MA
Medicare Medicaid Plan
HMO/HMOPOS
H1660 HARVARD PILGRIM HEALTH CARE INC.
HARVARD PILGRIM HEALTH CARE, INC. MA HMO/HMOPOS
H1944 UNITEDHEALTHCARE OF NEW ENGLAND, INC. UNITEDHEALTHCARE MA HMO/HMOPOS
H2224 SENIOR WHOLE HEALTH, LLC SENIOR WHOLE HEALTH MA HMO/HMOPOS
H2225 COMMONWEALTH CARE ALLIANCE, INC.
COMMONWEALTH CARE ALLIANCE, INC. MA HMO/HMOPOS
H2226 UNITEDHEALTHCARE INSURANCE COMPANY UNITEDHEALTHCARE MA HMO/HMOPOS
H2228 UNITEDHEALTHCARE INSURANCE COMPANY UNITEDHEALTHCARE MA Local PPO
H2230 BCBS OF MASSACHUSETTS HMO BLUE, INC.
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS MA Local PPO
H2256 TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION TUFTS HEALTH PLAN MA HMO/HMOPOS
H2261 BCBS OF MASSACHUSETTS HMO BLUE, INC.
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS MA HMO/HMOPOS
H7419 TUFTS HEALTH PUBLIC PLANS, INC. TUFTS HEALTH PLAN MA
Medicare Medicaid Plan
HMO/HMOPOS
H8578 HEALTH NEW ENGLAND, INC. HEALTH NEW ENGLAND MEDICARE ADVANTAGE PLANS MA HMO/HMOPOS
H9001 FALLON COMMUNITY HEALTH PLAN FALLON HEALTH MA HMO/HMOPOS
H2108 BRAVO HEALTH MID-ATLANTIC, INC. CIGNA MD HMO/HMOPOS
H2150 KAISER FNDN HP OF THE MID-ATLANTIC STS KAISER PERMANENTE MD 1876 Cost
H3890 HOPKINS HEALTH ADVANTAGE, INC. JOHNS HOPKINS HEALTHCARE MD Local PPO
Medicare HOS 2017-2019 Cohort 20 Performance Measurement Participating MAOs July 2020 Page 8
Reporting Unit
MAO Organization Name
MAO Product Name
MAO State
Medicare Plan Type
H5322 CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.
UNITEDHEALTHCARE MD HMO/HMOPOS
H8854 UNIVERSITY OF MARYLAND HEALTH ADVANTAGE, INC.
UNIVERSITY OF MARYLAND HEALTH ADVANTAGE MD HMO/HMOPOS
H1365 MARTIN'S POINT GENERATIONS ADVANTAGE, INC.
MARTIN'S POINT GENERATIONS ADVANTAGE ME Local PPO
H2001 SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. UNITEDHEALTHCARE ME Local PPO
H3597 AETNA HEALTH INC. (ME) AETNA MEDICARE ME HMO/HMOPOS
H5591 MARTIN'S POINT GENERATIONS ADVANTAGE, INC.
MARTIN'S POINT GENERATIONS ADVANTAGE ME HMO/HMOPOS
H5619 ARCADIAN HEALTH PLAN, INC. HUMANA ME HMO/HMOPOS
H8432 EMPIRE HEALTHCHOICE HMO, INC.
EMPIRE BLUECROSS BLUESHIELD ME HMO/HMOPOS
H0192 AMERIHEALTH MICHIGAN, INC. AMERIHEALTH CARITAS VIP CARE PLUS MI
Medicare Medicaid Plan
HMO/HMOPOS
H0480 MERIDIAN HEALTH PLAN OF MICHIGAN, INC. MERIDIANCOMPLETE MI
Medicare Medicaid Plan
HMO/HMOPOS
H1977 UPPER PENINSULA HEALTH PLAN, LLC
UPPER PENINSULA HEALTH PLAN (UPHP) MI HEALTH LINK MI
Medicare Medicaid Plan
HMO/HMOPOS
H2320 PRIORITY HEALTH PRIORITY HEALTH MEDICARE MI HMO/HMOPOS
H2322 ALLIANCE HEALTH AND LIFE INSURANCE COMPANY HAP SENIOR PLUS (PPO) MI Local PPO
H2354 HEALTH ALLIANCE PLAN OF MICHIGAN HAP SENIOR PLUS MI HMO/HMOPOS
H4875 PRIORITY HEALTH PRIORITY HEALTH MEDICARE MI Local PPO
H5475 MERIDIAN HEALTH PLAN OF MICHIGAN, INC. WELLCARE MI HMO/HMOPOS
H5883 BLUE CARE NETWORK OF MICHIGAN BLUE CARE NETWORK MI HMO/HMOPOS
H5926 MOLINA HEALTHCARE OF MICHIGAN, INC.
MOLINA HEALTHCARE OF MICHIGAN MI HMO/HMOPOS
H7844 MOLINA HEALTHCARE OF MICHIGAN, INC.
MOLINA HEALTHCARE OF MICHIGAN MI
Medicare Medicaid Plan
HMO/HMOPOS
Medicare HOS 2017-2019 Cohort 20 Performance Measurement Participating MAOs July 2020 Page 9
Reporting Unit
MAO Organization Name
MAO Product Name
MAO State
Medicare Plan Type
H8026 AETNA BETTER HEALTH OF MICHIGAN INC.
AETNA BETTER HEALTH PREMIER PLAN MI
Medicare Medicaid Plan
HMO/HMOPOS
H8908 HUMANA MEDICAL PLAN OF MICHIGAN, INC. HUMANA MI HMO/HMOPOS
H9487 MICHIGAN COMPLETE HEALTH, INC. MICHIGAN COMPLETE HEALTH MI
Medicare Medicaid Plan
HMO/HMOPOS
H9572 BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY
BLUE CROSS BLUE SHIELD OF MICHIGAN MI Local PPO
H9712 HAP MIDWEST HEALTH PLAN, INC.
HAP EMPOWERED MI HEALTH LINK MI
Medicare Medicaid Plan
HMO/HMOPOS
H1537 CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO UNITEDHEALTHCARE MN Local PPO
H2416 PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE PRIMEWEST HEALTH MN HMO/HMOPOS
H2419 SOUTH COUNTRY HEALTH ALLIANCE
SOUTH COUNTRY HEALTH ALLIANCE MN HMO/HMOPOS
H2422 HEALTHPARTNERS, INC. HEALTHPARTNERS MN HMO/HMOPOS
H2425 BLUE PLUS BLUE PLUS MN HMO/HMOPOS
H2450 MEDICA INSURANCE COMPANY MEDICA MN 1876 Cost
H2456 UCARE MINNESOTA UCARE'S MSHO MN HMO/HMOPOS
H2458 MEDICA HEALTH PLANS MEDICA MN HMO/HMOPOS
H2459 UCARE MINNESOTA UCARE MN HMO/HMOPOS
H2461 BLUE CROSS AND BLUE SHIELD OF MINNESOTA
BLUE CROSS AND BLUE SHIELD OF MINNESOTA MN 1876 Cost
H2462 GROUP HEALTH PLAN, INC. (MN) HEALTHPARTNERS MN 1876 Cost
H5652 SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. UNITEDHEALTHCARE MN HMO/HMOPOS
H5703 SOUTH COUNTRY HEALTH ALLIANCE
SOUTH COUNTRY HEALTH ALLIANCE MN HMO/HMOPOS
H9834 QUARTZ HEALTH PLAN MN CORPORATION SENIOR PREFERRED MN HMO/HMOPOS
H1352 BLUE-ADVANTAGE PLUS OF KANSAS CITY, INC.
BLUE CROSS AND BLUE SHIELD OF KANSAS CITY MO HMO/HMOPOS
H2610 ESSENCE HEALTHCARE, INC. ESSENCE HEALTHCARE MO HMO/HMOPOS
H2663 COVENTRY HEALTH CARE OF MISSOURI, INC AETNA MEDICARE MO HMO/HMOPOS
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Reporting Unit
MAO Organization Name
MAO Product Name
MAO State
Medicare Plan Type
H9460 CIGNA HEALTHCARE OF ST LOUIS, INC. CIGNA MO HMO/HMOPOS
H4407 HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY CIGNA MS HMO/HMOPOS
H0107 HEALTH CARE SERVICE CORPORATION
BLUE CROSS AND BLUE SHIELD OF MONTANA MT Local PPO
H3404 BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA
BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA NC Local PPO
H3449 BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA
BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA NC HMO/HMOPOS
H6306 FIRSTCAROLINACARE INSURANCE COMPANY FIRSTMEDICARE DIRECT NC HMO/HMOPOS
H8064 FIRSTCAROLINACARE INSURANCE COMPANY FIRSTMEDICARE DIRECT NC Local PPO
H9725 CIGNA HEALTHCARE OF NORTH CAROLINA, INC. CIGNA NC HMO/HMOPOS
H9808 CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA
CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA NC Local PPO
H2802 UNITEDHEALTHCARE OF THE MIDLANDS, INC. UNITEDHEALTHCARE NE HMO/HMOPOS
H7149 AETNA HEALTH INC. (PA) AETNA MEDICARE NE HMO/HMOPOS
H3536 MATTHEW THORNTON HEALTH PLAN, INC.
ANTHEM BLUE CROSS AND BLUE SHIELD NH HMO/HMOPOS
H6750 HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC.
HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC. NH HMO/HMOPOS
H7728 ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC.
ANTHEM BLUE CROSS AND BLUE SHIELD NH Local PPO
H0913 WELLCARE HEALTH PLANS OF NEW JERSEY, INC. WELLCARE NJ HMO/HMOPOS
H3113 OXFORD HEALTH PLANS (NJ), INC. UNITEDHEALTHCARE NJ HMO/HMOPOS
H3152 AETNA HEALTH INC. (NJ) AETNA MEDICARE NJ HMO/HMOPOS
H3154 HORIZON INSURANCE COMPANY HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY NJ HMO/HMOPOS
H3240 AMERIGROUP NEW JERSEY, INC. AMERIGROUP COMMUNITY CARE NJ HMO/HMOPOS
H5141 CLOVER INSURANCE COMPANY CLOVER HEALTH NJ Local PPO
H7971 HORIZON INSURANCE COMPANY HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY NJ Local PPO
Medicare HOS 2017-2019 Cohort 20 Performance Measurement Participating MAOs July 2020 Page 11
Reporting Unit
MAO Organization Name
MAO Product Name
MAO State
Medicare Plan Type
H3204 PRESBYTERIAN HEALTH PLAN PRESBYTERIAN HEALTH PLAN NM HMO/HMOPOS
H3206 PRESBYTERIAN INSURANCE COMPANY, INC.
PRESBYTERIAN INSURANCE COMPANY, INC. NM Local PPO
H3251 HEALTH CARE SERVICE CORPORATION
BLUE CROSS AND BLUE SHIELD OF NEW MEXICO NM HMO/HMOPOS
H5746 AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC.
AMERIGROUP COMMUNITY CARE OF NEW MEXICO NM HMO/HMOPOS
H9082 MOLINA HEALTHCARE OF NEW MEXICO, INC.
MOLINA HEALTHCARE OF NEW MEXICO, INC. NM HMO/HMOPOS
H2906 HOMETOWN HEALTH PLAN, INC. SENIOR CARE PLUS NV Local PPO
H2960 HOMETOWN HEALTH PLAN, INC. SENIOR CARE PLUS NV HMO/HMOPOS
H4346 HMO COLORADO, INC. ANTHEM BLUE CROSS AND BLUE SHIELD NV HMO/HMOPOS
H5945 PROMINENCE HEALTHFIRST PROMINENCE HEALTH PLAN NV HMO/HMOPOS
H0423 METROPLUS HEALTH PLAN, INC. METROPLUS HEALTH PLAN NY HMO/HMOPOS
H1777 CATHOLIC SPECIAL NEEDS PLAN, LLC ARCHCARE ADVANTAGE NY HMO/HMOPOS
H2773 QUALITY HEALTH PLANS OF NEW YORK, INC. QUALITY HEALTH PLANS NY HMO/HMOPOS
H2775 AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY WELLCARE NY Local PPO
H3305 MVP HEALTH PLAN, INC. MVP HEALTH CARE NY HMO/HMOPOS
H3307 OXFORD HEALTH PLANS (NY), INC. UNITEDHEALTHCARE NY HMO/HMOPOS
H3312 AETNA HEALTH INC. (NY) AETNA MEDICARE NY HMO/HMOPOS
H3328 THE NEW YORK STATE CATHOLIC HEALTH PLAN, INC. FIDELIS LEGACY PLAN NY HMO/HMOPOS
H3330 HEALTH INSURANCE PLAN OF GREATER NEW YORK
EMBLEMHEALTH MEDICARE HMO NY HMO/HMOPOS
H3335 EXCELLUS HEALTH PLAN, INC. EXCELLUS HEALTH PLAN, INC NY Local PPO
H3342 EMPIRE HEALTHCHOICE ASSURANCE, INC.
EMPIRE BLUECROSS BLUESHIELD NY Local PPO
H3344 INDEPENDENT HEALTH BENEFITS CORPORATION INDEPENDENT HEALTH NY Local PPO
H3347 ELDERPLAN, INC. ELDERPLAN NY HMO/HMOPOS
H3351 EXCELLUS HEALTH PLAN, INC. EXCELLUS HEALTH PLAN, INC NY HMO/HMOPOS
H3359 HEALTHFIRST HEALTH PLAN, INC. HEALTHFIRST MEDICARE PLAN NY HMO/HMOPOS
Medicare HOS 2017-2019 Cohort 20 Performance Measurement Participating MAOs July 2020 Page 12
Reporting Unit
MAO Organization Name
MAO Product Name
MAO State
Medicare Plan Type
H3362 INDEPENDENT HEALTH ASSOCIATION, INC. INDEPENDENT HEALTH NY HMO/HMOPOS
H3379 UNITEDHEALTHCARE OF NEW YORK, INC. UNITEDHEALTHCARE NY HMO/HMOPOS
H3384 HEALTHNOW NEW YORK INC. BLUECROSS BLUESHIELD OF WNY AND BLUESHIELD OF NENY NY HMO/HMOPOS
H3387 UNITEDHEALTHCARE OF NEW YORK, INC. UNITEDHEALTHCARE NY HMO/HMOPOS
H3388 CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. CDPHP MEDICARE ADVANTAGE NY HMO/HMOPOS
H3533 HUMANA HEALTH COMPANY OF NEW YORK, INC. HUMANA NY HMO/HMOPOS
H4868 WELLCARE OF NEW YORK, INC. WELLCARE NY HMO/HMOPOS
H4922 AGEWELL NEW YORK, LLC AGEWELL NEW YORK NY HMO/HMOPOS
H5042 CDPHP UNIVERSAL BENEFITS, INC. CDPHP MEDICARE ADVANTAGE NY Local PPO
H5441 HEALTHFIRST HEALTH PLAN, INC. HEALTHFIRST MEDICARE PLAN NY
Medicare Medicaid Plan
HMO/HMOPOS
H5526 HEALTHNOW NEW YORK INC. BLUECROSS BLUESHIELD OF WNY AND BLUESHIELD OF NENY NY Local PPO
H5549 VNS CHOICE VNSNY CHOICE MEDICARE NY HMO/HMOPOS
H5970 HUMANA INSURANCE COMPANY OF NEW YORK HUMANA NY Local PPO
H5989 CENTERLIGHT HEALTHCARE, INC. CENTERLIGHT HEALTHCARE NY HMO/HMOPOS
H5991 HEALTH INSURANCE PLAN OF GREATER NEW YORK
EMBLEMHEALTH MEDICARE HMO NY HMO/HMOPOS
H6988 CENTERS PLAN FOR HEALTHY LIVING, LLC
CENTERS PLAN FOR HEALTHY LIVING NY HMO/HMOPOS
H8490 VNS CHOICE VNSNY CHOICE FIDA COMPLETE NY Medicare
Medicaid Plan HMO/HMOPOS
H9615 MVP HEALTH PLAN, INC. MVP HEALTH CARE NY Local PPO
H0022 BUCKEYE COMMUNITY HEALTH PLAN, INC.
BUCKEYE HEALTH PLAN - MYCARE OHIO OH
Medicare Medicaid Plan
HMO/HMOPOS
H0908 BUCKEYE COMMUNITY HEALTH PLAN, INC. ALLWELL OH HMO/HMOPOS
Medicare HOS 2017-2019 Cohort 20 Performance Measurement Participating MAOs July 2020 Page 13
Reporting Unit
MAO Organization Name
MAO Product Name
MAO State
Medicare Plan Type
H1846 MOUNT CARMEL HEALTH INSURANCE COMPANY MEDIGOLD OH Local PPO
H2406 UNITEDHEALTHCARE INSURANCE COMPANY UNITEDHEALTHCARE OH Local PPO
H2531 UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC.
UNITEDHEALTHCARE COMMUNITY PLAN OH
Medicare Medicaid Plan
HMO/HMOPOS
H3653 PARAMOUNT CARE, INC. PARAMOUNT ELITE/MEDICARE PLANS OH HMO/HMOPOS
H3655 COMMUNITY INSURANCE COMPANY
ANTHEM BLUE CROSS AND BLUE SHIELD OH HMO/HMOPOS
H3660 SUMMACARE INC. SUMMACARE MEDICARE ADVANTAGE PLANS OH HMO/HMOPOS
H3664 AULTCARE HEALTH INSURING CORPORATION PRIMETIME HEALTH PLAN OH HMO/HMOPOS
H3668 MOUNT CARMEL HEALTH PLAN, INC. MEDIGOLD OH HMO/HMOPOS
H3672 THE HEALTH PLAN OF WEST VIRGINIA, INC. THE HEALTH PLAN OH HMO/HMOPOS
H4497 MEDICAL MUTUAL OF OHIO MEDICAL MUTUAL OF OHIO OH Local PPO
H5280 MOLINA HEALTHCARE OF OHIO, INC. MOLINA HEALTHCARE OF OHIO OH
Medicare Medicaid Plan
HMO/HMOPOS
H6723 MEDICAL MUTUAL OF OHIO MEDICAL MUTUAL OF OHIO OH HMO/HMOPOS
H7172 AETNA BETTER HEALTH, INC. (OH)
AETNA BETTER HEALTH OF OHIO, MYCARE OHIO OH
Medicare Medicaid Plan
HMO/HMOPOS
H8452 CARESOURCE CARESOURCE MYCARE OHIO OH Medicare
Medicaid Plan HMO/HMOPOS
H8604 THP INSURANCE COMPANY THE HEALTH PLAN OH Local PPO
H9190 GATEWAY HEALTH PLAN OF OHIO, INC.
GATEWAY HEALTH MEDICARE ASSURED OH HMO/HMOPOS
H3706 GLOBALHEALTH, INC. GLOBALHEALTH OK HMO/HMOPOS
H3749 UNITEDHEALTHCARE OF OKLAHOMA, INC. UNITEDHEALTHCARE OK HMO/HMOPOS
H3755 COMMUNITY CARE HMO, INC COMMUNITYCARE SENIOR HEALTH PLAN (HMO) OK HMO/HMOPOS
H3979 GHS HEALTH MAINTENANCE ORGANIZATION, INC.
BLUE CROSS AND BLUE SHIELD OF OKLAHOMA OK HMO/HMOPOS
Medicare HOS 2017-2019 Cohort 20 Performance Measurement Participating MAOs July 2020 Page 14
Reporting Unit
MAO Organization Name
MAO Product Name
MAO State
Medicare Plan Type
H4198 COMMUNITYCARE GOVERNMENT PROGRAMS, INC.
COMMUNITYCARE ADVANTAGE MEDICARE PLAN (HMO) OK HMO/HMOPOS
H2174 TRILLIUM COMMUNITY HEALTH PLAN
TRILLIUM MEDICARE ADVANTAGE OR HMO/HMOPOS
H3805 UNITEDHEALTHCARE OF OREGON, INC. UNITEDHEALTHCARE OR HMO/HMOPOS
H3810 ALLCARE HEALTH PLAN, INC. ALLCARE ADVANTAGE OR HMO/HMOPOS
H3811 SAMARITAN HEALTH PLANS, INC.
SAMARITAN ADVANTAGE HEALTH PLAN OR HMO/HMOPOS
H3813 MODA HEALTH PLAN, INC. MODA HEALTH PLAN, INC. OR Local PPO
H3814 ATRIO HEALTH PLANS ATRIO HEALTH PLANS OR HMO/HMOPOS
H3817 REGENCE BLUECROSS BLUESHIELD OF OREGON
REGENCE BLUECROSS BLUESHIELD OF OREGON OR Local PPO
H3864 PACIFICSOURCE COMMUNITY HEALTH PLANS PACIFICSOURCE MEDICARE OR HMO/HMOPOS
H5859 HEALTH PLAN OF CAREOREGON, INC. CAREOREGON ADVANTAGE OR HMO/HMOPOS
H5995 ATRIO HEALTH PLANS ATRIO HEALTH PLANS OR HMO/HMOPOS
H6237 REGENCE BLUECROSS BLUESHIELD OF OREGON
REGENCE BLUECROSS BLUESHIELD OF OREGON OR HMO/HMOPOS
H6743 ATRIO HEALTH PLANS ATRIO HEALTH PLANS OR Local PPO
H6815 HEALTH NET HEALTH PLAN OF OREGON
HEALTH NET HEALTH PLAN OF OREGON, INC. OR HMO/HMOPOS
H7006 ATRIO HEALTH PLANS ATRIO HEALTH PLANS OR Local PPO
H8506 MODA HEALTH PLAN, INC. MODA HEALTH PLAN, INC. OR HMO/HMOPOS
H9003 KAISER FOUNDATION HP OF THE N W KAISER PERMANENTE OR HMO/HMOPOS
H9047 PROVIDENCE HEALTH ASSURANCE
PROVIDENCE MEDICARE ADVANTAGE PLANS OR HMO/HMOPOS
H3907 UPMC HEALTH PLAN, INC. UPMC FOR LIFE PA HMO/HMOPOS
H3909 QCC INSURANCE COMPANY PERSONAL CHOICE 65 PPO PA Local PPO
H3916 HIGHMARK SENIOR HEALTH COMPANY HIGHMARK INC. PA Local PPO
H3923 CAPITAL ADVANTAGE INSURANCE COMPANY
CAPITAL ADVANTAGE INSURANCE COMPANY PA Local PPO
H3924 GEISINGER INDEMNITY INSURANCE COMPANY GEISINGER GOLD PA Local PPO
H3931 AETNA HEALTH INC. (PA) AETNA MEDICARE PA HMO/HMOPOS
Medicare HOS 2017-2019 Cohort 20 Performance Measurement Participating MAOs July 2020 Page 15
Reporting Unit
MAO Organization Name
MAO Product Name
MAO State
Medicare Plan Type
H3949 BRAVO HEALTH PENNSYLVANIA, INC. CIGNA PA HMO/HMOPOS
H3952 KEYSTONE HEALTH PLAN EAST, INC. KEYSTONE 65 HMO PA HMO/HMOPOS
H3954 GEISINGER HEALTH PLAN GEISINGER GOLD PA HMO/HMOPOS
H3957 HIGHMARK CHOICE COMPANY HIGHMARK INC. PA HMO/HMOPOS
H3959 AETNA HEALTH INC. (PA) AETNA MEDICARE PA HMO/HMOPOS
H3962 KEYSTONE HEALTH PLAN CENTRAL, INC.
KEYSTONE HEALTH PLAN CENTRAL, INC. PA HMO/HMOPOS
H4227 VISTA HEALTH PLAN, INC. VISTA HEALTH PLAN INC. PA HMO/HMOPOS
H4279 UPMC FOR YOU, INC UPMC FOR LIFE DUAL PA HMO/HMOPOS
H5521 AETNA LIFE INSURANCE COMPANY AETNA MEDICARE PA Local PPO
H5522 HEALTHASSURANCE PENNSYLVANIA, INC. AETNA MEDICARE PA Local PPO
H5533 UPMC HEALTH NETWORK, INC. UPMC FOR LIFE PA Local PPO
H5932 GATEWAY HEALTH PLAN, INC. GATEWAY HEALTH MEDICARE ASSURED PA HMO/HMOPOS
H9207 HEALTH PARTNERS PLANS, INC. HEALTH PARTNERS MEDICARE PA HMO/HMOPOS
H2029 HUMANA INSURANCE OF PUERTO RICO, INC. HUMANA PR Local PPO
H3054 CONSTELLATION HEALTH, LLC. CONSTELLATION HEALTH PR HMO/HMOPOS
H4003 MMM HEALTHCARE, LLC MEDICARE Y MUCHO MAS PR HMO/HMOPOS
H4004 MMM HEALTHCARE, LLC PMC MEDICARE CHOICE PR HMO/HMOPOS
H4005 TRIPLE S ADVANTAGE, INC. TRIPLE-S ADVANTAGE PR Local PPO
H4007 HUMANA HEALTH PLANS OF PUERTO RICO, INC. HUMANA PR HMO/HMOPOS
H5577 MCS ADVANTAGE, INC. MCS CLASSICARE PR HMO/HMOPOS
H5774 TRIPLE S ADVANTAGE, INC. TRIPLE S ADVANTAGE PR HMO/HMOPOS
H7522 MMM HEALTHCARE, LLC MEDICARE Y MUCHO MÁS PR Local PPO
H8266 CONSTELLATION HEALTH, LLC. CONSTELLATION HEALTH PR HMO/HMOPOS
H4152 BLUE CROSS & BLUE SHIELD OF RHODE ISLAND
BLUE CROSS & BLUE SHIELD OF RHODE ISLAND RI HMO/HMOPOS
H1723 ABSOLUTE TOTAL CARE, INC. ABSOLUTE TOTAL CARE SC Medicare
Medicaid Plan HMO/HMOPOS
Medicare HOS 2017-2019 Cohort 20 Performance Measurement Participating MAOs July 2020 Page 16
Reporting Unit
MAO Organization Name
MAO Product Name
MAO State
Medicare Plan Type
H2533 MOLINA HEALTHCARE OF SOUTH CAROLINA, INC.
MOLINA HEALTHCARE OF SOUTH CAROLINA SC
Medicare Medicaid Plan
HMO/HMOPOS
H7020 CIGNA HEALTHCARE OF SOUTH CAROLINA, INC. CIGNA SC HMO/HMOPOS
H8170 AMERICA'S 1ST CHOICE OF SOUTH CAROLINA, INC.
AMERICA'S 1ST CHOICE OF SOUTH CAROLINA SC HMO/HMOPOS
H8213 SELECT HEALTH OF SOUTH CAROLINA, INC. FIRST CHOICE VIP CARE PLUS SC
Medicare Medicaid Plan
HMO/HMOPOS
H8748 UNITEDHEALTHCARE INSURANCE COMPANY UNITEDHEALTHCARE SC HMO/HMOPOS
H0251 UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. UNITEDHEALTHCARE TN HMO/HMOPOS
H3259 VOLUNTEER STATE HEALTH PLAN BLUECARE PLUS TENNESSEE TN HMO/HMOPOS
H4461 CARITEN HEALTH PLAN INC. HUMANA TN HMO/HMOPOS
H7917 BLUECROSS BLUESHIELD OF TENNESSEE, INC.
BLUECROSS BLUESHIELD OF TENNESSEE TN Local PPO
H0174 WELLCARE OF TEXAS, INC. WELLCARE TX HMO/HMOPOS
H0332 KS PLAN ADMINISTRATORS, LLC KELSEYCARE ADVANTAGE TX HMO/HMOPOS
H1666 HCSC INSURANCE SERVICES COMPANY
BLUE CROSS AND BLUE SHIELD OF TEXAS TX Local PPO
H2171 CARE N' CARE INSURANCE COMPANY, INC.
CARE N' CARE INSURANCE COMPANY TX HMO/HMOPOS
H4506 SELECTCARE OF TEXAS, INC. WELLCARE TX HMO/HMOPOS
H4513 HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. CIGNA TX HMO/HMOPOS
H4514 UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.
UNITEDHEALTHCARE TX HMO/HMOPOS
H4523 AETNA HEALTH INC. (TX) AETNA MEDICARE TX HMO/HMOPOS
H4527 PHYSICIANS HEALTH CHOICE OF TEXAS, LLC UNITEDHEALTHCARE TX HMO/HMOPOS
H4590 UNITEDHEALTHCARE BENEFITS OF TEXAS, INC. UNITEDHEALTHCARE TX HMO/HMOPOS
H5294 SUPERIOR HEALTH PLAN, INC. ALLWELL TX HMO/HMOPOS
H5656 SELECTCARE HEALTH PLANS, INC. WELLCARE TX HMO/HMOPOS
Medicare HOS 2017-2019 Cohort 20 Performance Measurement Participating MAOs July 2020 Page 17
Reporting Unit
MAO Organization Name
MAO Product Name
MAO State
Medicare Plan Type
H6328 CARE N' CARE INSURANCE COMPANY, INC.
CARE N' CARE INSURANCE COMPANY TX Local PPO
H6870 SUPERIOR HEALTH PLAN, INC. SUPERIOR HEALTHPLAN TX Medicare
Medicaid Plan HMO/HMOPOS
H7115 MEMORIAL HERMANN HEALTH PLAN
MEMORIAL HERMANN HEALTH PLAN TX HMO/HMOPOS
H7678 MOLINA HEALTHCARE OF TEXAS, INC.
MOLINA HEALTHCARE OF TEXAS, INC. TX HMO/HMOPOS
H7680 PROMINENCE HEALTHFIRST OF TEXAS PROMINENCE HEALTH PLAN TX HMO/HMOPOS
H7787 HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. CIGNA TX Local PPO
H7833 UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.
UNITEDHEALTHCARE TX Medicare
Medicaid Plan HMO/HMOPOS
H8133 GHS INSURANCE COMPANY BLUE CROSS AND BLUE SHIELD OF TEXAS TX HMO/HMOPOS
H8197 MOLINA HEALTHCARE OF TEXAS, INC. MOLINA HEALTHCARE OF TEXAS TX
Medicare Medicaid Plan
HMO/HMOPOS
H8423 HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.
CIGNA-HEALTHSPRING CAREPLAN TX
Medicare Medicaid Plan
HMO/HMOPOS
H8554 GHS INSURANCE COMPANY BLUE CROSS AND BLUE SHIELD OF TEXAS TX HMO/HMOPOS
H8786 AMERIGROUP TEXAS, INC. AMERIGROUP STAR+PLUS MMP TX Medicare
Medicaid Plan HMO/HMOPOS
H1994 SELECTHEALTH, INC. SELECTHEALTH UT HMO/HMOPOS
H2486 HUMANA MEDICAL PLAN OF UTAH, INC. HUMANA UT HMO/HMOPOS
H4604 UNITEDHEALTHCARE OF UTAH, INC. UNITEDHEALTHCARE UT HMO/HMOPOS
H4605 REGENCE BLUECROSS BLUESHIELD OF UTAH
REGENCE BLUECROSS BLUESHIELD OF UTAH UT Local PPO
H5628 MOLINA HEALTHCARE OF UTAH, INC.
MOLINA HEALTHCARE OF UTAH & IDAHO UT HMO/HMOPOS
H8649 AETNA HEALTH OF UTAH, INC AETNA MEDICARE UT HMO/HMOPOS
H1659 UNITEDHEALTHCARE INSURANCE CO OF THE RIVER VALLEY
PIEDMONT MEDICARE ADVANTAGE VA Local PPO
Medicare HOS 2017-2019 Cohort 20 Performance Measurement Participating MAOs July 2020 Page 18
Reporting Unit
MAO Organization Name
MAO Product Name
MAO State
Medicare Plan Type
H2563 OPTIMA HEALTH PLAN OPTIMA MEDICARE VA HMO/HMOPOS
H3447 HEALTHKEEPERS, INC. ANTHEM HEALTHKEEPERS VA HMO/HMOPOS
H4909 ANTHEM INSURANCE COMPANIES, INC.
ANTHEM BLUE CROSS AND BLUE SHIELD VA Local PPO
H1286 UNITEDHEALTHCARE OF OREGON, INC. UNITEDHEALTHCARE WA HMO/HMOPOS
H1894 AMERIGROUP WASHINGTON, INC. AMERIGROUP WA HMO/HMOPOS
H1997 REGENCE BLUESHIELD REGENCE BLUESHIELD WA HMO/HMOPOS
H3471 HEALTH ALLIANCE NORTHWEST HEALTH PLAN HEALTH ALLIANCE NORTHWEST WA HMO/HMOPOS
H5008 UNITEDHEALTHCARE INSURANCE COMPANY UNITEDHEALTHCARE WA HMO/HMOPOS
H5009 REGENCE BLUESHIELD REGENCE BLUESHIELD WA Local PPO
H5010 ASURIS NORTHWEST HEALTH ASURIS NORTHWEST HEALTH WA Local PPO
H5050 KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
KAISER FOUNDATION HEALTH PLAN OF WASHINGTON WA HMO/HMOPOS
H5823 MOLINA HEALTHCARE OF WASHINGTON, INC.
MOLINA HEALTHCARE OF WASHINGTON, INC. WA HMO/HMOPOS
H5826 COMMUNITY HEALTH PLAN OF WASHINGTON
COMMUNITY HEALTH PLAN OF WA MEDICARE ADVANTAGE WA HMO/HMOPOS
H7245 PREMERA BLUE CROSS PREMERA BLUE CROSS MEDICARE ADVANTAGE WA HMO/HMOPOS
H9302 PREMERA BLUE CROSS PREMERA BLUE CROSS MEDICARE ADVANTAGE WA HMO/HMOPOS
H0294 CARE IMPROVEMENT PLUS WISCONSIN INSURANCE COMPANY
UNITEDHEALTHCARE WI Local PPO
H1181 NETWORK HEALTH INSURANCE CORPORATION
NETWORK HEALTH MEDICARE ADVANTAGE PLANS WI MSA
H2237 INDEPENDENT CARE HEALTH PLAN, INC. ICARE WI HMO/HMOPOS
H2879 MOLINA HEALTHCARE OF WISCONSIN, INC.
MOLINA HEALTHCARE OF WISCONSIN WI HMO/HMOPOS
H3794 CARE IMPROVEMENT PLUS WISCONSIN INSURANCE COMPANY
UNITEDHEALTHCARE WI HMO/HMOPOS
H4036 ANTHEM INSURANCE COMPANIES, INC.
ANTHEM BLUE CROSS AND BLUE SHIELD WI Local PPO
Medicare HOS 2017-2019 Cohort 20 Performance Measurement Participating MAOs July 2020 Page 19
Reporting Unit
MAO Organization Name
MAO Product Name
MAO State
Medicare Plan Type
H4388 SECURITY HEALTH PLAN OF WISCONSIN, INC.
SECURITY HEALTH PLAN OF WISCONSIN, INC. WI MSA
H5209 CARE WISCONSIN HEALTH PLAN, INC.
CARE WISCONSIN HEALTH PLAN, INC. WI HMO/HMOPOS
H5211 SECURITY HEALTH PLAN OF WISCONSIN, INC.
SECURITY HEALTH PLAN OF WISCONSIN, INC. WI HMO/HMOPOS
H5215 NETWORK HEALTH INSURANCE CORPORATION
NETWORK HEALTH MEDICARE ADVANTAGE PLANS WI Local PPO
H5216 HUMANA INSURANCE COMPANY HUMANA WI Local PPO
H5253 UNITEDHEALTHCARE OF WISCONSIN, INC. UNITEDHEALTHCARE WI HMO/HMOPOS
H5256 MEDICAL ASSOCIATES CLINIC HEALTH PLAN
MEDICAL ASSOCIATES CLINIC HEALTH PLAN OF WISCONSIN WI 1876 Cost
H5262 QUARTZ HEALTH PLAN CORPORATION SENIOR PREFERRED WI HMO/HMOPOS
H5264 DEAN HEALTH PLAN, INC. DEAN HEALTH PLAN, INC. WI 1876 Cost
H6622 HUMANA WI HEALTH ORGANIZATION INSURANCE CORP
HUMANA WI HMO/HMOPOS
H8189 MANAGED HEALTH SERVICES, WISCONSIN ALLWELL WI HMO/HMOPOS
H9096 DEAN HEALTH PLAN, INC. DEAN ADVANTAGE, PREVEA360 MEDICARE ADVANTAGE WI HMO/HMOPOS
H9525 COMPCARE HEALTH SERVICES INSURANCE CORPORATION
ANTHEM BLUE CROSS AND BLUE SHIELD WI HMO/HMOPOS
H1692 COVENTRY HEALTH CARE OF WEST VIRGINIA, INC. AETNA MEDICARE WV HMO/HMOPOS
H5106 HIGHMARK SENIOR SOLUTIONS COMPANY HIGHMARK INC. WV Local PPO
H2816 AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY WELLCARE FS PFFS
H2944 HUMANA INSURANCE COMPANY HUMANA FS PFFS
H4213 USABLE MUTUAL INSURANCE COMPANY
ARKANSAS BLUE CROSS AND BLUE SHIELD FS PFFS
H5435 UNITEDHEALTHCARE INSURANCE COMPANY UNITEDHEALTHCARE FS PFFS
H8145 HUMANA INSURANCE COMPANY HUMANA FS PFFS
R3175 UNITEDHEALTHCARE INSURANCE COMPANY UNITEDHEALTHCARE RS Regional PPO
Medicare HOS 2017-2019 Cohort 20 Performance Measurement Participating MAOs July 2020 Page 20
Reporting Unit
MAO Organization Name
MAO Product Name
MAO State
Medicare Plan Type
R3332 BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. FLORIDA BLUE RS Regional PPO
R3444 CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.
UNITEDHEALTHCARE RS Regional PPO
R5342 UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK
UNITEDHEALTHCARE RS Regional PPO
R5826 HUMANA INSURANCE COMPANY HUMANA RS Regional PPO
R5941 ANTHEM INSURANCE COMPANIES, INC.
ANTHEM BLUE CROSS AND BLUE SHIELD RS Regional PPO
R6694 AETNA LIFE INSURANCE COMPANY AETNA MEDICARE RS Regional PPO
R6801 CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY UNITEDHEALTHCARE RS Regional PPO
R7444 UNITEDHEALTHCARE INSURANCE COMPANY UNITEDHEALTHCARE RS Regional PPO
Medicare HOS 2017-2019 Cohort 20 Performance Measurement Participating MAOs July 2020 Page 21
Key to the Table of Participating MAOs
Category
Abbreviation
Definition
PLAN TYPE
HMO/ HMOPOS
Health Maintenance Organization (HMO)/Point of Service (POS)
An HMO assumes the financial risks associated with providing medical services and the responsibility for health care delivery in a geographic area for HMO members, usually in return for a fixed, prepaid fee. Financial risks may be shared with providers participating in the HMO. A POS plan resembles an HMO for in-network services. Reimbursement for out-of-network providers is based on a fee schedule or customary and reasonable charges.
Local PPO Local Preferred Provider Organization (Local PPO)
A PPO has a network of providers that have agreed to a contractually specified reimbursement for covered benefits with the organization offering the plan; provides for reimbursement for all covered benefits regardless of whether the benefits are provided within the network; and is offered by an organization that is not licensed or organized under state law as an HMO. Local PPOs serve the counties the PPO chooses to include in its service area.
Regional PPO Regional Preferred Provider Organization (Regional PPO)
Regional PPOs serve one of 26 regions established by Medicare. These may be single-state or multi-state regions.
PFFS
Private Fee-for-Service (PFFS) Contract
A PFFS contract is offered by a state licensed risk bearing entity that has a yearly contract with CMS to provide beneficiaries with all their Medicare benefits plus any additional benefits the company decides to provide. MAO beneficiaries can see any provider who is eligible to receive payment from Medicare and agrees to accept payment from the PFFS contract.
1876 Cost 1876 Cost Contract
In 1876 Cost contracts, Medicare beneficiaries are not restricted to the HMO or Competitive Medical Plan (CMP) for receipt of covered Medicare services. Enrollees may use the cost plan's network of providers or receive their health care services through Original Medicare. Medicare payment to the HMO/CMP is based on reasonable costs of providing services to the MAO beneficiaries.
MSA Medical Savings Account (MSA) Contract
An MSA contract combines a high-deductible health plan with a medical savings account. Enrollees of Medicare MSAs can initially use their savings accounts to help pay for health care, and then will have coverage through a high-deductible insurance plan once they reach their deductible. Medicare MSAs provide MAO beneficiaries with more control over health care utilization, while still providing coverage against catastrophic health expenses.
MMP Medicare-Medicaid Plan (MMP)
An MMP is a demonstration plan that coordinates benefits between the Federal Government and states to provide quality health care services to beneficiaries who are enrolled in both the Medicare and Medicaid programs (Medicare-Medicaid enrollees, sometimes referred to as “dual eligible” beneficiaries).
Medicare HOS 2017-2019 Cohort 20 Performance Measurement Participating MAOs July 2020 Page 22
Category
Abbreviation
Definition
STATE
AK – WV, DC, PR, VI
Two Letter State Abbreviation
Typically, the plan state is determined at the MAO level and is assigned to the state in which an MAO is reported. The field may represent any of the 50 U.S. states of Alaska (AK) through West Virginia (WV), as well as the District of Columbia (DC), and U.S. territories of Puerto Rico (PR), and the Virgin Islands (VI).
FS, RS
State Abbreviations for Regional PPO and PFFS Contracts
Regional PPO and PFFS contracts, which may represent beneficiaries from multi-county or multi-state regions, are assigned unique state designations of RS for Regional PPOs or FS for PFFS contracts in the table. These MAOs are included in the national HOS performance measurement sample; however, they are not reported in any state or region numbers.