HEALTH MAINTENANCE ORGANIZATIONS.Serving L.A. County; ranked by number of Southern California Southern California, also colloquially known as SoCal, is the southern portion of the U.S. state of California. Centered on the cities of Los Angeles and San Diego, Southern California is home to nearly 24 million people and is the nation's second most populated region, members EXECUTIVE SUMMARY THIS year, five of the 15 HMOs on the list showed a decline in enrollment numbers, compared with only one last year. In addition, the 10 companies that did show growth increased by smaller increments than those on last year's list. Disenchantment dis·en·chant tr.v. dis·en·chant·ed, dis·en·chant·ing, dis·en·chants To free from illusion or false belief; undeceive. [Obsolete French desenchanter, from Old French, with provider service could be one factor for the decline. PacifiCare, No. 2 on the list, is one of five HMOs named in the largest legal assault to date on the managed care system, a class-action lawsuit lawsuit: see procedure; tort. alleging violations of federal laws governing gov·ern v. gov·erned, gov·ern·ing, gov·erns v.tr. 1. To make and administer the public policy and affairs of; exercise sovereign authority in. 2. health plans. The suit is the latest chapter in the public outcry over the practice of restricting re·strict tr.v. re·strict·ed, re·strict·ing, re·stricts To keep or confine within limits. See Synonyms at limit. [Latin restringere, restrict- : re-, members' access to treatment, in part by urging primary care doctors to refer patients to specialists only when absolutely necessary. Health plan stocks have fallen in recent months as public opinion has turned, and state and federal lawmakers have begun to increase HMO HMO health maintenance organization. HMO n. A corporation that is financed by insurance premiums and has member physicians and professional staff who provide curative and preventive medicine within certain financial, regulation. THE PACESETTER KAISER PERMANENTE Kaiser Permanente is an integrated managed care organization, based in Oakland, California, founded in 1945 by industrialist Henry J. Kaiser and physician Sidney R. Garfield. THE largest health maintenance organization in Southern California, Kaiser Permanente continues to increase its membership, and while still losing money it is beginning to show financial improvement. Kaiser's Southern California enrollment currently stands at 2.9 million, up from 2.8 million in 1998. It owns and operates six hospitals in L.A. County with a network of 3,500 physicians working at more than 100 facilities throughout Southern California. In the third quarter ended Sept. 30, Kaiser reported a net loss of $29 million, compared with a net loss of $89 million in the year-earlier quarter. Kaiser cites several reasons for the rebound rebound (rē´bownd), n/v 1. a recovery from illness. n 2. an outbreak of fresh reflex activity after withdrawal of a stimulus rebound adjective , such as continued membership growth and an improved cost structure. In particular, the HMO has regained control over hospital operating expenses Operating expenses The amount paid for asset maintenance or the cost of doing business, excluding depreciation. Earnings are distributed after operating expenses are deducted. and improved hospital capacity during key periods, reducing the use of non-Kaiser hospitals. Last year, Kaiser cited outside treatment of patients as a key reason for financial difficulties. Founded in 1945, Kaiser Permanente is a nonprofit organization Nonprofit Organization An association that is given tax-free status. Donations to a non-profit organization are often tax deductible as well. Notes: Examples of non-profit organizations are charities, hospitals and schools. with headquarters in Oakland Oakland, city (1990 pop. 372,242), seat of Alameda co., W Calif., on the eastern side of San Francisco Bay; inc. 1852. Together with San Francisco and San Jose, the city comprises the fourth largest metropolitan area in the United States. and Pasadena Pasadena (păs'ədē`nə). 1 City (1990 pop. 131,591), Los Angeles co., S Calif., at the base of the San Gabriel Mts.; inc. 1866. . It has 30 medical centers and 361 medical offices nationwide.
Rank Company Enrollment
* name (current/year ago)
* address * So. California [1]
* L.A. County
* companywide
1 Kaiser Permanante 2,938,690/2,836,056
393 E. Walnut St. NA/1,495,363
Pasadena 91188 8,560,683/8,559,469
2 PacifiCare of California 1,556,475/1,500,000
3415 S. Sepulveda Blvd., Suite 800 672,000/550,000
Los Angeles 90034 2,386,800/2,300,000
3 Blue Cross HMO (CaliforniaCare) 1,186,122/1,038,084
21555 Oxnard St. 673,414/586,682
Woodland Hills 91367 1,941,558/1,711,398
4 Health Net 1,180,932/1,244,117
21600 Oxnard St., 10th Floor 700,005/699,993
Woodland Hills 91367 2,184,598/2,256,063
5 L.A. Care Health Plan 622,034/591,391
3530 Wilshire Blvd. same
Los Angeles 90010 same
6 Blue Shield of California HMO 584,562/598,850
6701 Center Drive West, Suite 800 284,430/300,181
Los Angeles 90045 933,416/885,732
7 Cigna HealthCare of California 439,875/447,221
505 N. Brand Blvd., Suite 400 262,460/NA
Glendale 91203 663,500/699,619
8 Universal Care 266,040/220,878
1600 E. Hill St. 186,374/158,887
Signal Hill 90806 266,040/215,878
9 Maxicare 248,086/265,426
1149 S. Broadway St. 200,122/208,420
Los Angeles 90015 471,016/514,068
10 Molina Medical Centers 147,293/139,699
One Golden Shore Drive 100,932/100,375
Long Beach 90802 167,999/165,000
11 UHP HealthCare 107,876/100,000
3405 W. Imperial Highway, Suite 605 97,832/95,000
Inglewood 90303 107,876/100,000
12 United HealthCare of California Inc. 100,031/108,500
180 E. Ocean Blvd., Suite 500 57,600/62,600
Long Beach 90802 8,600,000/5,800,000
13 Inter Valley Health Plan 66,150/59,085
300 S. Park Ave. 29,106/25,411
Pomona 91769 66,150/59,085
14 Scan Health Plan 41,718/40,246
3780 Kilroy Airport Way 18,889/14,650
Long Beach 90806 41,718/40,246
15 One Health Play of California 36,513/33,413
330 N. Brand Blvd., Suite 875 NA/NA
Glendale 91203 68,830/65,173
Rank California Affiliates Revenues [2] PPO
(current/year ago) * companywide
* hospitals (1999/1998)
* physicians * % spent on medical care
1 42/42 NA/$15,500 none
6,780/6,599 96%
2 244/305 NA/9,500 PacifiCare
30,590/31,000 85
3 414/375 NA/6,500 Prudent Buyer Plan
31,395/28,543 NA
4 419/435 2,753 [3]/897.9 Health Net PPO
37,209/36,390 88
5 133/119 596/365.5 none
8,337/9,200 94
6 324/260 NA/2,500 Blue Shield Preferred
24,811/23,651 81.5 Plan
7 241/240 NA/1,200 Cigna HelathCare of
31,000/30,967 87.5 California
8 170/160 220/155 none
25,000/22,000 89
9 200/194 NA/727.2 Maxi-Select
28,681/21,100 NA
10 120/115 NA/135 none
9,800/9,800 86.7
11 98/75 182/200 none
3,250/3,000 83
12 173/255 19,500/NA options
24,848/30,994 86
13 160/104 NA/140 none
16,403/14,713 87.9
14 104/106 NA/172.2 none
12,159/9,470 NA
15 211/199 NA/NA One Health Plan of
23,452/22,838 NA CA PPO
Rank Profile Structure
* year established * plan model
* headquarters * status
* enrollment phone * parent company
1 1945 group
Oakland/Pasadena non-profit
(800) 611-3616 same
2 1978 contractual
Cypress profit
(800) 624-8822 PacificCare Health Systems
3 1986 mixed
Woodland Hills profit
(800) 220-3996 WellPoint Health Networks
4 1979 mixed
Woodland Hills profit
(800) 522-0088 Foundation Health Systems
5 1997 mixed
Los Angeles non-profit
(888) 452-2273 same
6 1939 contractual
San Francisco non-profit
(800) 559-5905 California Physician Services
7 1929 contractual
Glendale profit
(818) 546-5399 Cigna HealthCare
8 1983 mixed
Signal Hill profit
(800) 635-6668 same
9 1973 mixed
Los Angeles profit
(800) 234-6294 Maxicare Health Plans
10 1980 mixed
Long Beach profit
(800) 526-8196 same
11 1967 mixed
Inglewood non-profit
(800) 847-1222 WattsHealth Foundation
12 1986 contractual
Minnetonka, Minn. profit
(800) 875-4206 United HealthGroup
13 1979 mixed
Pomona non-profit
(800) 251-8191 same
14 1977 mixed
Long Beach non-profit
(562) 989-5100 SCAN
15 1996 contractual
San Jose profit
(800) 663-8081 Great West Life & Annity Co.
Rank Top Local Executive
* name
* title
* phone
1 Oliver Goldsmith, M.D.
medical director
(626) 405-5000
2 Rick Badger
ceo, president
(714) 952-1121
3 Ron Williams
president, Blue Cross of Calif.
(818) 703-2345
4 Cora Tellez
ceo, president
(818) 676-6775
5 Anthony Rogers
ceo
(213) 251-8300
6 Alan Puzarne
s.v.p., ceo, So. region
(310) 670-4040
7 Bud Volberding
president
(818) 500-6262
8 Howard Davis
ceo, president
(562) 981-4028
9 Warren Foon
v.p., gen. mgr.
(213) 765-2000
10 J. Mario Molina, M.D.
ceo
(562) 435-3666
11 Clyde Oden, Jr., O.D.
ceo, president
(310) 680-3591
12 Emery Dameron
ceo
(562) 951-6400
13 Mike Nelson
ceo, president
(909) 623-6333
14 Sam L. Erwin
ceo, president
(562) 989-5100
15 Kurt Hoekendorf
executive director
(800) 284-7132
NA -- Not Available
(1.)Southern California is defined as Los Angeles, Orange, Ventura, San
Bernadino, Riverside, Imperial, and San Diego counties.
(2.)In millions.
(3.)From Jan. 1 to Sept. 30, 1999.
Note: The information on this list was supplied by representatives of the
health plans themselves. HMOs are ranked by Southern California enrollment,
and all figures represent the most current data available unless otherwise
noted. The survey was completed during the week of December 27, 1999.
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