SCAN Health Plan

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SCAN Health Plan
not-for-profit
Industryhealthcare
Founded1977
FounderSenior Care Action Network
HeadquartersLong Beach, California
Key people
Chris Wing,
President and chief executive
RevenueIncrease $2.3 billion[1]
Number of employees
1,100
Websitewww.scanhealthplan.com

SCAN Health Plan (SCAN) is a not-for-profit, Medicare Advantage, health maintenance organization (HMO) based in Long Beach, California. Founded in 1977, they provide healthcare coverage to Medicare beneficiaries throughout the state, currently serving nearly 200,000 members. They are one of the largest not-for-profit Medicare Advantage Prescription Drug plans in the country.[2]

Early history[edit]

SCAN helped implement a huge shift in healthcare in the late 1970s when a group of senior activists joined city officials in an effort to make healthcare services more accessible, more connected and more affordable for Long Beach's growing number of older residents. This group included 12 seniors who represented the most active and prominent organizations for older adults in the city, as well as representatives from the Long Beach Department of Senior Citizen Affairs. Together, with assistance from the University of Southern California (USC), they created a blueprint for a new and improved healthcare system. This system brought all the city's diverse social service agencies and medical providers into an integrated, community-based organization, providing greater access to affordable support and services for the elderly.

The Senior Care Action Network, or SCAN, was created based on the proposal developed by the team at USC. (The new network was briefly known as the Long Beach Geriatric Healthcare Council, Inc., before changing its name to SCAN.)[3] Their healthcare delivery model was centered on assessing each senior's needs on an individual level in order to coordinate appropriately for each unique case, providing specific social services and medical care through a network of local agencies, community providers and hospitals.[4]

Multipurpose Senior Services Program[edit]

In 1979, the state of California selected SCAN as one of eight sites for the state's Multipurpose Senior Services Program (MSSP). This program exists to help elderly Medi-Cal recipients in the Long Beach area stay out of nursing institutions as long as possible by providing home-based services to deliver the care they need. For the last 40 years, SCAN has served California's most at-risk seniors as one of the state's 62 MSSP sites through Independence at Home, a community service of SCAN.[5]

Social HMO[edit]

Until 1983, SCAN had been relatively unknown outside of Long Beach. That changed when they were awarded a contract from the federal government as one of four sites nationwide to pilot the Social Health Maintenance Organization (SHMO) demonstration program.[6] The SHMO concept expanded what SCAN was already doing (offering home-based services so seniors could avoid or delay nursing home placement) to also include the at-risk elderly enrolled in Medicare and provide healthcare coverage to other Medicare beneficiaries.

In November 1984, under a three-and-a-half-year contract with the federal government, SCAN was officially licensed as a health plan in California. In March 1985, they began enrolling members in their Social HMO.[7] Congress renewed the SHMO demonstration project five times before the program was ended in 2004.[8]

Growth and expansion[edit]

Between 1996 and 1998, SCAN more than doubled its membership by expanding into three Southern California counties (Orange, Riverside and San Bernardino).

When the government ended the SHMO program, SCAN continued to operate as a Medicare Advantage plan, offering Medicare beneficiaries healthcare coverage and services beyond what the federal program alone would cover. SCAN continued to grow,[9] extending their service area and membership between 2005 and 2007 when it added three California counties (Ventura, Kern and San Diego) and also Maricopa County, Arizona. In 2010, SCAN entered the Northern California market with Contra Costa, San Francisco, San Joaquin and Santa Clara counties. In 2011, Pima County, Arizona was added, but by 2016 the company phased out all operations in Arizona. Instead, the company focused its efforts in California, adding Napa and Sonoma counties.[10][11]

Quality of care[edit]

In 2018, SCAN Health Plan received an overall rating of 4.5 out of 5.* This 5-star Quality Rating System is given by the Centers for Medicaid and Medicare Services (CMS) and is based on SCAN's offered plans (except SCAN Healthy at Home, an HMO Special Needs Plan; and VillageHealth, an HMO-POS Special Needs Plan).[12]

*Medicare evaluates plans based on a 5-star rating system. Star ratings are calculated each year and may change from one year to the next.

Current coverage by counties[edit]

SCAN provides healthcare coverage to more than 194,000 Medicare beneficiaries in 11 counties in Northern California and Southern California.[13]

Northern California Marin County
Napa County
San Francisco County
Santa Clara County
Sonoma County
Southern California Los Angeles County
Orange County
Riverside County
San Bernardino County
San Diego County
Ventura County

Community benefits[edit]

Independence at Home (IAH), a community service of SCAN Health Plan, provides long-term and personal care coordination for low-income seniors, as well as functionally-disabled adults. This service is provided through various county and state contract programs, the largest of which is the Multipurpose Senior Services Program. IAH also provides a resource and referral line to connect seniors and their caregivers to needed services and support in Los Angeles, Orange, Riverside and San Bernardino counties.

Volunteer Action for Aging (VAA) is a SCAN community service that provides individuals and groups the ability to volunteer for episodic events and/or ongoing opportunities that engage isolated seniors in the local community. In addition, SCAN provides grants and donations to senior-focused organizations in the communities it serves. Grants are made in three categories: senior support services, emergency assistance funding and nutrition.

References[edit]

  1. ^ [1]
  2. ^ "SCAN Health Plan Names Top Performing Medical Groups". www.scanhealthplan.com. Retrieved 2018-07-06.
  3. ^ "SCAN Celebrates 40 Years of Senior Care in Long Beach".
  4. ^ "About SCAN".
  5. ^ "Multipurpose Senior Services Program-Contacts (By County)".
  6. ^ "The Social HMO Demonstration: Early Experience".
  7. ^ "Migrated Medicare Demonstration SHMO Report" (PDF).
  8. ^ "HR4954".
  9. ^ https://www.govtrack.us/congress/bills/107/hr4954/summary
  10. ^ https://www.lacera.com/healthcare/pdf/new_retiree_packet/medical_plans_overview.pdf
  11. ^ https://napavalleyregister.com/business/columnists/health-insurance-guys/scan-health-plan-questions/article_8016a330-d65f-500c-abcf-555012dfbdb7.html
  12. ^ https://health.usnews.com/health-news/best-medicare-plans/articles/best-medicare-advantage-plans
  13. ^ https://health.usnews.com/medicare/scan-health-plan-medicare-plans-in-california

External links[edit]