SCAN Health Plan

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SCAN Health Plan
not-for-profit
Industry healthcare
Founded 1977
Founder Senior Care Action Network
Headquarters Long Beach, California
Key people
Chris Wing,
President and chief executive
Revenue Increase $1.9 Billion [1]USD
Number of employees
1,100
Website www.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]

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]

Key Dates[edit]

SCAN was founded in 1977 by a group of seniors who were frustrated by their lack of access to services and who wanted an organization that addressed their specific needs. These seniors formed the Senior Care Action Network, now known as SCAN Health Plan.

Up until 1982, SCAN was relatively unknown. In that year, however, Congress awarded the organization one of four Social Health Maintenance Organization (SHMO) contracts, which became effective in 1985. The SHMO contract was renewed several times over the years until the Social HMO program ended.[9]

In 1996, SCAN expanded into three Southern California counties: Orange, Riverside, and San Bernardino. The HMO expanded to Ventura County, California, in 2005, to Kern County, California, and Maricopa County, Arizona, in 2006, and to San Diego County, California, in 2007. The company entered the Northern California market in 2010, with Contra Costa, San Francisco, San Joaquin, and Santa Clara counties. SCAN added a second Arizona county, Pima County, in 2011.[10]

In 2015, SCAN expanded into two Northern California counties: Napa and Sonoma.[11]

In 2015, SCAN was ranked by the Centers for Medicare and Medicaid (CMS) as a 4.0 Star plan.[12]

For 2018, SCAN Health Plan received an overall Star Rating of 4.5 from Medicare.

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

As of the new benefit year commencing on January 1, 2018, SCAN Health Plan no longer provides coverage in the county of San Joaquin.

Independence at Home[edit]

One of the first eight Multi-Purpose Senior Service Projects (MSSP) in California, Independence at Home (IAH) now operates as a division of SCAN Health Plan. IAH provides community-based, long-term care and personal care coordination for low-income, frail seniors, as well as functionally disabled adults. With a mission of enabling clients to stay healthy and independent in their own homes, IAH is projected to serve approximately 17,000 clients in 2014.[14]

Community Benefit[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.

References[edit]

External links[edit]