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MEDICA STATE PUBLIC
PROGRAMS
– Isai, Medica member
WE VALUE
OUR MEMBERS.
Medica values its members. We understand their situation today may
not be their situation tomorrow. We’ve built plans with programs that
grow and change just like they do – to meet their needs. Wherever our
members are in life, they belong to a health plan that puts them first.
QUALITY SERVICE
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MEDICA’S MEDICAID PLAN IS
RANKED NUMBER ONE OF ALL
MEDICAID HEALTH INSURANCE PLANS, IN MINNESOTA
(NCQA’s Medicaid Health
Insurance Plan Ranking
2013-2014)
Since 2005, NCQA has consistently ranked Medica
in the Top 20 of all Medicaid plans nationwide. More
significantly, we have outranked our closest Minnesota
competitors in every year since 2008.
Firsts
Our work has earned us a reputation for developing
innovative solutions to the complex medical, behavioral
and social problems that affect the health of vulnerable
populations. For example, we were an early leader in
building quality incentives into provider contracts. We
were the first health plan Minnesota to provide free
transportation so members could keep their appointments
for care. We were the first managed care organization
in the state to dedicate resources to securing affordable
housing for individuals whose chronic homelessness is
a barrier to their health. And we remain the only health
plan that pays mental health providers more to care for
members whose needs are more complicated and timeintensive.
Our Members
Today, our State Public Programs (SPP) division serves
nearly 162,000 people in the Medical Assistance (MA)
programs. We have an additional 33,000 members served
by our dual-eligible programs. Our SPP enrollment has
grown 59% since January 2014, with the expansion of
Medicaid eligibility due to the Affordable Care Act.
EXCEEDING THE NATIONAL AVERAGE
92%
5%
91%
79%
MEDICA HAS A MEDICAL LOSS RATIO OF
92% (COMPARED TO 87% NATIONAL
AVERAGE)
MEDICA HAS AN ADMINISTRATIVE LOSS
RATIO OF 5% (COMPARED TO 11%
NATIONAL AVERAGE)
MEMBERS SAID THEY RECEIVED THE HELP
THEY NEEDED FROM MEDICA CUSTOMER
SERVICE (COMPARED TO 80% NATIONAL
AVERAGE)
OF OUR SURVEYED MEDICAID MEMBERS
WERE SATISFIED WITH THEIR MEDICA
HEALTH PLAN (COMPARED TO 75%
NATIONAL AVERAGE)
“Marie, my health coach from Medica,
has been a big source of emotional
support. She is a pusher – a good pusher.
She boosts my confidence. She holds me
accountable to the things I’m supposed
to be working on and she doesn’t take
any excuses. It’s so nice to hear someone
say that I did a good job, because no one
ever told me that before.”
–TAMMY MEDICA CHOICE CARE (MA) MEMBER
Source: CAHPS member survey
data; 2014 Millman Report
ABOUT MEDICA
Medica is headquartered in Minnetonka, Minnesota and is Minnesota’s second largest
nonprofit health insurer. As a nonprofit with a 40-year record of service to members,
Medica is a major contributor to the community through its grant-making and research
foundations. Our primary service area is Minnesota, North Dakota, South Dakota and
western Wisconsin. Approximately 1.5 million individuals use Medica health insurance
products and services. Medica is a $3.3 billion company with nearly 1,400 employees and
in 2013 paid $95 million in premium taxes and fees.
Our Mission
Our mission is to meet our members’ needs for health plan products and services. In doing
so, we work with members and providers to make health care accessible, affordable and a
means by which our members improve their health.
Our Values
•• Member Focus
Our work must be done with all of our customers in mind. We are dedicated to providing our customers better value and service than our competitors.
•• Excellence
To achieve customer satisfaction, we must strive for excellence in everything we do, in our products, our services, our human relations, our competitiveness, our timeliness and in our execution of large and small tasks.
•• Stewardship
The premiums and fees we are paid is our customers’ money. We must be prudent in its use. We are accountable to our customers, stakeholders and one another for the wise and effective use of all of our resources.
•• Integrity
The conduct of our company and our employees must be pursued in a manner that is socially responsible, fosters trust and commands respect for its integrity.
•• Diversity
Our people are our greatest asset. We are committed to a workforce that reflects the strength and character of the customers and communities we serve. We promote a spirit of openness, discovery and learning in order to live our mission and achieve our vision.
© 2015 Medica. Medica® is a registered service mark of Medica Health Plans. “Medica” refers to
the family of health plan businesses that includes Medica Health Plans, Medica Health Plans of
Wisconsin, Medica Insurance Company, Medica Self-Insured, and Medica Health Management, LLC.
SPP51191-00415A