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WellCare Health Plans, Inc. Kathy Warner, Chief Operating Officer for SC and Tammie Burnette, Community Relations Representative
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WellCare Health Plans, Inc. Kathy Warner, Chief Operating Officer for SC and Tammie Burnette, Community Relations Representative

Feb 25, 2016

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WellCare Health Plans, Inc. Kathy Warner, Chief Operating Officer for SC and Tammie Burnette, Community Relations Representative. WellCare Health Plans, Inc. Company Snapshot. Medicaid, Medicare Advantage & Medicare Part D PDP. Medicare Advantage & Medicare Part D PDP. - PowerPoint PPT Presentation
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Page 1: WellCare Health Plans, Inc. Kathy Warner, Chief Operating Officer for SC  and  Tammie Burnette, Community Relations Representative

WellCare Health Plans, Inc.

Kathy Warner, Chief Operating Officer for SC and

Tammie Burnette, Community Relations Representative

Page 2: WellCare Health Plans, Inc. Kathy Warner, Chief Operating Officer for SC  and  Tammie Burnette, Community Relations Representative

2Data as of March 31, 2013

WellCare Health Plans, Inc.Founded in 1985 in Tampa, Fla.

• Approximately 2.7 million members nationwide• More than 210,700 contracted health care providers• More than 66,300 contracted pharmaciesServing approximately 1.7 million Medicaid members, including:

• Aged, Blind and Disabled (ABD)• Children’s Health Insurance Plan (CHIP)• Family Health Plus (FHP)• Supplemental Security Income (SSI)• Temporary Assistance for Needy Families (TANF)

Serving Medicare members, including:• Approximately 256,000 Medicare Advantage members• Approximately 757,000 Prescription Drug Plan members

Serving the full spectrum of member needs• Dual-eligible populations (Medicare and Medicaid)• Managed Long Term Care

Spearheading efforts to sustain the social safety net• The WellCare Community Foundation• Advocacy Programs• Creation of Public-Private Partnerships

Significant contributor to the national economy• A FORTUNE 500 company• Ranked #18 in the nation on the Barron’s 500• More than 4,900 associates nationwide• Offices in all states where the company provides managed

care

Company Snapshot

Medicare Advantage & Medicare Part D PDPMedicaid & Medicare Part D PDP Medicare Part D PDP (49 states & D.C.)

Medicaid, Medicare Advantage & Medicare Part D PDP

Page 3: WellCare Health Plans, Inc. Kathy Warner, Chief Operating Officer for SC  and  Tammie Burnette, Community Relations Representative

3Data as of March 31, 2013

VisionTo be the leader in government-sponsored health care programs in partnership with the members, providers, government customers and communities we serve.

Mission• Enhance our members' health and quality of life

• Partner with providers and government customers to provide quality, cost-effective health care solutions

• Create a rewarding and enriching environment for our associates

Core Values• Partnership

• Integrity

• Accountability

• Teamwork

WellCare Health Plans, Inc.

Page 4: WellCare Health Plans, Inc. Kathy Warner, Chief Operating Officer for SC  and  Tammie Burnette, Community Relations Representative

4Data as of March 31, 2013

At WellCare, our members are our reason for being.

We work each day toenhance our members’

health and quality of life.

Our Mission to Serve

Emphasis on lower income populations and value-focused benefit design

Community-based solutions to close gaps in the social safety net

Focus on preventive care including regular doctor visits

Communication among members and providers to improve outcomes

Page 5: WellCare Health Plans, Inc. Kathy Warner, Chief Operating Officer for SC  and  Tammie Burnette, Community Relations Representative

5Data as of March 31, 2013

Company History & Growth State Began Operations

Florida 1985

Connecticut 1998

New York 1998

Illinois 2004

Louisiana 2004

Georgia 2006

Missouri 2007

Ohio 2007

New Jersey 2008

Texas 2008

Hawaii 2009

Kentucky 2011

California 2012

Arizona 2013

South Carolina 2013Medicaid and Medicare Advantage Plans

Page 6: WellCare Health Plans, Inc. Kathy Warner, Chief Operating Officer for SC  and  Tammie Burnette, Community Relations Representative

WellCare of SC Timeline• Purchased United Health Care Community Plan 2/1/2013• Transition of Services with United 2/1 through 8/31/2013

“Business as Usual”• Member Notices around 7/25/2013• Provider Notices around 7/25/2013• Provider and Member in-services and education month of

August• Go Live and operate Medicaid plan as WellCare of South

Carolina• Transition of Carolina Medical Homes Membership Projected

for 12/1/2013

Page 7: WellCare Health Plans, Inc. Kathy Warner, Chief Operating Officer for SC  and  Tammie Burnette, Community Relations Representative

7Data as of March 31, 2013

• Providing managed care services targeted to government-sponsored health care programs, focusing on Medicaid, Medicare and Prescription Drug Plans

• Serving a variety of people including families; children; and the aged, blind and disabled; includes a focus on low-income, dual-eligible populations

• Improving quality of care, increasing health care access and improving outcomes for members

• Relieving providers of administrative work and hassles

• Providing cost savings for government customers and taxpayers

What We Do

Reduce Cost and Improve Quality and Accessfor Government Health Programs by:

WellCare

Medicaid

Dual-Eligible

Members

MedicareAdvantage

Prescription

Drug Plans

Managed Long Term

Care

Page 8: WellCare Health Plans, Inc. Kathy Warner, Chief Operating Officer for SC  and  Tammie Burnette, Community Relations Representative

8Data as of March 31, 2013

Medicaid Presence

• Presence in 5 of the 10 largest states

• Broad range of eligibility groups

• Capabilities to integrate medical, pharmacy and behavioral services

• Coordination with Medicare benefit a strength

Approximately 1.7 million members across 9 states

Page 9: WellCare Health Plans, Inc. Kathy Warner, Chief Operating Officer for SC  and  Tammie Burnette, Community Relations Representative

9Data as of March 31, 2013

Medicare Advantage Presence

• Serving 204 counties, encompassing more than 15 million Medicare-eligible residents

• Offering Dual Special Needs Plans in nearly all counties

• Complementary to Medicaid and stand-alone PDP

Approximately 256,000 members across 14 states

Page 10: WellCare Health Plans, Inc. Kathy Warner, Chief Operating Officer for SC  and  Tammie Burnette, Community Relations Representative

10Data as of March 31, 2013

Prescription Drug Plans Presence

• Focused on value-conscious beneficiaries

• A leader in generic utilization

• More than 75% of our members have selected our plans (as opposed to being auto-assigned)

• Pharmacy data, purchase volume and infrastructure benefit Medicaid and Medicare Advantage plans

Approximately 757,000 members across 49 states and D.C.

Page 11: WellCare Health Plans, Inc. Kathy Warner, Chief Operating Officer for SC  and  Tammie Burnette, Community Relations Representative

11Data as of March 31, 2013

WellCare’s Integrated Care Model

Members&

Caregivers

Primary Care

Specialists

Case Management

Mental HealthPharmacy ManagementDisease Management

Home and Community-based Care

Therapy

Transportation

Optical

Community-Based Social Services

• Enhance quality of life for members and family caregivers • Provide value to state customers and members

• Significantly decrease inpatient readmissions • Reduce over-utilization across multiple segments

• Reduce non-emergency ground transportation costs • Reduce inpatient bed days

Integrated Care Management and Coordination of Care can:

Page 12: WellCare Health Plans, Inc. Kathy Warner, Chief Operating Officer for SC  and  Tammie Burnette, Community Relations Representative

12Data as of March 31, 2013

Focused Giving

The weCare WellCare Gives Back program encourages employee volunteerism, specifically in low-income, underserved and aged populations.

In 2012, employees donated more than 1,500 hours to community partners through the weCare WellCare Gives Back program.

WellCare strives to enhance the health, well-being, safety and quality of life for the disabled, economically disadvantaged and medically underserved, and the communities in which they live.

Some of our partners include:

The WellCare Community Foundation works with a number of organizations to improve outcomes for our members and lower the overall cost of health care, including:• Big Brothers and Big Sisters• The Family Café• The Greater New Orleans Foundation• The Judeo Christian Health Clinic• The National Association of Area Agencies

on Aging• Nathaniel’s Hope

Page 13: WellCare Health Plans, Inc. Kathy Warner, Chief Operating Officer for SC  and  Tammie Burnette, Community Relations Representative

13

Free Community Programs

• Eating Healthy on a Budget• A is for Asthma• Lead Away • Know Your Number (Healthy Heart Presentation)• Heart Disease and Stroke (Healthy Heart Presentation)• Nutrition and the Heart (Healthy Heart Presentation)• Diabetes and the Heart (Healthy Heart Presentation)• Tobacco and the Heart (Healthy Heart Presentation)• Exercise Presentation combined with Stress Management Presentation

(Healthy Heart Presentation)• Fitness Day/ Night (family friendly line dancing)• Sugar Presentation• Portion Distortion Presentation• Sodium Presentation• Fitness activities for kids

Page 14: WellCare Health Plans, Inc. Kathy Warner, Chief Operating Officer for SC  and  Tammie Burnette, Community Relations Representative

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Local Community Partnerships

• Attend and participate in community meetings

• Volunteer for community projects• Provide education for the

community agency clients• We not only want to help to

provide affordable healthcare for our Medicaid population, but we also want to help make the communities be healthier.

Page 15: WellCare Health Plans, Inc. Kathy Warner, Chief Operating Officer for SC  and  Tammie Burnette, Community Relations Representative

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Helpful Website for Us

• https://www.wellcare.com

Page 16: WellCare Health Plans, Inc. Kathy Warner, Chief Operating Officer for SC  and  Tammie Burnette, Community Relations Representative

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Contact Information

• Kathy Warner Phone: 803-724-1393Email: [email protected]

• Tammie BurnettePhone: 803-404-0653Email: [email protected]

Page 17: WellCare Health Plans, Inc. Kathy Warner, Chief Operating Officer for SC  and  Tammie Burnette, Community Relations Representative

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Questions?