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Page 1: PowerPoint Presentation - Right Care Initiative · **All monetary values presented represent charge values, and may not be completely reflective of actual costs of care
Page 2: PowerPoint Presentation - Right Care Initiative · **All monetary values presented represent charge values, and may not be completely reflective of actual costs of care
Page 3: PowerPoint Presentation - Right Care Initiative · **All monetary values presented represent charge values, and may not be completely reflective of actual costs of care
Page 4: PowerPoint Presentation - Right Care Initiative · **All monetary values presented represent charge values, and may not be completely reflective of actual costs of care
Page 5: PowerPoint Presentation - Right Care Initiative · **All monetary values presented represent charge values, and may not be completely reflective of actual costs of care
Page 6: PowerPoint Presentation - Right Care Initiative · **All monetary values presented represent charge values, and may not be completely reflective of actual costs of care
Page 7: PowerPoint Presentation - Right Care Initiative · **All monetary values presented represent charge values, and may not be completely reflective of actual costs of care
Page 8: PowerPoint Presentation - Right Care Initiative · **All monetary values presented represent charge values, and may not be completely reflective of actual costs of care
Page 9: PowerPoint Presentation - Right Care Initiative · **All monetary values presented represent charge values, and may not be completely reflective of actual costs of care

Total Charges for All Payers - AMI's in California

Medicare Medi-Cal Private Knox-Keene Managed Care Other Private All Other

Total AMI Discharges for All Payers

Medicare Medi-Cal Private Knox-Keene Managed Care Other Private All Other

Total Charges Total AMI Discharges

Medicare $6.60 Billion 51,561

Medi-Cal $2.05 Billion 12,816

Private Knox-Keene Managed Care $1.01 Billion 9,978

Other Private $1.17 Billion 6,745

All Other $432 Million 2,833

Total $11.3 Billion 83,933

**All monetary values presented represent charge values, and may not be completely reflective of actual costs of care.

Page 10: PowerPoint Presentation - Right Care Initiative · **All monetary values presented represent charge values, and may not be completely reflective of actual costs of care

Total Charges Total Stroke Discharges

Medicare $12.7 Billion 140,530

Medi-Cal $5.32 Billion 33,342

Private Knox-Keene Managed

Care$1.46 Billion 15,939

Other Private $2.06 Billion 13,332

All Other Payers $769 Million 5,439

Total $22.3 Billion 208,582

Total Charges for All Payers - Strokes in CA

Medicare Medi-Cal Private Knox-Keene Managed Care Other Private All Other Payers

Total Stroke Discharges for All Payers

Medicare Medi-Cal

Private Knox-Keene Managed Care Other Private

All Other Payers **All monetary values presented represent charge values, and may not be completely reflective of actual costs of care.

Page 11: PowerPoint Presentation - Right Care Initiative · **All monetary values presented represent charge values, and may not be completely reflective of actual costs of care

- 5,000 10,000 15,000 20,000 25,000 30,000 35,000 40,000 45,000 50,000

Sharp Health Plan

California Health and Wellness Plan

Western Health Advantage

Cigna HealthCare of California, Inc.

Molina Healthcare of California DBA: American Family Care

Aetna Health Plans of California, Inc.

Local Initiative Health Authority For L.A. County (DBA LA Care Health Plan)

Blue Shield of California

Blue Cross of California

UHC of California United Healthcare of CA Frmrly PacifiCare/Secure Horizons of CA

Health Net of California, Inc.

Kaiser Foundation Health Plan, Inc.

AMI and Stroke Discharges and Charges for Selected Health Plans, for All Payers

STROKE

AMI

$754,989,144

$1,150,957,576

$716,888,527

$1,129,737,621

$715,916,960

$652,120,281

$809,181,420

$261,181,011

$287,008,216

$27,874,008

$19,887,857

$28,271,768

**All monetary values presented represent charge values, and may not be completely reflective of actual costs of care.

Page 12: PowerPoint Presentation - Right Care Initiative · **All monetary values presented represent charge values, and may not be completely reflective of actual costs of care

AMI ONLY Medicare Medi-Cal Private All Other Payers Total

$$ ## $$ ## $$ ## $$ ## $$ ##Aetna Health Plans of California, Inc. $324,123,361 284 ..

..$312,929,223 427

.... $637,052,584 711

Blue Cross of California$339,984,895 205 $ 92,802,155.00 667 $149,974,153 924 $ 6,323,936 22 $589,085,139 1,818

Blue Shield of California$201,958,766 595 $ 478,707.00 6 $137,615,276 767 $ 5,893,529 12 $345,946,278 1,380

California Health and Wellness Plan .. .. $ 6,807,386.00 66 .. .. .. .. $6,807,386 66 Cigna HealthCare of California, Inc. $97,248,645 3 .. .. $124,503,801 262 .. .. $221,752,446 265 Health Net of California, Inc.

$30,558,782 1,387 $ 169,777,120.00 1,157 $57,696,266 817 $ 3,108,389 21 $261,140,557 3,382 Kaiser Foundation Health Plan, Inc. $35,039,682 9,242 $ 6,136,486.00 184 $59,285,536 5,473 $ 1,536,485 2 $101,998,189 14,901 LA Care Health Plan)

$17,445,762 84 $ 140,809,466.00 975 $41,373,654 70 $ 937,830 8 $200,566,712 1,137 Molina Healthcare of California $125,352 117 $ 67,643,741.00 439 $18,773,227 44 .. .. $86,542,320 600 Sharp Health Plan

.. .. .. .. $8,891,145 55 .. .. $8,891,145 55 United Healthcare

$11,384,879 2,568 $ 709,686.00 14 $5,844,453 425 $ 136,738 9 $18,075,756 3,016 Western Health Advantage

.. .. .. $4,931,439 113 ..

.. $4,931,439 113 **All monetary values presented represent charge values, and may not be completely reflective of actual costs of care.

Page 13: PowerPoint Presentation - Right Care Initiative · **All monetary values presented represent charge values, and may not be completely reflective of actual costs of care

STROKES ONLY Medicare Medi-Cal Private All Other Payers Total

$$ ## $$ ## $$ ## $$ ## $$ ##Aetna Health Plans of California, Inc. $52,882,564 615 $89,966 2 $119,156,306 831 $172,128,836 1,448 Blue Cross of California

$61,976,198 556 $234,822,555 1,772 $235,125,010 1,567 $ 8,728,719 39 $540,652,482 3,934 Blue Shield of California

$164,494,491 1,508 $172,160 3 $199,973,000 1,310 $ 5,331,031 14 $369,970,682 2,835 California Health and Wellness Plan … … $13,080,471 163 $13,080,471 163 Cigna HealthCare of California, Inc. $234,564 5 $217,872 3 $64,803,334 459 $65,255,770 467 Health Net of California, Inc.

$329,539,768 3,368 $362,804,433 2,971 $188,319,215 1,475 $ 9,153,603 36 $889,817,019 7,850 Kaiser Foundation Health Plan, Inc. $350,514,874 24,533 $8,638,225 459 $293,399,587 7,403 $ 438,269 6 $652,990,955 32,401 Local Initiative Health Authority For L.A. County (DBA LA Care Health Plan)

$26,691,411 261 $410,322,753 2,531 $14,209,401 173 $ 330,004 9 $451,553,569 2,974

Molina Healthcare of California DBA: American Family Care $34,585,846 344 $128,743,786 959 $11,309,059 97 $174,638,691 1,400 Sharp Health Plan

$19,380,623 150 $19,380,623 150 UHC of California United Healthcare of CA Frmrly PacifiCare/Secure Horizons of CA

$572,937,187 6,477 $2,713,781 56 $119,527,553 837 $ 3,634,250 $698,812,771 7,370

Western Health Advantage$1,572,650 3 $21,369,919 154 $22,942,569 157 **All monetary values presented represent charge values, and

may not be completely reflective of actual costs of care.