Quality Health Care Solutions by AmeriHealth Caritas
Founded: 1983
Headquarters: 3875 West Chester Pike Newtown Square, PA 19073 USA
Phone: 312-212-0968
Website: www.amerihealthcaritas.com
AmeriHealth Caritas: A National Leader in Health Care Solutions
Finding a health insurance company that offers quality, affordable, and personalized health care solutions can be challenging. But not with AmeriHealth Caritas. AmeriHealth Caritas is a national leader in health care solutions for people who are at a low income level and/or are chronically ill. With over 35 years of experience, AmeriHealth Caritas serves approximately 5 million members in 13 states and the District of Columbia with excellence and innovation. Here are some of the reasons why AmeriHealth Caritas is the best choice for anyone looking for a health insurance company.
The History of AmeriHealth Caritas
AmeriHealth Caritas was founded in 1983 in a West Philadelphia hospital, with a vision to provide health care to the underserved and vulnerable populations. Since then, AmeriHealth Caritas has grown into one of the largest and most respected Medicaid managed care organizations in the country, serving approximately 5 million members in 13 states and the District of Columbia. AmeriHealth Caritas is part of the Independence Health Group, the parent company of Independence Blue Cross, and Blue Cross Blue Shield of Michigan, the strategic partner and investor.
The Services of AmeriHealth Caritas
AmeriHealth Caritas offers a wide range of services to meet the diverse needs of the members. Whether someone needs preventive care, chronic care, or specialty care, AmeriHealth Caritas has it covered. Some of the services include:
Medical, dental, and vision plans that cover essential health benefits and more.
Behavioral health services that address mental health and substance use disorders.
Pharmacy benefit management services that ensure access to safe, effective, and affordable medications.
Long-term services and supports that help members with disabilities and complex needs live independently in their communities.
Individual and family health plans that provide coverage for people who are not eligible for Medicaid or Medicare.
The Solutions of AmeriHealth Caritas
AmeriHealth Caritas is not just a health insurance company. AmeriHealth Caritas is a health care solutions company. AmeriHealth Caritas uses its expertise, experience, and innovation to deliver integrated, holistic, and outcomes-driven care for the members and partners. Some of the solutions include:
1. Community-based care coordination that connects members with local resources and supports.
2. Health outreach programs that deliver care locally through health information, classes, screenings, and other community-based clinical services.
3. Social determinants of health initiatives that address factors such as housing, food, transportation, and employment that affect health and well-being.
4. Next Generation Model of Care that leverages data, technology, and analytics to improve care quality, access, and efficiency.
The Funding of AmeriHealth Caritas
AmeriHealth Caritas is a financially stable and sustainable company that has received funding from various sources. Some of the funding rounds include:
In 2013, AmeriHealth Caritas received a $100 million investment from Blue Cross Blue Shield of Michigan, which became the parent company and strategic partner.
In 2017, AmeriHealth Caritas refinanced its debt with a $1.5 billion credit facility, which improved its liquidity and financial flexibility.
In 2023, AmeriHealth Caritas expanded its investments into innovative community-based programs with a grant of more than $355,000 from the Pennsylvania Homecare Association.
The Partnerships of AmeriHealth Caritas
AmeriHealth Caritas believes in the power of partnerships to achieve its mission and vision. AmeriHealth Caritas collaborates with various stakeholders, such as:
1. State and federal governments, to design and implement customized health care solutions for publicly funded programs.
2. Providers, to deliver high-quality, patient-centered, and coordinated care for the members.
3. Community organizations, to address the social determinants of health and support the well-being of the members and communities.
4. Diverse businesses and suppliers, to promote and partner with small, women-, and minority-owned businesses, and increase its procurement from these businesses by 87 percent since 2013.
The Recognition of AmeriHealth Caritas
AmeriHealth Caritas is honored to receive recognition from various organizations for its excellence in health care, especially the ones it makes every day — improving health outcomes and increasing access to quality care. Some of the recognition include:
1. National Committee for Quality Assurance (NCQA) Accreditation for 10 of its health plans, which demonstrates its commitment to quality improvement and customer satisfaction.
2. NCQA Multicultural Health Care (MHC) Distinction for 10 of its health plans, which honors its efforts to monitor and improve culturally and linguistically appropriate services and reduce health care disparities.
3. NCQA Long-Term Services and Supports (LTSS) Distinction for two of its health plans, which recognizes its ability to provide person-centered, integrated, and coordinated care for members with complex needs.
4. NCQA Managed Behavioral Healthcare Organization (MBHO) Accreditation for PerformCare, its behavioral health subsidiary, which validates its performance in delivering effective and efficient behavioral health services.
5. NCQA Case Management Accreditation for AmeriHealth Caritas District of Columbia, which verifies its competence in providing case management services for members with complex conditions.
6. NCQA Utilization Management Accreditation for PerformRx, its pharmacy benefit management subsidiary, which confirms its compliance with industry standards and best practices for utilization management.
7. Utilization Review Accreditation Commission (URAC) Pharmacy Benefit Management Accreditation for PerformRx, which demonstrates its adherence to quality measures and consumer protection for pharmacy benefit management services.
8. URAC Drug Therapy Management Accreditation for PerformRx, which signifies its excellence in providing drug therapy management services that optimize therapeutic outcomes and reduce medication-related problems.
9. URAC Specialty Pharmacy Accreditation for PerformSpecialty, its specialty pharmacy subsidiary, which indicates its proficiency in providing specialty pharmacy services that meet the highest standards of quality and safety.
10. URAC Rare Disease Pharmacy Center of Excellence Designation for PerformSpecialty, which distinguishes its expertise in providing specialty pharmacy services for rare and orphan diseases.
11. Accreditation Commission for Health Care (ACHC) DMEPOS Accreditation for PerformSpecialty, which certifies its compliance with the Medicare Quality Standards for durable medical equipment, prosthetics, orthotics, and supplies.
12. ACHC Specialty Pharmacy Accreditation for PerformSpecialty, which affirms its capability in providing specialty pharmacy services that exceed the expectations of patients and prescribers.
How to Join AmeriHealth Caritas
Anyone who is ready to join AmeriHealth Caritas and discover the difference it can make in their life can do so easily and conveniently. Just visit the website or call at 1-215-937-8000 to learn more about the plans and eligibility requirements. AmeriHealth Caritas looks forward to hearing from anyone soon.
Disclaimer: Please note that the names and positions of employees mentioned may be subject to change, as individuals may move to different roles or organizations. While we make every effort to keep our information accurate and up-to-date, we cannot guarantee that all employee details are current or complete. We encourage you to verify the identity and positions of any individual mentioned and check their Linkedin Profile before taking any action based on their role.
Employees
Neil Gomes – Chief Digital Officer
Chad Goodwin – Vice President & Chief Procurement Officer
Daniel Vickers – Chief Operating Officer
Fred Dickson – Executive Vice President and Chief Information Officer
T. Kyle Godfrey – Chief Operating Officer
Tom Wehrle – Vice President, Chief Information Security Officer
Haish Nakra – Chief Data Officer
Peter Jakuc – Senior Vice President, Chief Development Officer
Jerome Schorr – Chief Operations Officer
Mark Grippi – Market President/CEO Amerihealth Caritas of Ohio
Adrian Mebane – Executive Vice President and Chief Risk Officer
Chris Zitzer – Vice President, Chief Compliance Officer
Heidi Chan – Market President AmeriHealth Caritas North Carolina
Helene Roybal – Chief Transformation Officer
Julia Wright – Chief Medical Officer
Emmilyn Lawson – Plan President
Dr. David Hamlin – Chief Dental Officer
Karen S. Amstutz – EVP & Chief Medical Officer
Jordan Weisman – Chief Medical Officer, Behavioral Health
Kyle Viator – Market President
Bernard Cohen – Chief Medical Officer, Long Term Service and Supports
Pamela Schmidt – Vice President Treasury and Chief Investment Officer