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September 12, 2006

Background information on M-CARE

  • M-CARE launched in 1986 as a non-profit, University-owned and University-designed HMO (health maintenance organization). At the time, HMOs were still a novel idea in health plans, with an emphasis on prevention and active management of health care choices and expenses. They were seen as a way to contain the growth of health costs while improving members’ health.
  • M-CARE now offers health plans for more than 1,500 employer groups and almost 200,000 members — including more than 60,000 University of Michigan employees, retirees, graduate students and their dependents or survivors. It is one of the only University-owned health plans in the nation that is also open to employers and individuals in the community. More than 5,100 health care providers and nearly 30 hospitals, including all of the UMHS, are part of the M-CARE provider network.

  • In addition to the HMO plan that it began with, M-CARE now offers Point of Service, Preferred-Provider Organization, and Health Savings Account plans, as well as a Medicare Select HMO that complements Medicare coverage. The HMO and POS plans serve the Michigan counties of Genesee, Livingston, Macomb, Oakland, Wayne, Washtenaw and parts of Ingham, Jackson, Lapeer, Monroe and St. Clair. The PPO plan is a product of the Michigan Health Insurance Co., a wholly owned for-profit subsidiary of M­CARE, and provides care through the PPOM network throughout southeast Michigan. The M-CARE HSA plan combines an M-CARE high-deductible HMO or PPO health plan with a health savings account offered through Mellon Financial Corp. that participants can use to pay for qualified medical expenses.
  • M-CARE serves the Medicaid population in Washtenaw, Livingston and part of Wayne counties through its M-CAID HMO, which is contracted by the Michigan Department of Community Health to provide administrative services and arrange for the provision of all M-CAID covered services. M-CARE also offers a plan under MIChild, Michigan’s health plan for pregnant women and children in working families who are not eligible for Medicaid.
  • M-CARE also runs the GradCare plan for U-M graduate students and dependents.

  • In recognition of the high-quality, high-value plans it provides, M-CARE has received an excellent rating from the National Committee on Quality Assurance for six years in a row, based in part on its high marks on the Health Plan Employer Data and Information Set.
  • On surveys of quality and customer service, M-CARE exceeded the national average or has a top 10 percent national rating in many categories, including overall ratings by members and customer service. U.S. News & World Report magazine has rated M-CARE’s M-CAID Medicaid plan as one of the top 25 in the nation.
  • Because of its relationship to the University and its Health System, M-CARE has been able to use evidence-based treatment guidelines developed by U-M physicians and to offer its members access to one of the nation’s top medical centers, as well as to community physicians and hospitals in the state. It has also worked with U-M researchers to foster studies of health care delivery and quality that can be used to find new ways to improve health care.
  • Some of the more innovative programs and services offered by M-CARE include several free disease-management programs that help members with chronic diseases get intensive guidance on staying healthy and preventing complications; a Web-based portal for members and providers called M-CARE Connect; and a new Open Access option that allows members to see any provider outside the M-CARE network for an additional out-of-pocket cost.
  • M-CARE has approximately 400 employees, all of whom are employed by U-M and located at the headquarters in Ann Arbor or in a satellite office in Southfield.

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