CHCN is widely recognized as a uniquely efficient model for community health centers to organize managed health care delivery. Owned and operated by our member community health centers, the Network shares resources for many managed care functions. For example, HMO contracting and utilization management are centrally conducted by CHCN.
CHCN currently holds full professional risk managed care contracts with three HMOs on behalf of our health centers. We provide managed care services to approximately 30,000 Medicaid patients. We also have expanded insurance coverage to 7,000 additional patients through the California Children’s Health Insurance Program (Healthy Families) and four other managed care insurance products specifically designed for previously uninsured individuals and families. In January 2008, CHCN added a Medicare Advantage Special Needs Plan for dual eligible MediCaid and Medicare beneficiaries to our portfolio of offered plans.
As a fully integrated managed care network, CHCN provides all managed care business functions: HMO contracting for our member health centers, primary care contracting, specialty care contracting, utilization management, membership reporting, quality improvement services, claims adjudication, capitation payment, centralized credentialing services, managed care information technology services, and financial data reporting.
For more information on our Insurance Plans, click here.
For more Information for our Providers, click here.