Independent Health Association Inc

PROVIDE HEALTH-RELATED PRODUCTS AND SERVICES THAT ENABLE AFFORDABLE ACCESS TO QUALITY HEALTH CARE.

INDEPENDENT HEALTH ASSOCIATION (IHA) COORDINATES THE DELIVERY OF QUALITY HEALTH CARE COVERAGE THROUGH CONTRACTS WITH THE INDIVIDUAL PRACTICE ASSOCIATION OF WESTERN NEW YORK (IPAWNY), A TAXABLE NON-PROFIT, FOR ITS COMMERCIAL AND MEDICARE HMO PRODUCTS WITHIN THE EIGHT COUNTIES OF WESTERN NEW YORK (WNY). IHA ALSO PROVIDES COVERAGE AND COORDINATES SERVICES TO ITS MEDICAID HMO PRODUCT (WHICH INCLUDES THE FAMILY HEALTH PLUS (FHP) PROGRAM AVAILABLE TO ELIGIBLE RESIDENTS OF ERIE COUNTY AND THE CHILD HEALTH PLUS (CHP) PROGRAM) FOR THE ARRANGEMENT OF PHYSICIAN, HOSPITAL, MEDICALLY NECESSARY HEALTH SERVICES, DIAGNOSTIC AND PREVENTIVE HEALTH SERVICES TO THE COMMUNITIES LOCATED IN ERIE AND NIAGARA COUNTY (SEE SCH O FOR ADDITIONAL DETAIL).HEADQUARTERED IN BUFFALO, INDEPENDENT HEALTH BEGAN OPERATIONS IN 1980 AND HAS CONSISTENTLY BEEN RATED AMONG THE TOP HEALTH PLANS IN THE COUNTRY FOR CUSTOMER SERVICE AND MEMBER SATISFACTION. INDEPENDENT HEALTH'S COMPREHENSIVE PORTFOLIO OF PROGRESSIVE PRODUCTS INCLUDE HMO, POS, PPO AND EPO PRODUCTS, MEDICARE AND MEDICAID PLANS, TRADITIONAL INDEMNITY INSURANCE, INDIVIDUAL AND SMALL GROUP EXCHANGE PRODUCTS, AND CONSUMER-DIRECTED PLANS, PLUS COVERAGE FOR SELF-FUNDED EMPLOYERS. INDEPENDENT HEALTH'S SUBSIDIARY COMPANIES INCLUDE PHARMACY BENEFIT DIMENSIONS, RELIANCE RX AND NOVA HEALTHCARE ADMINISTRATORS, INC., AND WNY COLLABORATIVE MANAGEMENT SERVICES, LLC.IHA OFFERS ITS MEMBERS HEALTH RISK MANAGEMENT TOOLS INCLUDING AN ONLINE HEALTH RISK ASSESSMENT TO GIVE THEM THE INFORMATION THEY NEED TO HELP CONTROL CURRENT AND PREVENT FUTURE PROBLEMS. PROGRAMS FOR COVERED EMPLOYEES, AS WELL AS FOR EMPLOYERS, HELP THEM MAKE GOOD HEALTH A PART OF THEIR CULTURE. IHA OFFERS A 24-HOUR MEDICAL HELP LINE WITH ACCESS TO A REGISTERED NURSE WHO HELPS MEMBERS EXPLORE TREATMENT OPTIONS, DISCUSS NEEDED HEALTH SCREENINGS AND HELP DETERMINE APPROPRIATE CARE. OTHER MEMBERSHIP SERVICES INCLUDE PREVENTIVE CARE WITH ACTIVE PARTICIPATION BY COMMUNITY ORGANIZATIONS IN INITIATIVES SUCH AS THE POPULATION HEALTH COLLABORATIVE OF WESTERN NEW YORK, A NOT-FOR-PROFIT DEDICATED TO IMPROVING THE HEALTH OF PEOPLE IN WESTERN NEW YORK. IT DEPENDS ON UNPRECEDENTED COLLABORATION AMONG KEY STAKEHOLDERS AND THE SECURE SHARING OF CLINICAL INFORMATION, AS WELL AS THE ADOPTION OF HEALTH INFORMATION TECHNOLOGY AND ELECTRONIC MEDICAL RECORDS, THROUGH ORGANIZATIONS SUCH AS HEALTHELINK.IN THE PAST, THE IHA HEALTH COACH PROGRAM OFFERED A BROAD RANGE OF SERVICES, INCLUDING EDUCATION AND CARE COORDINATION, TO IMPROVE THE HEALTH OF IHA MEMBERS AND EMPLOYEES. AS A CURRENT RESOURCE TO ENGAGE WITH MEMBERS AT ANY POINT IN THEIR DAY OR ANY STAGE OF HEALTH, BROOK DIGITAL HEALTH COMPANION IS AN AVAILABLE RESOURCE. BROOK IS AN INNOVATIVE COMPANY THAT HAS DEVELOPED A DIGITAL PERSONAL ASSISTANT TO HELP PEOPLE WITH CHRONIC CONDITIONS (THE FIRST CONDITION ADDRESSED WAS DIABETES), AS WELL AS PEOPLE LOOKING TO MAINTAIN THEIR GENERAL WELL-BEING, BETTER MANAGE THEIR HEALTH VIA THEIR SMARTPHONE. BROOK BLENDS INTELLIGENT, TECHNOLOGY-BASED RESPONSES WITH THE INTERACTION AND HUMAN TOUCH THAT CAN ONLY COME FROM COMPASSIONATE, UNDERSTANDING EXPERTS. IHA'S MEDICARE FAMILY CHOICE PLAN IS A MEDICARE ADVANTAGE SPECIAL NEEDS PLAN OFFERED IN NURSING FACILITIES IN WESTERN NEW YORK. FAMILY CHOICE OF NEW YORK IS A CARE MANAGEMENT COMPANY THAT WORKS IN PARTNERSHIP WITH AREA NURSING HOMES, PHYSICIANS AND HOSPITALS TO BRING ADDITIONAL CARE - INCLUDING ENHANCED HEALTH CARE AND SOCIAL SERVICES - TO THE PATIENTS WHO NEED SPECIALIZED MEDICAL AND NURSE MANAGEMENT. THE PROGRAM ACCOMPLISHES THIS BY ASSIGNING A NURSE PRACTITIONER WHO IS SPECIALLY TRAINED IN GERIATRICS TO NURSING HOME RESIDENTS. THE GOAL IS TO IMPROVE NOT ONLY THE MEMBER'S QUALITY OF CARE, BUT ALSO THEIR QUALITY OF LIFE. FAMILY CHOICE'S SPECIALLY TRAINED NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS ARE ON CALL 24 HOURS A DAY, SEVEN DAYS A WEEK TO PROVIDE CARE AND SUPPORT AS NEEDED. THEY WORK IN COLLABORATION WITH THE MEMBER'S PHYSICIANS AND THE NURSING FACILITY'S STAFF TO IDENTIFY POTENTIAL PROBLEMS BEFORE THEY BECOME SERIOUS AND MINIMIZE UNNECESSARY AND DISRUPTIVE EMERGENCY ROOM VISITS AND HOSPITAL STAYS WHENEVER IT'S SAFE AND APPROPRIATE.IHA ALSO OFFERS ASSURE ADVANTAGE HMO C-SNP. THIS IS A MEDICARE ADVANTAGE CHRONIC SPECIAL NEEDS PLAN SPECIFICALLY DEVELOPED FOR ELIGIBLE MEDICARE BENEFICIARIES WHO HAVE BEEN DIAGNOSED WITH BOTH DIABETES AND CHRONIC HEART FAILURE AND RESIDE IN ERIE COUNTY. THIS PLAN INCLUDES PROVIDERS WHO SPECIALIZE IN TREATING CHRONIC HEART FAILURE AND DIABETES. IT INCLUDES BENEFITS AND HEALTH PROGRAMS AND CARE COORDINATION SERVICES DESIGNED TO SERVE THE SPECIALIZED NEEDS OF PEOPLE WITH THESE CONDITIONS. IN ADDITION, ASSURE ADVANTAGE COVERS PRESCRIPTION DRUGS TO TREAT MOST MEDICAL CONDITIONS, INCLUDING THE DRUGS THAT ARE USUALLY USED TO TREAT CHRONIC HEART FAILURE AND DIABETES. PART OF THE AFFORDABLE CARE ACT AND MEDICAID REFORM EFFORTS, HEALTH HOMES ARE COMMUNITY NETWORKS OF PROVIDERS DESIGNATED BY THE STATE TO COORDINATE CARE AND SOCIAL NEEDS FOR MEDICAID MEMBERS WITH CHRONIC CONDITIONS, SUCH AS HIV/AIDS, SERIOUS MENTAL ILLNESS OR MULTIPLE CHRONIC HEALTH PROBLEMS. IHA ASSIGNS MEMBERS TO HEALTH HOMES AND SUPPORTS THESE NETWORKS ADMINISTRATIVELY, BILLING FOR SERVICES RENDERED AND REIMBURSING THEM. FOR FRAIL ELDERLY MEMBERS AND THEIR CAREGIVERS, THE CAREPARTNERS PROGRAM IS AVAILABLE AT NO ADDITIONAL COST. THIS HOME-BASED PROGRAM FACILITATES THE RIGHT CARE AND LIVING ENVIRONMENT AND IS DESIGNED TO PREVENT EMERGENCY ROOM VISITS AND HOSPITALIZATIONS. THROUGH HOME VISITS AND PHONE CALLS, REGISTERED NURSES AND SOCIAL WORKERS HELP COORDINATE CARE AND OFFER PSYCHO-SOCIAL SUPPORT, INCLUDING LINKING MEMBERS AND CAREGIVERS TO COMMUNITY AND FINANCIAL RESOURCES, ASSESSING THE SAFETY OF THE MEMBER AND HELPING COMPLETE ADVANCE DIRECTIVES IN ACCORDANCE WITH THE MEMBER'S WISHES. MEMBERS ALSO HAVE 24-HOUR ACCESS TO A REGISTERED NURSE THROUGH THIS PROGRAM.IHA OFFERS AN ADDITIONAL LEVEL OF SUPPORT AT NO COST TO MEMBERS FACING SERIOUS ILLNESS AND THEIR FAMILIES THROUGH OUR PALLIATIVE CARE PROGRAM. THE PALLIATIVE CARE TEAM, WHICH INCLUDES A REGISTERED NURSE, SOCIAL WORKER AND MEDICAL DIRECTOR, PARTNERS WITH THE MEMBER'S PHYSICIAN TO COORDINATE CARE AND REDUCE AVOIDABLE HOSPITAL VISITS AND ADMISSIONS. THE PALLIATIVE CARE PROFESSIONALS HAVE OPEN AND SUPPORTIVE DISCUSSIONS ABOUT TREATMENT CHOICES WITH THE MEMBER AND PROVIDE THE SAME OUTREACH AND SERVICES AS CAREPARTNERS WITH THE GOAL OF HELPING MEMBERS LIVE MORE COMFORTABLY BY MANAGING SYMPTOMS IN ACCORDANCE WITH THEIR HEALTH CARE WISHES TO PROVIDE A BETTER QUALITY OF LIFE. IN ADDITION, IHA DEVELOPS AND CONDUCTS EXTENSIVE COMMUNITY WELLNESS AND BENEFIT INITIATIVES THAT HELP MEMBERS LEAD HEALTHIER LIVES AND HELP EMPLOYERS CONTROL HEALTH CARE COSTS. THROUGH ITS PARTNERSHIP WITH JERICHO ROAD COMMUNITY HEALTH CENTER, IN 2019 THE INDEPENDENT HEALTH MEDICALLY ORIENTED GYM (MOG) AT JERICHO ROAD WAS CREATED TO PROVIDE PHYSICAL THERAPY AND EXERCISE PROGRAMMING FOR COMMUNITY MEMBERS, ESPECIALLY INDIVIDUALS SUFFERING FROM CHRONIC DISEASES LIKE DIABETES AND CARDIOVASCULAR DISEASE. DESIGNED TO FOCUS ON MEDICAL OUTCOMES IN ADDITION TO FITNESS, THE MOG IS LOCATED IN A ZIP CODE WITH SOME OF THE HIGHEST RATES OF DIABETES AND HIGH BLOOD PRESSURE IN THE REGION. IN EARLY 2021, INDEPENDENT HEALTH BEGAN A REFRESH OF ITS FIVE-YEAR STRATEGIC PLAN, ENTITLED IH2025: DESTINATION EXCELLENCE, TO HELP ENVISION WHAT THE FUTURE OF HEALTH CARE LOOKS LIKE AND THE CAPABILITIES THAT ARE NEEDED TO BE SUCCESSFUL. IH2025: DESTINATION EXCELLENCE WILL FOCUS ON SEVERAL AREAS INCLUDING ADVANCED CARE MODELS, THE ENHANCED DIGITAL EXPERIENCE FOR MEMBERS THROUGH REDSHIRT 2.0 AND OPERATIONAL EXCELLENCE. THE HOPE IS IH2025: DESTINATION EXCELLENCE WILL IMPROVE THE HEALTH OF OUR MEMBERS, STRENGTHEN OUR POSITION AS THE LEADING HEALTH PLAN IN OUR COMMUNITY AND EMPOWER ASSOCIATES TO CONTINUE PROVIDING THE BEST REDSHIRT EXPERIENCE FOR OUR MEMBERS.