Chorus Community Health Plans Inc

TO PROVIDE ACCESS TO QUALITY HEALTH CARE AND SERVICES TO ITS MEMBERS IN WI.

CCHP'S PURPOSE IS TO PROMOTE ACCESS TO HEALTHCARE SERVICES FOR LOW-INCOME CHILDREN AND CERTAIN OTHER DISADVANTAGED RESIDENTS OF THE STATE OF WISCONSIN, AND TO PROMOTE OR SPONSOR PROGRAMS FURTHERING THE HEALTH OF ITS MEMBERS AND THE LARGER COMMUNITIES SERVED. CCHP IS AN HMO FOR WISCONSIN MEDICAID-ELIGIBLE INDIVIDUALS AND FAMILIES LIVING IN BROWN, CALUMET, DOOR, FOND DU LAC, FOREST, GREEN LAKE, JEFFERSON, KENOSHA, KEWAUNEE, LINCOLN, MANITOWOC, MARINETTE, MILWAUKEE, OCONTO, ONEIDA, OUTAGAMIE, OZAUKEE, RACINE, ROCK, SHAWANO, SHEBOYGAN, VILAS, WALWORTH, WASHINGTON, WAUKESHA, WAUPACA, WAUSHARA, AND WINNEBAGO COUNTIES IN WISCONSIN. THE MEDICAID ENROLLMENT AT THE END OF DECEMBER 2021 WAS 150,212 MEMBERS, AND THERE WERE 10,322 INPATIENT ADMISSIONS, 416,292 AMBULATORY ENCOUNTERS, AND 2,588 DELIVERIES IN 2021. THE PLAN ALLOWS MEMBERS TO CHOOSE FROM A LARGE NETWORK OF PROVIDERS, WHICH INCLUDED MORE THAN 9,500 PHYSICIANS, 10,600 NON PHYSICIANS, AND 78 HOSPITALS IN 2021. IN ADDITION, CCHP OFFERS HOME CARE, MEDICAL EQUIPMENT PROVIDERS AND THE CCHP NURSELINE FOR ITS MEMBERS.

CCHP SELLS INDIVIDUAL COMPREHENSIVE INSURANCE PLANS SUBJECT TO THE AFFORDABLE CARE ACT ON THE FEDERALLY FACILITATED MARKETPLACE AND OFF EXCHANGE, DIRECTLY TO CONSUMERS. THERE WERE 15,986 MEMBERS ENROLLED AT THE END OF DECEMBER 2021. APPROXIMATELY 77 PERCENT OF THE POLICY HOLDERS RECEIVED AN ADVANCE PREMIUM TAX CREDIT (APTC), AND THESE CREDITS ACCOUNTED FOR 65 PERCENT OF THE PREMIUM REVENUE FROM MEMBERS. ADDITIONALLY, APPROXIMATELY 38 PERCENT OF THE ENROLLMENT MONTHS WERE ON SILVER PLANS THAT QUALIFIED FOR COST SUBSIDY REIMBURSEMENT (CSR), ALTHOUGH CMS NO LONGER PAYS THE SUBSIDY.

CCHP RECORDED REVENUE AND EXPENSES FOR CHHS' FOSTER CARE MEDICAL HOME PROGRAM CALLED CARE4KIDS. CARE4KIDS IS A NON-RISK PREPAID INPATIENT HEALTH PLAN CONTRACT BETWEEN CHHS AND WISCONSIN MEDICAID THAT PROVIDES COMPREHENSIVE HEALTHCARE SERVICES FOR QUALIFYING FOSTER CHILDREN IN SOUTHEASTERN WISCONSIN. CCHP PROVIDES UTILIZATION MANAGEMENT AND A PROVIDER NETWORK, AND PROCESSES CLAIMS FOR THE PARTICIPANTS VIA A SUBCONTRACT AGREEMENT WITH CHHS. THERE WERE 2,900 FOSTER CHILDREN IN CARE4KIDS AT THE END OF DECEMBER 2021.