Civic Intelligence

Preferredone Community Health Plan

990 • Fiscal year 2015 • EIN 41-1796007

Jan 01, 2015 to Dec 31, 2015 • Filed on Oct 24, 2016

6105 Golden Hills DriveGolden Valley, MN 55416

(763) 847-3204

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

75th percentile

0.57x

Higher debt load relative to assets than 75% of similar nonprofits.

2015 filings • 501(c)4 • $25M-$50M nonprofits • Source year 2015

Liabilities / Revenue

31st percentile

0.17x

Higher debt load relative to revenue than 31% of similar nonprofits.

2015 filings • 501(c)4 • $25M-$50M nonprofits • Source year 2015

Net Margin

23rd percentile

-3.4%

Higher net margin than 23% of similar nonprofits.

2015 filings • 501(c)4 • $25M-$50M nonprofits • Source year 2015

Top Officer Pay

98th percentile

$1,985,283

Higher top officer pay than 98% of similar nonprofits.

Top officer pay equals 7.2% of source-year revenue.

2015 filings • $25M-$50M nonprofits • Source year 2015

Asset Growth

2nd percentile

-33%

Faster asset growth than 2% of similar nonprofits.

2015 filings • $25M-$50M nonprofits • Annualized from 2014 to 2015

Revenue Growth

6th percentile

-52%

Faster revenue growth than 6% of similar nonprofits.

2015 filings • $25M-$50M nonprofits • Annualized from 2014 to 2015

Assets

Down

$7,973,848

Down $3,972,149 (-33%) from 2014

Net Assets

Down

$3,400,048

Down $1,553,627 (-31%) from 2014

Liabilities

Down

$4,573,800

Down $2,418,522 (-35%) from 2014

Revenue

Down

$27,684,469

Down $29,974,301 (-52%) from 2014

Expenses

Down

$28,619,455

Down $31,887,875 (-53%) from 2014

Net Income

Up

-$934,986

Up $1,913,574 (+67%) from 2014

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$40M$30M$20M$10M$0Assets 2010: $30,772,746Liabilities 2010: $18,557,275Net Assets 2010: $12,215,4712010Assets 2011: $22,484,115Liabilities 2011: $11,537,652Net Assets 2011: $10,946,4632011Assets 2012: $19,501,887Liabilities 2012: $9,021,748Net Assets 2012: $10,480,1392012Assets 2013: $14,751,956Liabilities 2013: $6,966,615Net Assets 2013: $7,785,3412013Assets 2014: $11,945,997Liabilities 2014: $6,992,322Net Assets 2014: $4,953,6752014Assets 2015: $7,973,848Liabilities 2015: $4,573,800Net Assets 2015: $3,400,0482015Assets 2016: $4,860,454Liabilities 2016: $1,259,795Net Assets 2016: $3,600,6592016Assets 2017: $3,824,320Liabilities 2017: $2,325,426Net Assets 2017: $1,498,8942017Assets 2018: $3,517,621Liabilities 2018: $2,328,165Net Assets 2018: $1,189,4562018Assets 2019: $3,420,023Liabilities 2019: $1,935,760Net Assets 2019: $1,484,2632019Assets 2020: $3,784,365Liabilities 2020: $1,835,347Net Assets 2020: $1,949,0182020Assets 2021: $2,826,703Liabilities 2021: $1,584,951Net Assets 2021: $1,241,7522021Assets 2022: $2,579,868Liabilities 2022: $1,478,433Net Assets 2022: $1,101,4352022Assets 2023: $2,802,952Liabilities 2023: $0Net Assets 2023: $2,802,9522023Assets 2024: $2,880,581Liabilities 2024: $21,496Net Assets 2024: $2,859,0852024

Highlighted filing

2015

Assets$7,973,848
Liabilities$4,573,800
Net Assets$3,400,048

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$150M$100M$50M$0-$50MExpenses 2010: $140,111,5412010Expenses 2011: $104,517,4192011Expenses 2012: $64,957,1092012Revenue 2013: $60,421,353Expenses 2013: $63,083,152Net Income 2013: -$2,661,7992013Revenue 2014: $57,658,770Expenses 2014: $60,507,330Net Income 2014: -$2,848,5602014Revenue 2015: $27,684,469Expenses 2015: $28,619,455Net Income 2015: -$934,9862015Revenue 2016: $10,787,096Expenses 2016: $10,665,700Net Income 2016: $121,3962016Revenue 2017: $3,754,474Expenses 2017: $4,296,909Net Income 2017: -$542,4352017Revenue 2018: $2,784,797Expenses 2018: $3,059,141Net Income 2018: -$274,3442018Revenue 2019: $2,494,368Expenses 2019: $2,250,300Net Income 2019: $244,0682019Revenue 2020: $2,161,138Expenses 2020: $1,732,957Net Income 2020: $428,1812020Revenue 2021: $1,188,255Expenses 2021: $1,850,335Net Income 2021: -$662,0802021Revenue 2022: $20,471Expenses 2022: $78,912Net Income 2022: -$58,4412022Revenue 2023: $27,728Expenses 2023: $6,329Net Income 2023: $21,3992023Revenue 2024: $86,170Expenses 2024: $52,937Net Income 2024: $33,2332024

Highlighted filing

2015

Revenue$27,684,469
Expenses$28,619,455
Net Income-$934,986
Jump To
Filing Snapshot
Filing Period
Jan 1, 2015 to Dec 31, 2015
Signed
Oct 24, 2016
Return Version
2015v2.1
Gross Receipts
$35,772,410
Mission and Program Overview

Mission

The mission of preferredone community health plan (pchp) is to make available to the residents of the state of minnesota comprehensive health maintenance services that are accessible, acceptable, and delivered in a manner congruent with the economic and social needs of the community. The health plan will advocate for improvements in the delivery, quality and coverage of health care services and pursue health care programs to meet community needs.

See schedule o for organization mission statement.

Balance Sheet Detail
LineBeginningEndChange
Assets
Investments Other Securities$9,719,987$5,013,087▼ $4,706,900
Accounts Receivable$1,533,727$2,648,222▲ $1,114,495
Cash and Non-Interest-Bearing Accounts$363,870$200,702▼ $163,168
Savings and Temporary Cash Investments$143,809$67,973▼ $75,836
Prepaid Expenses and Deferred Charges$24,727$10,424▼ $14,303
Total Assets$11,945,997$7,973,848▼ $3,972,149
Other Assets Total$159,877$33,440▼ $126,437
Liabilities
Other Liabilities$4,733,828$3,529,082▼ $1,204,746
Accounts Payable and Accrued Expenses$1,585,662$729,595▼ $856,067
Deferred Revenue$672,832$315,123▼ $357,709
Total Liabilities$6,992,322$4,573,800▼ $2,418,522
Net Assets / Fund Balance
Unrestricted Net Assets$4,953,675$3,400,048▼ $1,553,627
Total Net Assets Fund Balance$4,953,675$3,400,048▼ $1,553,627
Total Liabilities and Net Assets / Fund Balance$11,945,997$7,973,848▼ $3,972,149

Asset Categories

AssetBook ValueDepreciationBasis
Other Securities$992,251--
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseOtherTotal
Paul D GeiwitzExec VP/chief Marketing OfficerPT$60,073$25,659$85,732
Michael S UmlandTreasurerPT$40,059$21,918$61,977
Howard R EpsteinExec VP/chief Medical Officer-$49,836$9,400$59,236
Robert J GadolaVP Operations/hipaa Privacy Officer-$33,534$21,138$54,672
Darcee a WeberVP, Network ManagementPT$33,792$20,645$54,437
Debra Jr ShoemakerSecretaryPT$32,714$20,700$53,414
John M HofflanderSr VP, Is & CIO and Security Officer-$31,619$20,989$52,608
Joseph M PupkesVP, Uw & Product DevelopmentPT$29,397$18,642$48,039
Mary MillerVP Integrated Healthcare ServicesPT$25,632$17,575$43,207
Renee M AmbrosiaVP, Account ManagementPT$21,728$15,561$37,289
Patricia L RissingerVP, Business Systems-$22,490$14,195$36,685
David P CrosbyPresidentPT$20,670$8,797$29,467
Ann M NowakChair-$4,200-$4,200
Meghann a CharboneauVice Chair-$2,450-$2,450
Sara J KennarDirector-$1,400-$1,400
Andrea R SamuelsonDirector-$1,050-$1,050

Board Members and Trustees

NameTitle
Daniel M FrommDirector
Donald L DeyeDirector
Patrick B Herson MdDirector
Steven E Prawer MdDirector
Tiffany H ZitzewitzDirector
Todd R OstendorfDirector
John P Frederick MdFormer Key Employee
Marcus a MerzFormer Officer
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$27,050,944
Investment Income
$633,525
Other Revenue
$0
Change in Net Assets
$-934,986

Audited Revenue Reconciliation

Revenue per Audited Statements
$27,682,433
Revenue Not Reported on Financial Statements
$2,036
Revenue Not Reported on Form 990
$-613,302
Other Revenue Adjustments
$2,036
Total Revenue per Audited Statements
$27,069,131
Total Revenue per Form 990
$27,684,469
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$28,212,549
Salaries, Compensation, and Employee Benefits$406,906
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Fees for Services Other$9,008,966$145,363-$9,154,329
Fees for Services Management-$951,704-$951,704
Other Expenses$2,811,154$762,148-$762,148
All Other Expenses-$734,939-$734,939
Current Officers, Directors, Trustees, and Key Employees-$406,906-$406,906
Fees for Services Accounting-$45,255-$45,255
Fees for Service Investment Mgmnt Fees-$40,722-$40,722
Insurance-$35,151-$35,151
Total Functional Expenses$25,497,267$3,122,188$0$28,619,455

Audited Expense Reconciliation

Line ItemAmount
Total Expenses per Form 990$28,619,455
Expenses per Audited Statements$28,578,733
Total Expenses per Audited Statements$28,576,697
Expenses Not Reported on Financial Statements$40,722
Other Expense Adjustments$40,722
Expenses Not Reported on Form 990$-2,036
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Subject to proxy tax
No
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Claims Payable$3,451,476
Due to Affiliates$56,965
Due to Providers$20,641
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
No
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, Line 6

Members consist of the participants on the board of directors. The board of directors consists of: contributing members, composed of employees of provider owners that have contributed capital to preferredone community health plan; non-contributing members, composed of individuals of preferredone physicians association, which are practicing physicians; and enrollee directors, which are employees of employer groups that have purchased health insurance coverage or health administrative services through pchp or its affiliates.

Form 990, Part VI, Section A, Line 7A

Members consist of the participants on the board of directors. The board of directors consists of: contributing members, composed of employees of provider owners that have contributed capital to preferredone community health plan; non-contributing members, composed of individuals of preferredone physicians association, which are practicing physicians; and enrollee directors, which are employees of employer groups that have purchased health insurance coverage or health administrative services through pchp or its affiliates. The two contributing members appoint (and fill vacancies of) up to 4 directors respectively. The non-contributing member may appoint (and fill vacancies of) up to 2 directors. Vacancies that arise with respect to enrollee directors are filled by majority vote of other enrollee directors for the remainder of the unexpired term.

Form 990, Part VI, Section B, Line 11

The manager of accounting completes form 990. The director of accounting, cfo, and board review form 990 prior to filing with the irs.

Form 990, Part VI, Section B, Line 12C

Annually board of directors update conflict of interest statements.

Form 990, Part VI, Section B, Line 15

Preferredone administrative services (pas), the common paymaster of pchp, has a compensation committee consisting of the ceo and members of the board of directors of pas that meet annually to review compensation of pchp officers. Every three years this compensation review process involves an outside compensation consultant that conducts industry comparison analysis and other compensation comparisons.

Form 990, Part VI, Section C, Line 19

Financial statements, conflict of interest policy and governing documents are available upon request for the same period of disclosure as set forth in section 6104(d). Annual statutory filings are available on the state of mn website. Tri-annual audits by the mn department of commerce are also available.

Form 990, Part VII, Columns (D) and (E)

The compensation reported in part vii, columns (d) and (e) equals the total reportable compensation, as reported on form w-2/1099-misc. Preferredone administrative services (pas), the common paymaster of pchp, pays all compensation and forms w-2/1099-misc are issued from pas. The compensation reported in part vii, column (d), reportable compensation from the organization (w-2/1099-misc), is the portion of compensation allocated to pchp.

Filing and Contact Details

Filer

Filer Name
Preferredone Community Health Plan
EIN
41-1796007
Phone
7638473204
Address
6105 GOLDEN HILLS DRIVE, GOLDEN VALLEY, MN 55416

Signing Officer

Name
Michael Umland
Title
Treasurer
Phone
7638473204
Signed
2016-10-24
Discuss with paid preparer
Yes

Organization Details

Principal Officer
David Crosby
Formed
1994
Legal Domicile
Mn
Voting Board Members
9
Independent Board Members
9
Employees
0
Volunteers
0

Preparer

Firm
Rsm US Llp
Address
801 NICOLLET MALL SUITE 1100, MINNEAPOLIS, MN 55402
Preparer
Todd a Jackson
Phone
6123324300
Supplemental Narrative

Additional Explanations

Form 990, Part IX, Line 11G

Professional medical services: program service expenses 9,008,966. Management and general expenses 0. Fundraising expenses 0. Total expenses 9,008,966. Admin fees & other purchased services: program service expenses 0. Management and general expenses 28,639. Fundraising expenses 0. Total expenses 28,639. Other fees: program service expenses 0. Management and general expenses 88,895. Fundraising expenses 0. Total expenses 88,895. Bank service fees: program service expenses 0. Management and general expenses 27,829. Fundraising expenses 0. Total expenses 27,829.

Form 990, Part I, Line 1

The mission of preferredone community health plan (pchp) is to make available to the residents of the state of minnesota comprehensive health maintenance services that are accessible, acceptable, and delivered in a manner congruent with the economic and social needs of the community. The health plan will advocate for improvements in the delivery, quality and coverage of health care services and pursue health care programs to meet community needs.

Form 990, Part III, Line 1

Our accreditation status was awarded after rigorous evaluation by ncqa of all aspects of our plan, including preventive health services, member satisfaction, physician credentialing and quality improvement.

Financial Statement Notes

PART X, LINE 2:

Pchp has reviewed its tax positions for all open tax years and has concluded that the adoption of fin 48 did not affect its financial statement presentation. Pchp is no longer subject to income tax examinations for years before calendar year 2012.

PART XI, LINE 2D - OTHER ADJUSTMENTS:

Investment expenses reclassed to expense -40,722.

PART XI, LINE 4B - OTHER ADJUSTMENTS:

Recovery of bad debts - reclassed from functional expense 2,036.

PART XII, LINE 2D - OTHER ADJUSTMENTS:

Recovery of bad debts - reclassed to stmt of revenue -2,036.

PART XII, LINE 4B - OTHER ADJUSTMENTS:

Investment expenses reclassed to expense 40,722.

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IRS990/Desc0PREFERREDONE COMMUNITY HEALTH PLAN MISSION - THE MISSION OF THE QUALITY MANAGEMENT (QM) PROGRAM IS TO IDENTIFY AND ACT ON OPPORTUNITIES THAT IMPROVE THE QUALITY, SAFETY AND VALUE OF CARE AND SERVICE PROVIDED TO PREFERREDONE MEMBERS; WORKING BOTH INDEPENDENTLY AND COLLABORATIVELY WITH CONTRACTED PRACTITIONERS AND COMMUNITY EFFORTS. AS PART OF THE ORGANIZATION'S MISSION, PREFERREDONE WILL ADVOCATE FOR IMPROVEMENTS IN THE DELIVERY, QUALITY AND COVERAGE OF HEALTH CARE SERVICES AND PURSUE HEALTH CARE PROGRAMS TO MEET COMMUNITY NEEDS.IN 2015, PREFERREDONE COMMUNITY HEALTH PLAN MAINTAINED AN ACCREDITATION STATUS OF COMMENDABLE FROM THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA), A PRIVATE, NONPROFIT ORGANIZATION THAT EVALUATES AND REPORTS ON HEALTH CARE QUALITY. NCQA ACCREDITATION RECOGNIZES THE COMMITMENT OF OUR ORGANIZATION TO PROVIDE QUALITY HEALTH CARE TO OUR MEMBERS AND DEMONSTRATES THAT WE HAVE INCORPORATED QUALITY IMPROVEMENTS INTO THE FABRIC OF OUR BUSINESS. OUR ACCREDITATION STATUS WAS AWARDED AFTER RIGOROUS EVALUATION BY NCQA OF ALL ASPECTS OF OUR PLAN, INCLUDING PREVENTIVE HEALTH SERVICES, MEMBER SATISFACTION, PHYSICIAN CREDENTIALING AND QUALITY IMPROVEMENT.
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IRS990/Form990PartVIISectionAGrp/PersonNm1MEGHANN A CHARBONEAU
IRS990/Form990PartVIISectionAGrp/PersonNm2PATRICK B HERSON MD
IRS990/Form990PartVIISectionAGrp/PersonNm3DONALD L DEYE
IRS990/Form990PartVIISectionAGrp/PersonNm4DANIEL M FROMM
IRS990/Form990PartVIISectionAGrp/PersonNm5TIFFANY H ZITZEWITZ
IRS990/Form990PartVIISectionAGrp/PersonNm6STEVEN E PRAWER MD
IRS990/Form990PartVIISectionAGrp/PersonNm7ANDREA R SAMUELSON
IRS990/Form990PartVIISectionAGrp/PersonNm8TODD R OSTENDORF
IRS990/Form990PartVIISectionAGrp/PersonNm9SARA J KENNAR
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IRS990/Form990PartVIISectionAGrp/PersonNm11MICHAEL S UMLAND
IRS990/Form990PartVIISectionAGrp/PersonNm12DEBRA JR SHOEMAKER
IRS990/Form990PartVIISectionAGrp/PersonNm13JOHN M HOFFLANDER
IRS990/Form990PartVIISectionAGrp/PersonNm14ROBERT J GADOLA
IRS990/Form990PartVIISectionAGrp/PersonNm15HOWARD R EPSTEIN
IRS990/Form990PartVIISectionAGrp/PersonNm16PAUL D GEIWITZ
IRS990/Form990PartVIISectionAGrp/PersonNm17DARCEE A WEBER
IRS990/Form990PartVIISectionAGrp/PersonNm18JOSEPH M PUPKES
IRS990/Form990PartVIISectionAGrp/PersonNm19RENEE M AMBROSIA
IRS990/Form990PartVIISectionAGrp/PersonNm20PATRICIA L RISSINGER
IRS990/Form990PartVIISectionAGrp/PersonNm21MARY MILLER
IRS990/Form990PartVIISectionAGrp/PersonNm22MARCUS A MERZ
IRS990/Form990PartVIISectionAGrp/PersonNm23JOHN P FREDERICK MD
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IRS990/Form990PartVIISectionAGrp/TitleTxt0CHAIR
IRS990/Form990PartVIISectionAGrp/TitleTxt1VICE CHAIR
IRS990/Form990PartVIISectionAGrp/TitleTxt2DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt3DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt4DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt5DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt6DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt7DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt8DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt9DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt10PRESIDENT
IRS990/Form990PartVIISectionAGrp/TitleTxt11TREASURER
IRS990/Form990PartVIISectionAGrp/TitleTxt12SECRETARY
IRS990/Form990PartVIISectionAGrp/TitleTxt13SR VP, IS & CIO AND SECURITY OFFICER
IRS990/Form990PartVIISectionAGrp/TitleTxt14VP OPERATIONS/HIPAA PRIVACY OFFICER
IRS990/Form990PartVIISectionAGrp/TitleTxt15EXEC VP/CHIEF MEDICAL OFFICER
IRS990/Form990PartVIISectionAGrp/TitleTxt16EXEC VP/CHIEF MARKETING OFFICER
IRS990/Form990PartVIISectionAGrp/TitleTxt17VP, NETWORK MANAGEMENT
IRS990/Form990PartVIISectionAGrp/TitleTxt18VP, UW & PRODUCT DEVELOPMENT
IRS990/Form990PartVIISectionAGrp/TitleTxt19VP, ACCOUNT MANAGEMENT
IRS990/Form990PartVIISectionAGrp/TitleTxt20VP, BUSINESS SYSTEMS
IRS990/Form990PartVIISectionAGrp/TitleTxt21VP INTEGRATED HEALTHCARE SERVICES
IRS990/Form990PartVIISectionAGrp/TitleTxt22FORMER OFFICER
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IRS990/MissionDesc0THE MISSION OF PREFERREDONE COMMUNITY HEALTH PLAN (PCHP) IS TO MAKE AVAILABLE TO THE RESIDENTS OF THE STATE OF MINNESOTA COMPREHENSIVE HEALTH MAINTENANCE SERVICES THAT ARE ACCESSIBLE, ACCEPTABLE, AND DELIVERED IN A MANNER CONGRUENT WITH THE ECONOMIC AND SOCIAL NEEDS OF THE COMMUNITY. THE HEALTH PLAN WILL ADVOCATE FOR IMPROVEMENTS IN THE DELIVERY, QUALITY AND COVERAGE OF HEALTH CARE SERVICES AND PURSUE HEALTH CARE PROGRAMS TO MEET COMMUNITY NEEDS.
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IRS990/ProgSrvcAccomActy2Grp/Desc0PARTICIPATION IN COLLABORATIVE AND COMMUNITY PROJECTSPREFERREDONE TAKES PRIDE IN BEING DIRECTLY INVOLVED IN COMMUNITY ACTIVITIES THAT IMPACT OUR MEMBERS IN THE COMMUNITIES THEY LIVE AND WORK. IN AN EFFORT TO CREATE CONSISTENCY AMONG PROVIDER NETWORKS IN OUR COMMUNITY AND IMPROVE THE DELIVERY OF HEALTH CARE TO OUR MEMBERS PREFERREDONE PARTICIPATES IN SEVERAL COLLABORATIVE ACTIVITIES:1) MINNESOTA COMMUNITY MEASUREMENT (MNCM) IS A COLLABORATION AMONG HEALTH PLANS AND PROVIDER GROUPS DESIGNED TO IMPROVE THE QUALITY OF MEDICAL CARE IN MINNESOTA. MNCM IMPROVES CARE BY:- REPORTING THE RESULTS OF HEALTH CARE QUALITY PERFORMANCE AND IMPROVEMENT EFFORTS IN A FAIR, TRANSPARENT AND RELIABLE WAY TO MEDICAL GROUPS, REGULATORS, PURCHASERS AND CONSUMERS.- PROVIDING RESOURCES TO PROVIDERS AND CONSUMERS TO IMPROVE CARE.- INCREASING THE EFFICIENCIES OF HEALTH CARE REPORTING IN ORDER TO USE OUR HEALTH CARE DOLLARS WISELY.PREFERREDONE IS ONE OF SEVEN HEALTH PLAN FOUNDING MEMBERS OF MNCM. THE STATE MEDICAL ASSOCIATION, PARTICIPATING MEDICAL GROUPS, CONSUMERS, BUSINESSES AND HEALTH PLANS ARE ALL REPRESENTED ON THE ORGANIZATION'S BOARD OF DIRECTORS. DATA IS SUPPLIED BY PARTICIPATING HEALTH PLANS ON AN ANNUAL BASIS FOR USE IN DEVELOPING THEIR ANNUAL HEALTH CARE QUALITY REPORT.2) MINNESOTA COUNCIL OF HEALTH PLANS (MCHP) IS A NON-PROFIT TRADE ASSOCIATION REPRESENTING MINNESOTA HEALTH PLAN ORGANIZATIONS. THE COUNCIL PROMOTES THE DELIVERY OF HIGH-QUALITY, AFFORDABLE HEALTH CARE. HEALTH PLAN MEMBERS ARE ACTIVE IN THE AREAS OF HEALTH CARE REFORM, RESEARCH-BASED GUIDELINE DEVELOPMENT, COMMUNITY HEALTH AND PREVENTION, MEDICAL TECHNOLOGY ASSESSMENT AND HEALTH CARE QUALITY DATA COLLECTION.PREFERREDONE EXECUTIVES AND STAFF MEMBERS SERVE ON VARIOUS COMMITTEES THROUGH THE MCHP INCLUDING THE BOARD OF DIRECTORS, COMMUNITY HEALTH, COMMUNICATIONS, HEALTH POLICY, QUALITY AND MEDICAL ISSUES.3) BRIDGES TO EXCELLENCE IS A COLLABORATION OF HEALTH PLANS, PROVIDERS AND EMPLOYERS COMMITTED TO IDENTIFYING AND REWARDING HIGH QUALITY HEALTHCARE PROVIDERS. SEVERAL PREFERREDONE STAFF, INCLUDING THE CMO, ARE ACTIVELY INVOLVED IN THIS COMMUNITY COLLABORATION.
IRS990/ProgSrvcAccomActy3Grp/Desc0ORGANIZATIONAL SUPPORT FOR EMPLOYEE VOLUNTEER EVENTSPREFERREDONE SUPPORTS COMMUNITY INVOLVEMENT THROUGHOUT THE ORGANIZATION. EVENTS ARE EMPLOYEE-DRIVEN, WITH THE ORGANIZATION ENABLING OR PROVIDING EMPLOYEE TIME AND/OR FINANCIAL SUPPORT TO ENCOURAGE VOLUNTEERISM. EXAMPLES INCLUDE:- ADOPT-A-FAMILY (PREFERREDONE EMPLOYEES SPONSOR FAMILIES DURING THE HOLIDAY SEASON)- UNITED WAY- ON-SITE BLOOD DRIVES- ADOPT-A-SCHOOL (SCHOOL SUPPLY DRIVE TO SUPPORT ALICE SMITH ELEMENTARY SCHOOL)- TOYS FOR TOTS
IRS990/ProgSrvcAccomActyOtherGrp/Desc0OTHER CONDITION-SPECIFIC EDUCATION AND SUPPORT PROGRAMS:ACCORDANT - PREFERREDONE HAS A DELEGATION AGREEMENT IN PLACE WITH ACCORDANT HEALTH SERVICES TO OFFER DISEASE MANAGEMENT SERVICES DESIGNED TO IMPROVE MEMBER OUTCOMES AND REDUCE COSTS. ACCORDANTCARE FOCUSES ON PROVIDING DISEASE AND CASE MANAGEMENT SERVICES TO MEMBERS WHO SUFFER FROM CHRONIC, PROGRESSIVE CONDITIONS INCLUDING:- PARKINSON'S DISEASE- LUPUS- MYASTHENIA GRAVIS- SICKLE CELL DISEASE- CYSTIC FIBROSIS- GAUCHER DISEASE- HEMOPHILIA- SCLERODERMA- POLYMYOSITIS- CIPD- ALS- DERMATOMYOSITISACCORDANT HAS A UNIQUE PATIENT CARE MODEL THAT MINIMIZES THE OCCURRENCE OF COSTLY MEDICAL EVENTS AND CAN ACHIEVE REDUCTIONS IN HOSPITAL, HOME HEALTH, SPECIALTY PHARMACY AND PHYSICIAN VISIT COSTS. THE PREVALENCE RATE FOR THESE DISEASES OVERALL IS APPROXIMATELY 0.09%. IN 2015 THERE WERE 47 MEMBERS ENROLLED IN ACCORDANT'S DISEASE MANAGEMENT PROGRAMS.CHRONIC ILLNESS MANAGEMENT - PREFERREDONE HAS IMPLEMENTED A CHRONIC ILLNESS MANAGEMENT PROGRAM AVAILABLE TO MEMBERS WHO ARE DIAGNOSED WITH ANY OF THE FOLLOWING CHRONIC CONDITIONS:- DIABETES - CORONARY HEART DISEASE - CONGESTIVE HEART FAILURE- CHRONIC OBSTRUCTIVE PULMONARY DISEASE- ASTHMA (ADULT AND JUVENILE)- ULCERATIVE COLITIS- CROHN'S DISEASE- RHEUMATOID ARTHRITIS- MULTIPLE SCLEROSISTHE GOALS OF THE CHRONIC ILLNESS MANAGEMENT PROGRAM ARE TO PROMOTE SELF-MANAGEMENT OF CHRONIC CONDITIONS, IMPROVE ADHERENCE TO TREATMENT PLANS WITH AN EMPHASIS ON MEDICATION THERAPY, REDUCE OR DELAY DISEASE PROGRESSION AND COMPLICATIONS, REDUCE HOSPITALIZATIONS AND EMERGENCY ROOM VISITS AND IMPROVE QUALITY OF LIFE.IN 2015 THE CHRONIC ILLNESS MANAGEMENT PROGRAM (CIM) IDENTIFIED OVER 11,700 MEMBERS WHO COULD BENEFIT FROM DISEASE MANAGEMENT SERVICES. OF THESE, 4,627 PARTICIPATED IN THE PROGRAM. THE CONDITIONS THEY WERE TRIGGERED FOR CONSIST OF ASTHMA (18%), CORONARY ARTERY DISEASE (6%), CONGESTIVE HEART FAILURE (8%), CHRONIC OBSTRUCTIVE PULMONARY DISEASE (5%), AND DIABETES (64%). THERE WERE 2,163 MEMBERS WHO WERE ADHERENT WITH THEIR TREATMENT PLAN AND DID NOT TRIGGER CARE OPPORTUNITIES SUCH AS THE NEED FOR LAB WORK OR A PHYSICIAN VISIT. OF MEMBERS IDENTIFIED, 2,544 WORKED ACTIVELY WITH A NURSE TO ESTABLISH GOALS AND IMPROVE THEIR HEALTH.TREATMENT DECISION SUPPORT - TREATMENT DECISION SUPPORT (TDS) TARGETS TWO SPECIFIC CONDITIONS (LOW BACK PAIN AND PREGNANCY) THAT HAVE BEEN IDENTIFIED BASED ON THEIR PREVALENCE AND COST PER EPISODE. THE PROGRAM ENCOURAGES MEMBERS TO ACTIVELY ENGAGE WITH THEIR PROVIDERS IN TREATMENT DECISIONS BY EDUCATING THEM ABOUT THEIR MEDICAL CONDITIONS, POSSIBLE TREATMENT OPTIONS, AND THE CLINICAL AND COST RAMIFICATIONS OF VARIOUS OPTIONS WITH THE GOAL OF HELPING THEM MAKE INFORMED DECISIONS THAT ALIGN WITH THEIR INDIVIDUAL PREFERENCES AND VALUES. SPECIALIZED NURSES TRAINED IN SHARED DECISION MAKING PROVIDE EDUCATION AND RESOURCES. MEMBERS ARE IDENTIFIED FOR THE TREATMENT DECISION SUPPORT PROGRAM BY CLAIMS AND SELF REFERRAL. THE NURSES USE COMPREHENSIVE ASSESSMENT TOOLS, BEST PRACTICE GUIDELINES, AND DECISION MAKING TOOLS LIKE CHOOSING WISELY AND HEALTHWISE. THERE WERE 1,086 MEMBERS WHO WORKED WITH A NURSE IN THE HEALTHY MOM, HEALTHY BABY PROGRAM AND 221 MEMBERS WHO WORKED WITH A NURSE IN THE LOW BACK PAIN PROGRAM FOR A TOTAL OF 1,307 PARTICIPANTS IN THE TDS PROGRAM.QUIT FOR LIFE - PREFERREDONE CONTRACTS WITH OPTUM FOR ITS QUIT FOR LIFE TOBACCO CESSATION PROGRAMMING (FORMERLY ALERE/FREE & CLEAR). THIS PROGRAM USES INBOUND AND OUTBOUND TELEPHONE SUPPORT TO SYSTEMATICALLY MOVE PARTICIPANTS TOWARD A SUCCESSFUL QUIT. THE CORE COMPONENTS OF THE QUIT FOR LIFE PROGRAM INCLUDE:- INDIVIDUALIZED TELEPHONIC COUNSELING WITH A TOBACCO CESSATION SPECIALIST- PRINTED SELF-PACED MATERIALS (THE QUIT KIT)- EVALUATION AND DOSING RECOMMENDATIONS FOR NICOTINE REPLACEMENT THERAPY OR ZYBAN- OPTIONAL DIRECT MAIL-ORDER DELIVERY OF NICOTINE REPLACEMENT THERAPY- UNLIMITED USE OF A TOLL-FREE INBOUND SUPPORT LINEQUIT FOR LIFE IS A SYSTEMATIC AND SOLID SCIENTIFIC EVIDENCE BASED BE
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IRS990ScheduleD/OtherLiabilitiesOrgGrp/Desc2DUE TO PROVIDERS
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IRS990ScheduleD/OtherSecuritiesGrp/Desc0CORP DEBT SECURITIES
IRS990ScheduleD/OtherSecuritiesGrp/Desc1CERTIFICATE OF DEPOSITS

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Filings

Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024Facts available. Structured filing facts are available, but richer extracted sections are limited.$2.88$0.02$2.86$0.09$0.05$0.03
2023XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$2.80$0.00$2.80$0.03$0.01$0.02
2022Facts available. Structured filing facts are available, but richer extracted sections are limited.$2.58$1.48$1.10$0.02$0.08$0.06
2021XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$2.83$1.58$1.24$1.19$1.85$0.66
2020Facts available. Structured filing facts are available, but richer extracted sections are limited.$3.78$1.84$1.95$2.16$1.73$0.43
2019XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$3.42$1.94$1.48$2.49$2.25$0.24
2018XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$3.52$2.33$1.19$2.78$3.06$0.27
2017XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$3.82$2.33$1.50$3.75$4.30$0.54
2016XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$4.86$1.26$3.60$10.8$10.7$0.12
2015Detailed filing. Detailed filing data is available for this year.$7.97$4.57$3.40$27.7$28.6$0.93
2014Detailed filing. Detailed filing data is available for this year.$11.9$6.99$4.95$57.7$60.5$2.85
2013Detailed filing. Detailed filing data is available for this year.$14.8$6.97$7.79$60.4$63.1$2.66
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$19.5$9.02$10.5$65.0
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.$22.5$11.5$10.9$105
2010Facts available. Structured filing facts are available, but richer extracted sections are limited.$30.8$18.6$12.2$140