Scan Health Plan

“The sole member of the organization is scan group, a california nonprofit public benefit corporation.”

“The sole member has the power to appoint the members of the board of directors.”

“The form 990 is prepared by the accounting firm of deloitte tax, llp working in conjunction with scan's finance department. Scan health plan's director of accounting has direct responsibility for this effort, subject to supervision by the vice president and controller of scan health plan. After an initial draft of the form 990 is prepared, it is circulated for review and comment by relevant members of the executive team who have responsibility for and/or knowledge regarding the various matters disclosed and/or described in the form. The general counsel, in particular, reviews the form 990 and ensures accuracy of descriptions and that disclosure is complete. The draft form 990 is reviewed in pertinent part by the compensation committee of the board; the form 990 is provided in its entirety to the audit and compliance committees of the board of directors of scan group, and all members of the board of directors for review after it is prepared, and prior to filing.”

“Scan health plan regularly and consistently monitors and enforces compliance with its conflict of interest policy through annual circulation of a conflict of interest policy and disclosure questionnaire which all members of the board of directors, officers and members of executive management are required to complete and sign. In addition, there is annual mandatory compliance education and training and scan's compliance department is responsible for enforcement of scan's robust compliance program, including scan's code of conduct and compliance-related policies and procedures. Members of the executive team also have responsibility for enforcement. The legal department of scan group reviews all contractual relationships entered into by the organization and scan's general counsel is responsible for monitoring the conflict of interest questionnaire. The legal department of scan group monitors and enforces adherence to these policies on an ongoing basis.”

“The process for determining the compensation of the chief executive officer (ceo) of scan health plan is conducted by the compensation committee of the board of directors of scan group, all the voting members of which are independent persons. In determining the compensation of the ceo, the compensation committee works with and relies upon the counsel and expertise of an outside compensation consultant with well-established experience and expertise in the area of nonprofit health care organizations, executive compensation, and compliance with the intermediate sanctions requirements applicable to such compensation. The compensation consultant provides an executive compensation report to the compensation committee each year which furnishes the basis for determining the ceo's compensation package during the following year. The executive compensation report is based on a review of the executive compensation practices of a variety of organizations considered comparable to scan health plan based upon certain industry standard metrics. The compensation committee deliberates on the issue of the ceo's compensation package in consideration of the executive compensation report. Questions are asked of, and answered by the compensation consultant, regarding such report and other matters relevant to such package. Based on these deliberations, the compensation committee makes a recommendation to the board of directors of scan group regarding the compensation package for the ceo for the following year. The full board of directors of scan group deliberates and then votes on such recommendation; the ceo is recused for the entirety of such deliberations and vote. The minutes of the compensation committee and the board of directors for these meetings are prepared substantially contemporaneously and substantiate such deliberations and decisions. The outside compensation consultant providing the executive compensation report and guidance related to the 2018 salary package was sullivan cotter. The process for determining the compensation of the chief financial officer (cfo) of scan health plan follows the same process as described above for the ceo. The process for determining the compensation of officers and senior vice presidents of scan health plan and scan group is conducted by the human resources department of scan group and chief executive officer (ceo) of scan health plan, with the approval of the compensation committee of the board of directors of scan group. All of the voting members of the compensation committee are independent directors. In determining each employee's compensation, the human resources department and compensation committee work with and rely upon the counsel and expertise of an outside compensation consultant with well-established experience and expertise in the area of nonprofit health care organizations, executive compensation, and compliance with the intermediate sanctions requirements applicable to such compensation. The compensation consultant provides an executive compensation report to the human resources department each year which furnishes the basis for the determination of each employee's compensation package during the following year. The executive compensation report is based on a review of the executive compensation practices of a variety of organizations considered comparable to scan health plan based on various metrics. The chief executive officer (ceo) makes a recommendation to the compensation committee with respect to each employee's compensation package in light of the executive compensation report. At the compensation committee meeting addressing such matters, questions are asked of, and answered by, the compensation consultant, regarding their report and other matters relevant to the compensation package; pursuant to their deliberations, the compensation committee makes a decision regarding the compensation package for such employees for the following year. The minutes of the compensation committee for”

“Scan health plan's governing documents and conflict of interest policy are not made available to the public. Scan health plan's audited financial statements are publicly available through the department of managed health care's website and tax returns are available on request.”

“The health care services programs at scan are evidenced-based and aligned with geriatric best practices. They include but are not limited to, complex care management, advanced illness management, memory program, disease management, and care navigation and coordination. The programs are aligned with the institute for healthcare improvement's triple aim and seek to ensure: - a safe and satisfying health care experience - improved health outcomes for individuals and populations - access and affordability for our members in general, population based quality activities are performed by scan's health care services department, which includes a dedicated and highly qualified team of registered nurses and master's prepared social workers, supported by an interdisciplinary team of nurses, social workers, gerontologists, a board certified geriatrician, a behavioral health specialist, and a clinical pharmacist. Scan health plan supported the formation of the scan foundation in 2007 with a contribution of $205 million; for calendar year 2018 the scan foundation awarded grants in the amount of $5,564,600 and incurred program expenses in the amount of $2,902,709. In addition, scan health plan participates in numerous activities related to the care of seniors which provide significant community benefit, including but not limited to the following: 1. Change a life foundation (grant): one time grants to members and independence at home (iah) clients for needed services not otherwise available (ramps, refrigerators, extensive dental work, bathroom modifications, wheelchair ramps, chair lifts). 2. Connecting provider to home: scan staff work with medical groups to provide in home support through social worker and community health worker teams in order to enhance integration between the home and the physician. Serves members of other health plans as well as scan. Assesses the efficacy of a model that can be disseminated to multiple medical groups/health plans. 3. Council on aging: adopt-a-senior program: provides holiday gifts for older and/or disabled residents of care facilities in orange county. 4. Provider education: annually, scan offers four 1-hour training sessions for medical groups on compliance requirements to protect members from inappropriate denials and to assist the medical groups in improving their practices around service denials. 5. Coding quality training: scan builds and disseminates training materials to other health plans and medical groups to use as part of their internal program development. 6. Developed and disseminated educational podcasts: scan staff created, recorded and posted for the public informational podcasts on the following topics: falls, caregiving, and mental health. These are on the public facing platform called soundcloud. The goal of these podcasts is to bring education and resources to seniors and their caregivers to help them remain safe in the community. 7. Presentations at academic and policy conferences: scan leadership and designated staff prepare and make presentations at key policy and clinical conferences such as: snp alliance; ahip; american geriatrics society; and, california accountable physician groups (agpg capg); in order to improve care of older adults, educate professionals, and share best practices. 8. Pharmacy intern rotations: ucsf and other pharmacy schools rotate pharm d students through the scan pharmacy department for 6-16 weeks, where scan trains future pharmacists through engagement with pharmacy projects and case reviews. 9. Developed and hosted a quality symposium: onsite training and education for scan providers delivering information and best practices on topics impacting geriatric care. 10. Support california association of long term care medicine (caltcm) by providing ceo and board members educational programs: caltcm is an organization of professionals in the long term care field. The organization offers performance improvement education programs to improve the quality of car”

“In 2018, scan gave 41 grants in 9 counties, and supported 27 organizations through sponsorships. For the year ending december 31, 2018, independence at home incurred $13,647,995 in program expenses including grants of $892,588 paid to other non-profit organizations and received $3,367,909 in grants.”

“Medical services: program service expenses 2,425,942,432. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,425,942,432. Outside services consulting: program service expenses 14,264,531. Management and general expenses 14,134,510. Fundraising expenses 0. Total expenses 28,399,041.”