What is managed care?
Health care costs traditionally have been paid by insurance companies based on "fee for service." That is, a physician or hospital based their charges on the costs of providing that service. Insurance companies, depending upon their contracts with employers, paid for most of those costs.
Managed care is an attempt to lower the price of health care services by managing the access to that care. A patient's access to services may be coordinated and managed by a primary care provider, such as a family practice physician, pediatrician or internist. These services are offered within a defined network of health care providers.
What is St. Joseph's Health involvement in managed care?
St. Joseph's health offers to managed care organizations (HMOs and other insurance plans), the most comprehensive health care network in Central New York.
For patients, that means we offer health care services wherever they are on the health continuum, from wellness to illness. Patient's may need one or a number of our services to achieve optimum health. The integration among St. Joseph's health many programs and services means patients receive coordinated, continuous care.
For HMOs and other insurance plans, it means St. Joseph's health offers a complete array of quality services that are competitively priced.
With which insurance plans does St. Joseph's Health participate?
St. Joseph's Health is a preferred provider of inpatient and outpatient hospital services with a number of insurance plans, including the following:
- Excellus - BlueCross BlueShield (ALL Plans including Exchange and Essential Plans)
- Choice Care/Humana
- Coventry/ First Health/Meritain
- Empire Plan
- Fidelis Care New York (excluding Fidelis Platinum, Gold, Silver, Bronze and Catastrophic Products)
- HealthNow New York
- Independent Living Services/PACE-CNY
- Indian Health Service
- Martin's Point/US Family Health Plan
- MultiPlan/PHCS/Beech Street
- MVP Health Plan/Cigna (INCLUDING MVP Premier Individual, Small Group, Family Plans, and Essential Plans) (Excluding Value Options for Behavioral Health)
- Resolve Health Plan
- Today's Options (excluding Today's Options of New York Platinum, Gold, Silver, Bronze and Catastrophic Products)
- TotalCare (INCLUDING Beacon Health Strategies)
- UNITED HealthCare (including UHC Community Plan) (EXCLUDING Optum Behavioral Health)
In which Exchange/Essential plans does St. Joseph's Health participate?
St. Joseph's Health is considered "in network" with Excellus BlueCross BlueShield's and MVP’s Exchange and Essential products.
Q&A Guide for Health Insurance Exchange Products
Please see the questions and answers guide for more information about the Health Insurance Exchange products.