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Managed Care

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 involvement in managed care?

St. Joseph's 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 many programs and services means patients receive coordinated, continuous care.

For HMOs and other insurance plans, it means St. Joseph's offers a complete array of quality services that are competitively priced.

With which insurance plans does St. Joseph's participate?

Effective July 1, 2014, the Hospital and all SJ Physicians locations are considered "in-network" with United HealthCare Community Plan.

St. Joseph's is a preferred provider of inpatient and outpatient hospital services with a number of insurance plans, including the following:

  • Aetna  
  • Excellus - BlueCross BlueShield 
  • CD-PHP
  • Choice Care/Humana 
  • Coventry/ First Health/Meritain
  • Empire Plan
  • Fidelis Care New York (excluding Fidelis Platinum, Gold, Silver, Bronze and Catastrophic Products)
  • GHI
  • 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 (excluding MVP Premier Individual and Family Plans)
  • POMCO
  • Resolve Health Plan
  • RMSCO
  • Today's Options (excluding Today's Options of New York Platinum, Gold, Silver, Bronze and Catastrophic Products)
  • TotalCare
  • UNITED HealthCare (including UHC Community Plan)
  • Wellcare
In which Exchange plans does St. Joseph's participate?

St. Joseph's Hospital is considered "in network" with Excellus BlueCross BlueShield's Exchange product. Please see the
questions and answers guide for more information about the Health Insurance Exchange products.

Q&A Guide for Health Insurance Exchange Products
St. Joseph's Hospital Health Center
Managed Care Office
Phone: (315) 703-2121