EIN 23-2311553

Geisinger Health Plan

IRS 501(c) type
501(c)(4)
Num. employees
1,771
Year formed
1984
Most recent tax filings
2020-06
NTEE code, primary
Description
Geisinger Health Plan benefits the communities it serves by providing higher quality for each persons Health care dollar through innovative models of care and coverage that support the Geisinger Health systems charitable mission.
Related structure
Geisinger Health Plan is a subordinate organization under Geisinger Health System (GHS).

Program areas at Geisinger Health Plan

I. General information three companies comprise what is known as Geisinger Health Plan (ghp): Geisinger Health Plan, a traditional Health maintenance organization (hmo); Geisinger quality options, inc., preferred provider organization (ppo) plans; and Geisinger indemnity insurance company (giic), which operates as a third-party administrator (tpa) and offers administrative-only services. Together the three companies had more than 544,600 members at the end of fiscal year 2020. All three companies are based in danville, Pennsylvania. Geisinger Health Plan (ghp), a not-for-profit organization, provides pre- paid managed healthcare to its members. At the end of the 2020 fiscal year, ghp was predominately providing managed healthcare to government programs including 194,200 medicaid members, 69,100 medicare advantage members and 14,600 chip members. In addition, ghp provided managed healthcare to 54,000 commercial members. Founded in 1972, incorporated in 1984, and initially licensed by the department of insurance in 1985, ghp currently operates in 48 contiguous counties of predominately rural central and northeastern Pennsylvania. In addition, ghp contracts with more than 58,600 providers and 135 hospitals. Ghp is consistently recognized for quality. Geisinger Health Plan has been accredited for quality by the national committee for quality assurance (ncqa) since 1993. Our commercial and medicare hmos are both rated one of the top Health plans in the nation in the 2020-2021 national committee for quality assurance Health insurance Plan ratings. New facilities and more services because ghp is a 501(c)(4) nonprofit organization, revenues in excess of the cost of the healthcare provided to members are used to improve facilities and services, increase benefits and provide affordable rates. Ghp typically makes annual contributions to Geisinger Health, it's 501(c) (3) parent organization, to enhance teaching, education and research projects that benefit all pennsylvanians. These contributions are used to fund the development of new facilities and to add more services to our existing hospitals and physician clinics. This directly supports the charitable mission of Geisinger Health and its charitable affiliates by making it possible to enhance healthcare programs and services throughout the region while improving the availability of care for patients in our service area. Providing affordable, high quality, comprehensive healthcare and benefits increases the access of care to those who might not otherwise be able to afford healthcare and contributes to the quality of life in all of the communities we serve. Ghp provides comprehensive healthcare services on a prepaid basis through an integrated healthcare delivery system, which provides healthcare to the community as a whole. As part of an integrated Health system, ghp is able to channel experience, knowledge and funds to pursue unique projects with Geisinger. No other organization in this region has both provider and payer joined together to create synergies that improve the Health of the communities that we serve. Provenhealth navigator (phn) ghp's provenhealth navigator (phn) is a partnership between patients, primary care providers and ghp to improve members' Health. Also known as a "medical home," phn provides a case manager who works closely with the member's healthcare providers, the member and the member's family by coordinating care with hospitals, specialists, pharmacists and skilled nursing facilities. The model Geisinger employs blends aspects of a chronic care model, a medical home model and a patient-centered primary care model. Additional functional components are included, creating a new healthcare delivery vehicle: Health navigator. Acting as the first-line caregiver and guide, Geisinger Health Plan nurse case managers help members navigate the health-care system. The key strategy of Health navigator is to offer members access to a Health navigator case manager 24 hours a day, 7 days a week. The primary care practice team and ghp, working with the member at the center of the system, accept responsibility to optimize Health status for every individual and to meet pre-established quality, efficiency, and member satisfaction outcome targets for the practice population. The cost of providing phn to non-members was 3.9m during the fiscal year ended june 30, 2020. Provencare - chronic disease Geisinger identified common chronic diseases (diabetes, coronary artery disease, congestive heart failure) and adult prevention measures (immunizations, colonoscopies, etc.). Using evidence-based best practices, care was "bundled" to include the most effective treatment. Success is measured by meeting 100% of the bundle requirements, as tracked over time. Geisinger has made significant improvement in meeting the bundle requirements for diabetes and preventive care for adults. Provencare - acute episodic care (the "warranty") beginning with coronary artery bypass grafts (cabg), the process includes identifying high-volume diagnosis-related groups (drgs), determining best practice techniques and delivering evidence-based care. Working with ghp, the Geisinger clinical enterprise established a global fee that includes pre-operative care, hospitalization, physician fees, rehabilitation and any care (admissions due to complications) related to the surgery within 90 days. This additional care is not charged (if they are seen at a Geisinger facility). This "warranted" care has been very successful and featured in the new york times and published in the annals of surgery. In addition to cabg, Geisinger now has programs for angioplasty with an acute myocardial infarction (heart attack), hip replacement, cataracts, erythropoietin (a drug used for kidney patients), perinatal care, low back pain and bariatric surgery. Transitions of care helping individuals transition from one level of care to another, such as transitioning from the hospital to home, is an important component of ensuring comprehensive and high quality healthcare services. Geisinger has aligned resources and implemented new strategies within the hospital as well as within primary and specialty settings to anticipate patient needs and coordinate services to assure timely and safe transitions. These new strategies have incorporated more timely communication from the hospital to primary care providers, leveraged data from the electronic Health record & claims to identify risk and used case managers to provide early follow up services. Geisinger's efforts around transitions have demonstrated reductions in readmissions as well as more coordinated follow through after discharge. Electronic Health record (ehr) Geisinger is on the forefront in the development and use of the ehr. Ghp helped support the 100 million invested in the ehr over the last several years. The possibilities for improving the quality of care with the ehr are endless. Currently, ghp uses the ehr to communicate with members who are involved in medical or disease management programs and their physicians. Geisinger also allows community hospitals and physicians to access patient information. Disease and case management services to improve the Health of members, ghp provides disease and case management programs and services to coordinate care for those with chronic conditions. The programs are focused on congestive heart failure, hypertension, diabetes, coronary artery disease, osteoporosis, chronic obstructive pulmonary disease, chronic kidney disease, asthma, tobacco cessation and weight management. These in-depth programs were the result of a collaboration of expertise between ghp and providers in Geisinger and have attained national recognition by Health management organizations & industry groups. The success of this collaboration is one example of how this unique relationship can benefit the community. Community Health, education and outreach ghp employees provide the public with information on topics such as insurance education, advance directives, dental and hand hygiene, asthma care, the importance of screenings & immunizations and wellness. In all, ghp provided information to 549,564 individuals at 2,419 events including Health fairs, school-based presentations, seminars and organizational meetings. This education includes: more than 200 Health education events for children were held that covered dental, nutrition & physical activity, hand hygiene and sun safety topics. More than 3,730 children attended the events. Nearly 500 events were held that supported evidence-based chronic disease programming, reaching a total participation of over 1,550 individuals. Almost 2,500 wellness activities were held at employer groups and community events. All of our programs are available to our commercial members which represent approximately 245,185 individuals. 234 employer group and community flu events were held, providing 11,534 flu shots. Due to covid-19, all wellness in-person com

Form 990s for Geisinger Health Plan

Fiscal year endingDate received by IRSFormPDF link
2019-062020-09-23990View PDF
2018-062019-11-15990View PDF
2017-062018-11-15990View PDF
2016-062017-10-06990OView PDF
2015-062016-08-04990OView PDF
...and 5 more Form 990s

Who funds Geisinger Health Plan

Grants from foundations and other nonprofits
GrantmakerDescriptionAmount
Geisinger Health FoundationCapital Prog/service$36,814

Financials for Geisinger Health Plan

RevenuesFYE 06/2020
Total grants, contributions, etc.$0
Program services$2,638,418,907
Investment income and dividends$7,622,749
Tax-exempt bond proceeds$0
Royalty revenue$0
Net rental income$0
Net gain from sale of non-inventory assets$15,994,369
Net income from fundraising events$0
Net income from gaming activities$0
Net income from sales of inventory$0
Miscellaneous revenues$947,188
Total revenues$2,662,983,213

Personnel at Geisinger Health Plan

NameTitleCompensation
Steven R YousoPresident , Chief Executive Officer , D$1,713,650
Lisa Golden AcmChief Operating Officer$360,218
Daron K McReeChief of Compliance$284,433
 Subscribe to viewVice President Care Coord and Integr$248,503
 Subscribe to viewSenior Director , Acct Management , S$288,621
...and 5 more key personnel

Organizations like Geisinger Health Plan

OrganizationLocationRevenue
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Neighborhood Health Plan (NHP)Somerville, MA$804,952,986
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SelectHealthMurray, UT$3,453,823,588
Sharp Health PlanSan Diego, CA$789,103,336
Providence Health PlanRenton, WA$1,371,503,222
Capital District Physicians Health Plan (CDPHP)Albany, NY$1,610,134,034
Independent Health AssociationBuffalo, NY$1,466,225,076
Community Health ChoiceHouston, TX$748,382,087
Tufts Health Public PlansWatertown, MA$2,212,357,802
Delta Dental of WashingtonSeattle, WA$1,439,810,219
HealthPartnersMinneapolis, MN$2,156,321,342
Mclaren Health PlanFlint, MI$789,553,404
EmblemHealthNew York, NY$5,066,236,411
Blue Care Network of MichiganSouthfield, MI$4,366,314,594
Delta Dental of WisconsinStevens Point, WI$779,695,306
Health Alliance Plan of MichiganDetroit, MI$1,510,727,877
Capital Health Plan (CHP)Tallahassee, FL$917,972,525
Delta Dental of IllinoisNaperville, IL$794,010,075
Western Health AdvantageSacramento, CA$786,708,097
AvMedGainesville, FL$765,436,449
Priority HealthGrand Rapids, MI$3,469,212,832
Health New EnglandSpringfield, MA$732,351,554
Boston Medical Center HealthNet PlanCharlestown, MA$2,660,517,755
Community Health Plan of Washington (CHPW)Seattle, WA$939,382,290
Nonprofit Types
Issues
Characteristics
Key performance indicators
Total revenues
$2,662,983,213
2020
Yearly growth
-1.5%
% of revenues
n/a
Total expenses
$2,659,783,795
2020
Yearly growth
2.4%
% of expenses
n/a
Total assets
$795,495,670
2020
Yearly growth
24.9%
% of assets
n/a
Num. employees
1,771
2020
Yearly growth
1.9%
% of total
n/a
General information
Address
100 N Academy Ave MC 49-70
Danville, PA 17822
Metro area
Bloomsburg-Berwick, PA
Website URL
geisinger.org/ 
Phone
(570) 271-6624
IRS details
EIN
23-2311553
Fiscal year end
June
Taxreturn type
Form 990
Year formed
1984
Eligible to receive tax-deductible contributions (Pub 78)
No
Categorization
NTEE code, primary
E83: Health Care Financing
NAICS code, primary
52411: Direct Life, Health, and Medical Insurance Carriers
Parent/child status
Subordinate organization