WellCare

WellCare Health Plans, Inc. is an American health insurance company that provides managed care services primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug plans for more than 6.3 million members across the country. The company partners with more than 607,000 contracted providers and employs more than 14,000 associates.[3]

WellCare Health Plans, Inc.
Subsidiary
IndustryHealthcare
FoundedTampa, Florida (1985)
Headquarters
Tampa, Florida
,
Key people
  • Kenneth A. Burdick (CEO)
  • Andrew L. Asher (CFO)
  • Christian P. Michalik (Chairman)
ServicesManaged care
Revenue US$17.007 billion (2017)[1]
US$469 million (2017)[1]
US$374 million (2017)[1]
Total assets US$8.365 billion (2017)[1]
Total equity US$2.417 billion (2017)[1]
Number of employees
14,000 (October 2019)[1]
ParentCentene Corporation
Websitehttp://www.wellcare.com
Footnotes / references
[2]

Wellcare began operations in 1985 and is based in Tampa, Florida. It is a subsidiary of Centene Corporation. Wellcare Health Plans, Inc. is the holding company for several subsidiaries, including WellCare, Meridian Health Plan, Staywell Health Plan, 'Ohana Health Plan, Care1st Health Plan Arizona and Missouri Care, among others. Regional offices are located in Tampa, Atlanta, New York, Chicago, Detroit, Phoenix, Houston, Omaha and St. Louis, among others.

History

A WellCare bus in Astoria, Queens, New York City.

Wellcare began operations in 1985 in Tampa, Florida as a Medicaid provider for the State of Florida. With the passage of the Balanced Budget Act of 1997, WellCare began offering Medicare beneficiaries private health insurance plans. These programs were known as Medicare+Choice or Part C plans. In 2003, WellCare began offering Medicare Advantage plans with prescription drug benefits after the signing of the Medicare Prescription Drug, Improvement, and Modernization Act.

In 2004, it became a public company via an initial public offering.[4]

In 2006, Wellcare began offering Medicare Medicare Part D plans and has since become one of the top 10 Part D insurance providers by membership volume for these types of plans.

In November 2013, WellCare appointed Chairman David Gallitano to serve as interim CEO while conducting a national search for a permanent replacement.[5] The new executive team changed the company's focus towards health plan members instead of simply meeting quarterly earnings projections. Gallitano increased spending on technology and replaced the main campus "Ikea"-like artwork with photographs and portraits representing its 3.5 million health plan members, including those who suffer from chronic conditions, ailments, and social difficulties, such as cancer, homelessness, mental illness, and hunger.[6]

In December 2014, WellCare appointed Kenneth Burdick to be its new CEO and board member. Burdick had joined WellCare as national health plans president in January 2014 and was promoted to president and COO in July 2014. Burdick previously had served as CEO at Blue Cross Blue Shield of Minnesota and CEO of the Medicaid division at Coventry.[7]

In September 2017, WellCare announced a refreshed corporate rebrand that focused on holistic health and uses the tagline "Beyond Healthcare: A Better You." [8] The corporate logo would remain blue but in order to distinguish WellCare from other healthcare companies, its formal communication would now use an orange color scheme.[9]

In October 2017, WellCare announced a deal to include UNC Health Alliance primary care physicians and specialists into its Medicare Advantage network.[10]

Centers for Medicare and Medicaid Services (CMS) awarded WellCare a 4 out of 5 star rating for Plan Year 2018 Medicare plans for quality and care.[11]

In January 2018, WellCare announced the company will use the care management platform of VirtualHealth for population health management in 20 states.[12]

In January 2018, Fortune magazine named WellCare as one of World's Most Admired Companies.[13]

In January 2020, the company was acquired by Centene Corporation[14] for more than $17 billion. Centene has said "its proposed acquisition of WellCare will give the combined company 22 million members in all 50 states and combined revenue approaching $100 billion."[15]

Acquisitions

Since late 2012, WellCare has acquired many smaller Medicare & Medicaid supplement providers that has significantly expanded the company's national coverage areas:

• November, 2012: Easy Choice Health Plan in California[16]

• February, 2013: UnitedHealthcare's Medicaid business in South Carolina[17]

• April, 2013: Missouri Care, Incorporated[18]

• September, 2013: Purchase of Windsor Health Group (primarily in Mississippi, Tennessee, Arkansas, and South Carolina) was announced, anticipated to be completed in FQ4, 2013.[19]

• November, 2016: Universal American.[20]

• January, 2017: Care1st Health Plan Arizona, formerly a subsidiary of Care1st Health Plan, a Blue Shield of California affiliate.[21]

• May 2017: Phoenix Health Plan, formerly a subsidiary of Abrazo Community Health Network, a subsidiary of Tenet Healthcare[22]

• September, 2018: Meridian Health Plans, Detroit, Michigan[23]

2007 Florida Investigations

On October 24, 2007, law enforcement agents from the Federal Bureau of Investigation, Department of Health and Human Services, and the Florida Attorney General's Medicaid Fraud Control Unit executed a search warrant on the premises of WellCare Health Plans' headquarters in Tampa, FL. Trading on WellCare's stock was halted on the news but subsequently fell as low as 80% below the 52-week high.[25] The U.S. Securities and Exchange Commission (SEC) has WellCare's financials under watch and several class-action lawsuits were launched against WellCare on behalf of shareholders. WellCare has said that its normal business operations have not been affected by the federal and state investigations, and that it remains financially sound, with over $1 billion in cash and cash equivalents.

In a now-unsealed plea agreement, prosecutors and a former employee said the company inflated expenditures by submitting fake documents to the state. Under some mental health care contracts, WellCare was paid a flat per-patient fee and required to spend at least 80% of it on care. Any leftover amount beyond 20 percent was to be repaid to the state, but the bogus expenditures allowed WellCare to keep that surplus. WellCare agreed in August to repay $35 million, its best estimate of the total wrongly kept from 2002-2006. After the raid, the company restated its quarterly and annual profits, driving down net income by $32 million, and saw its top three executives resign. No criminal charges have been announced against WellCare or its officials but investigations by Florida, Connecticut, and federal prosecutors are ongoing. The Securities and Exchange Commission is leading an informal investigation, and Wellcare faces numerous shareholder lawsuits and sealed whistleblower complaints, the company's SEC filings say. WellCare has since halted all Florida campaign contributions.[26]

References

  1. "WellCare Health Plans, Inc. 2017 Annual Report (Form 10-K)". sec.gov. U.S. Securities and Exchange Commission. February 2018.
  2. "US SEC: Form 10-K WellCare Health Plans, Inc". U.S. Securities and Exchange Commission. Retrieved January 27, 2018.
  3. "Centene Corporation". Centene Corporation.
  4. Pritchard, Carolyn (June 30, 2004). "WellCare Group prices IPO of 7.3M shares at $17 each". MarketWatch.
  5. "David J. Gallitano Appointed Interim CEO of WellCare". yahoo.com. Retrieved August 6, 2018.
  6. "'Interim' CEO of WellCare shakes things up". tampabay.com. May 23, 2014. Retrieved August 6, 2018.
  7. "WellCare Appoints Kenneth A. Burdick CEO and Board Member". yahoo.com. Retrieved August 6, 2018.
  8. "WellCare Unveils New Corporate Brand Positioning Focused on Holistic Health". yahoo.com. Retrieved August 6, 2018.
  9. "WellCare Launches New Brand Promise: A Better You". wellcare.com. September 26, 2017. Retrieved August 6, 2018.
  10. "WellCare Partners UNC to Boost Medicare in North Carolina". nasdaq.com. October 12, 2017. Retrieved August 6, 2018.
  11. "WellCare Achieves High Star Quality Rating for Medicare Plans in Florida". www.prnewswire.com. Retrieved August 6, 2018.
  12. VirtualHealth (January 4, 2018). "WellCare Health Plans Selects VirtualHealth as its Care Management Platform". GlobeNewswire News Room.
  13. "See where these 5 Tamba Bay companies rank". www.bizjournals.com. January 19, 2019. Retrieved June 2, 2019.
  14. Centene Press release
  15. Japsen, Bruce. "WellCare's Medicare Numbers Rise As Centene Deal Moves Ahead". Forbes. Retrieved April 9, 2020.
  16. "WellCare To Acquire Windsor Health Group". yahoo.com. Retrieved August 6, 2018.
  17. "WellCare to Acquire Universal American Corp". www.prnewswire.com. Retrieved August 6, 2018.
  18. "WellCare Completes Acquisition of Care1st Health Plan Arizona". www.prnewswire.com. Retrieved August 6, 2018.
  19. Inc, WellCare Health Plans. "WellCare Completes Acquisition Of Arizona Medicaid Assets Of Phoenix Health Plan". Retrieved June 21, 2019.
  20. Japsen, Bruce. "WellCare To Buy Meridian Health Plans And PBM For $2.5 Billion". Forbes. Retrieved September 28, 2018.
  21. "CVS-Aetna Merger Wins Antitrust Approval From Judge". The New York Times. Reuters. September 4, 2019. Retrieved December 5, 2019.
  22. Travis Reed, Associated Press Writer AP: In Medicaid reform, Fla. GOP saw rich benefit The Chicago Tribune, February 14, 2009
This article is issued from Wikipedia. The text is licensed under Creative Commons - Attribution - Sharealike. Additional terms may apply for the media files.