Every community, every neighborhood, and every life—whole and healthy
Whole-person care is our specialty
Centura Health is the largest healthcare network in Colorado and western Kansas with one very important vision—to provide whole-person care to every community, every neighborhood, and every life. Our Christian mission cherishes the unique spiritual needs of those we serve throughout our hospitals, physician practices and clinics, urgent care and emergency centers, and more. Through Global Health Initiatives, Centura Health care teams also compassionately work with local mission hospitals in Africa, Asia, Central America and South America.
Our 21,000 mission-centered caregivers are guided by our Mission to extend the healing ministry of Christ by caring for those who are ill and by nurturing the health of the people in our communities. We are an entire ecosystem of connected people, services, and care sites, focused on building flourishing communities and whole-person care.
Health is better where we are
- $4.2B in net operating revenue | 21,000 connected caregivers
- 31 Hospitals.
- 17 Operated and 16 Affiliates:
- Flight for Life® Colorado
- 11 Urgent Care Centers
- Virtual and Mobile
- 1,000+ Employed Providers
- 277 Physician Practices
- Centura Health Physician Group:
- 39+ diagnostic imaging centers
- 6 emergency and urgent care centers
- 5300+ primary care providers and specialists
- Colorado Health Neighborhoods:
- 3 mountain emergency and urgent care centers
- 5 home health agencies
- 20 ambulatory surgery centers
We extend the healing ministry of Christ by caring for those who are ill and by nurturing the health of the people in our communities.
Case Scenario: You are a cross-functional team of consultants tasked by Centura Health to evaluate how the Medicare Advantage (MA) landscape will evolve in the Colorado market and to assess how Centura should engage with MA plans to bring significant value to our organization and the communities we serve.
Case Context/Background
Medicare-eligible beneficiaries enter Medicare at a rate of ~10,000 per day in the United States, making it the fastest-growing insurance segment in the nation. Many of those beneficiaries sign-up for Medicare Advantage benefit plans, which are growing at a substantial trend each year. Approximately 43% of Colorado Medicare beneficiaries belong to a Medicare Advantage benefit plan.
These plans typically provide a higher level of benefit than traditional Medicare and are offered by Medicare Advantage insurance companies. Benefit plans follow HMO and PPO plan standards, but these companies may also offer Special Needs Plans which focus on aligning benefits and providers for individuals with special needs such as chronic conditions, long-term institution needs, etc.
Because Medicare Advantage plans are essentially taking ‘risk’ through a capitated (per enrollee) amount from CMS, they are focused on managing the cost of care, risk factors and social determinants of health for their enrolled beneficiary population. Many Medicare Advantage plans have partnered with aligned networks, instituted a spectrum of risk and reward programs, and provided an opportunity for providers of all types to receive financial rewards for strong clinical and medical cost management performance.
Centura Health is currently contracted and in-network with several Medicare Advantage insurance companies with arrangements based on fee-for-service hospital care. Some beneficiaries are aligned through Centura’s ACO where up-side reward is achievable. Centura has not yet moved into partial or full-risk arrangements with these payors.
Deliverables
Please provide a 2-slide PowerPoint presentation with a speaker note (one slide per question).
Apply key takeaways from examples to Centura’s markets and provide a recommended MA strategy for Centura.
Which MA plan should Centura engage and in what capacity/arrangement? This can include existing plans in the market or potential new plan entrants or partners. Give reasons why you chose a particular plan and support it with evidence.
Under what market conditions should Centura pursue those relationships or business models? What are the market factors that will enable success?
Note: Centura network is in Colorado and western Kansas.
References
Blackwell, K. (2022). Medicare Advantage plans in Kansas. Medicare plans. Web.
Connecting More Communities to Incredible Care. Centura. Web.
Information about medicare advantage plans in Colorado. Medicare Advantage. Web.