Scott And White Health Plan

SCOTT AND WHITE HEALTH PLAN, DBA BAYLOR SCOTT & WHITE HEALTH PLAN (SWHP) IS PART OF BAYLOR SCOTT & WHITE HEALTH (BSWH). BSWH IS A TEXAS NONPROFIT, FAITH-BASED ORGANIZATION THAT PROVIDES PATIENT CARE, MEDICAL EDUCATION, MEDICAL RESEARCH AND OTHER COMMUNITY SERVICES TO THE RESIDENTS OF NORTH AND CENTRAL TEXAS. SWHP STARTED OPERATIONS IN JANUARY 1982 AS A NONPROFIT HEALTH MAINTENANCE ORGANIZATION MAKING AVAILABLE A COMPREHENSIVE HEALTH PLAN PROVIDING QUALITY CARE WITH DIGNITY AND RESPECT TO ITS MEMBERS. SWHP'S SERVICE AREA, WITH ITS SUBSIDIARY HEALTH PLANS, ENCOMPASSES 171 COUNTIES AND PROVIDES COVERAGE TO MORE THAN 400,000 ENROLLEES IN NORTH, CENTRAL AND WEST TEXAS.SWHP CONTINUES TO INTRODUCE NEW HEALTH PLANS, TECHNOLOGY AND SERVICES TO MEET THE NEEDS OF ENROLLEES, EMPLOYERS, AND THE COMMUNITY. IT CURRENTLY OFFERS INDIVIDUAL AND FAMILY PLANS, INSURED AND SELF-FUNDED PLANS FOR SMALL AND LARGE EMPLOYERS, MEDICARE ADVANTAGE AND PRESCRIPTION DRUG PLANS, AND MEDICAID PLAN.

SEE SCHEDULE OSWHP AND ITS AFFILIATED HEALTH PLANS MAKE AVAILABLE A WIDE VARIETY OF HEALTH BENEFIT PLANS TO INDIVIDUALS AND EMPLOYER GROUPS. IT PARTICIPATES IN GOVERNMENT PUBLIC PROGRAMS TO MAKE COVERAGE AVAILABLE TO MEDICAID AND MEDICARE ADVANTAGE PARTICIPANTS, AND THROUGH THE MARKETPLACE IN TEXAS. AS PART OF SWHP'S PURPOSE, IT IS FOCUSED ON ENROLLEE SATISFACTION AND THE QUALITY OF THE COVERAGE IT PROVIDES. SWHP IS ACCREDITED BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA) FOR BOTH ITS COMMERCIAL HMO AND MEDICAID PLANS. SINCE 2019, SWHP COMMERCIAL HMO PLAN HAS ACHIEVED A NCQA PLAN RATING OF 3.0. ADDITIONALLY, A 2022 US NEWS AND WORLD REPORT NAMED SWHP AS ONE OF THE BEST INSURANCE COMPANIES FOR MEDICARE ADVANTAGE. THIS REPORT USES DATA FROM THE CMS' ANNUAL STAR RANKING OF HEALTH PLANS, WHERE SWHP HMO EARNED AN OVERALL 4.5 OUT OF 5 STARS RATING IN 2021. FURTHERMORE, SWHP CONSISTENTLY HAS ONE OF THE HIGHEST HMO PLAN RATINGS IN TEXAS FOR ITS HEALTHCARE EFFECTIVENESS DATA AND INFORMATION SET (HEDIS) SCORES, EXCEEDING NATIONAL AND TEXAS AVERAGES FOR CHLAMYDIA SCREENING, PERSISTENCE OF BETA BLOCKER TREATMENT, CHOLESTEROL MANAGEMENT, HBA1C TESTING, DIABETIC EYE EXAM SCREENING, AND PRENATAL CARE SINCE MEASUREMENT YEAR 2021. SWHP HAS DEMONSTRATED A COMMITMENT TO THE HEALTH AND WELL-BEING OF NOT ONLY ITS ENROLLEES BUT THE COMMUNITY AS A WHOLE THROUGH A NUMBER OF DIRECTED PROGRAMS OF VARYING PURPOSE SOME OF THESE PROGRAMS ARE DESIGNED TO ENGAGE ENROLLEES IN THEIR OWN CARE OR ENCOURAGE A HEALTHY LIFESTYLE. OTHER PROGRAMS OFFER SUPPORT AND HELP COORDINATE THE DELIVERY OF CARE AT THE RIGHT PLACE, THE RIGHT TIME, AND FROM THE RIGHT PROVIDER, ESPECIALLY FOR THOSE ENROLLEES WITH COMPLEX OR CHRONIC CARE ISSUES. FINALLY, SWHP OFFERS WELLNESS PROGRAMS DESIGNED TO CREATE WELLNESS AND AWARENESS, IDENTIFY SOCIAL DETERMINANTS OF HEALTH AND TO BENEFIT THE ENTIRE COMMUNITY. A SAMPLING OF THE PROGRAMS THAT IT OFFERS TO ENROLLEES AND THE COMMUNITY AT LARGE ARE:THE WELLNESS ASSESSMENT: THE WELLNESS ASSESSMENT IS A FREE SWHP ONLINE TOOL AVAILABLE TO ENROLLEES THROUGH ITS VENDOR, WEBMD. THROUGH A SERIES OF QUESTIONS CONCERNING FAMILY HEALTH HISTORY, PERSONAL HEALTH HISTORY, SUBSTANCE ABUSE, STRESS/COPING, PHYSICAL ACTIVITY AND NUTRITION, AN ASSESSMENT IS PRODUCED WITH ADVICE TO HELP THAT INDIVIDUAL MAKE HEALTHIER CHOICES. ENROLLEES CAN ACCESS OTHER EDUCATIONAL AND SELF-MANAGEMENT TOOLS THRU WEBMD. WONDRWONDR IS AN ONLINE WEIGHT MANAGEMENT AND WEIGHT LOSS PROGRAM AVAILABLE TO ENROLLEES IN COMMERCIAL PLANS. THE QUARTERLY PROGRAM IS DESIGNED FOR ENROLLEES TO PARTICIPATE WITH OTHERS TO ESTABLISH ACCOUNTABILITY GOALS AND SUPPORT, WHILE INDIVIDUALLY TRACKING WEIGHT LOSS OR MANAGEMENT GOALS. EXPECTING THE BEST, MATERNITY CASE MANAGEMENT PROGRAM:SWHP HAS DEVELOPED AND OFFERS ITS EXPECTING THE BEST MATERNITY PROGRAM. THIS PROGRAM IS OFFERED TO ALL ENROLLED MEMBERS WHO ARE PREGNANT AND PROVIDES HEALTH SCREENING, EDUCATION, CARE COORDINATION, PERINATAL/POSTPARTUM DEPRESSION INTERVENTIONS, AND TELEPHONIC CASE MANAGEMENT SUPPORT, WITH THE GOAL OF HELPING TO IMPROVE HEALTH OUTCOMES FOR AT-RISK PREGNANT WOMEN AND NEONATES. COMPREHENSIVE MEDICAL AND BEHAVIORAL HEALTH CASE MANAGEMENT PROGRAM:SWHP OFFERS A COMPREHENSIVE CASE MANAGEMENT PROGRAM TO HELP ENROLLEES RECEIVE NEEDED CARE, SERVICES, EQUIPMENT, AND MEDICATIONS. LICENSED NURSES AND SOCIAL WORKERS WORK WITH ENROLLEES AND THEIR PROVIDERS TO HELP ACHIEVE DESIRED HEALTH OUTCOMES BY ASSISTING WITH CARE COORDINATION AND CONDITION MANAGEMENT. CASE MANAGERS ALSO ASSESS ENROLLEES FOR POSSIBLE SOCIAL DETERMINANT OF HEALTH BARRIERS THEY MAY BE EXPERIENCING AND REFER THOSE INDIVIDUALS TO COMMUNITY PROGRAMS AND RESOURCES. BABY SHOWERS:SWHP OFFERS PREGNANT WOMEN ENROLLED IN ITS MEDICAID PRODUCT A VIRTUAL BABY SHOWER. THE BABY SHOWER PROGRAM PROVIDES EDUCATIONAL INFORMATION ON PREGNANCY, PARENTING AND HEALTH INFORMATION, AND OTHER RESOURCES TO HELP BRIDGE SOCIAL DETERMINATE OF HEALTH GAPS. INCENTIVES OF NOMINAL VALUE ARE PROVIDED TO ENROLLEES TO ATTEND THE VIRTUAL PROGRAM AND RECEIVE PRENATAL CARE. VALUE-ADDED SERVICES FOR MEDICAID ENROLLEES:SWHP OFFERS OR MAKES AVAILABLE TO ENROLLEES IN ITS MEDICAID PRODUCT A VARIETY OF HEALTH EDUCATION PROGRAMS AND INCENTIVES TO OBTAIN PREVENTATIVE CARE. EXAMPLES OF INCENTIVES INCLUDE GIFT CARDS OF NOMINAL VALUE, VISION EXAMS FOR ADULTS, EYEWEAR ALLOWANCES, BASIC DENTAL SERVICES FOR PREGNANT WOMEN, BEHAVIORAL HEALTH RESOURCES, AND TRANSPORTATION ASSISTANCE. STEP-UP, SCALE-DOWN:FOR ENROLLEES IN ITS MEDICAID PRODUCT, SWHP OFFERS STEP UP, SCALE DOWN. STEP UP, SCALE DOWN IS A 12-WEEK PROGRAM FEATURING NUTRITION AND EXERCISE EDUCATION. EACH WEEK A DIFFERENT TOPIC IS FEATURED, INCLUDING SUCH TOPICS AS GOAL SETTING, READING NUTRITION LABELS, MEAL PLANNING, AND STARTING OR STEPPING UP AN EXERCISE PROGRAM. THE CLASSES ARE TAUGHT BY NURSES AND WELLNESS PROFESSIONALS WITH EXPERTISE IN EXERCISE AND NUTRITION. EMPLOYEE CONTRIBUTIONS:EMPLOYEES OF SWHP ARE ENCOURAGED TO PARTICIPATE IN COMMUNITY EVENTS SPONSORED BY NOT-FOR-PROFIT CHARITABLE ORGANIZATIONS THAT HELP RAISE FUNDS AND AWARENESS FOR SOCIAL ISSUES IMPACTING THE COMMUNITY. EXAMPLES INCLUDE PAST COMMUNITY EVENTS THAT HAVE BEEN SPONSORED BY THE UNITED WAY, FOOD FOR FAMILIES, PROJECT APPLE TREE, MCLANE CHILDREN'S BEREAVEMENT COMMITTEE, AND MARCH OF DIMES.INVOLVEMENT WITH COMMUNITY ORGANIZATIONS:SWHP EMPLOYEES HAVE ASSOCIATED AND PARTICIPATE ON OR WITH COMMUNITY ORGANIZATION BOARDS AND COALITIONS. PAST EXAMPLES OF CHARITABLE AND COMMUNITY ORGANIZATIONS THAT EMPLOYEES HAVE WORKED WITH INCLUDE BUT ARE NOT LIMITED TO, THE NURSE-FAMILY PARTNERSHIP, HEALTH BABIES COALITION, CITY OF TEMPLE MAYOR'S COUNCIL ON FITNESS, AND SAFE KIDS MID-TEXAS. WALK WITH A DOC:WALK WITH A DOC IS A COMMUNITY WALKING EVENT IN TEMPLE, TEXAS, THAT PROVIDES AN OPPORTUNITY FOR INDIVIDUALS OF ALL AGES TO INCREASE THEIR PHYSICAL ACTIVITY TO HELP IMPROVE HEALTH AND WELL-BEING. SWHP PARTNERS WITH BAYLOR SCOTT & WHITE HEALTH PHYSICIANS IN TEMPLE, TEXAS TO OFFER THESE COMMUNITY EVENTS.SWHP COMMUNITY EVENTS SPONSORSHIP:SWHP COLLABORATES WITH VARIOUS COMMUNITY ORGANIZATIONS TO CO-SPONSOR EVENTS THROUGHOUT ITS SERVICE AREA IN TEXAS. THE EVENTS ARE AVAILABLE TO ALL IN THE COMMUNITY, INCLUDING ENROLLEES, AND COVER A BROAD RANGE OF INTERESTS, SUCH AS HEALTH FAIRS, 5K/10K/HALF MARATHON RACES, AND CONCERT SERIES.COMMUNITY WELLNESS EVENTS:SWHP PROVIDES FREE HEALTH EDUCATION AND MATERIALS OF VARIOUS TOPICS TO THE PUBLIC AT A VARIETY OF HEALTH FAIR EVENTS THROUGHOUT ITS SERVICE AREA.COMMUNITY HUBS:SWHP WORKS WITH COMMUNITY ORGANIZATIONS TO HELP CONNECT ENROLLEES TO SERVICES FOR NON-MEDICAL NEEDS SUCH AS, FINANCIAL ASSISTANCE FOR RENT AND UTILITIES, FOOD BANKS, AND BASIC NEEDS ASSISTANCE.