Provider Network Comparison

Transcription

Provider Network Comparison
Provider Network
Comparison
A guide to choosing the right network for your business
Sharp Health Plan Provider Network Comparison
At Sharp Health Plan, we offer several provider networks to deliver cost-effective solutions to meet the unique needs of every
employer. Sharp Health Plan is the highest-rated Health Plan in California, with the Highest-rated Health Care, including
Personal Doctors and Health Promotion and Education among reporting California health plans.1 With access to more than
2,260 physicians, we have an option that’s right for you.2
Network 1 - Premier
Network 2 - Performance
Network 3 - Value
Network 4 - Choice
A high-performing,
select network and our
most affordable option.
An affordable network in
San Diego County offering
more choice for people living
in the North County area.
A large network of
medical professionals devoted
to giving you the best possible
care and value.
Our largest network,
offering the most choice
and convenience.
Physician Networks
Sharp Rees-Stealy (SRS)
SCMG Continued
Carmel Valley
Kearny Mesa
Chula Vista
La Mesa
Del Mar
Lakeside
Downtown San Diego
Mira Mesa
El Cajon
National City
Frost Street
Point Loma
Genesee
San Carlos
Kearny Villa
Santee
La Mesa/La Mesa West
Tierrasanta
Mira Mesa
University City
Mt. Helix
Otay Ranch
Point Loma
Rancho Bernardo
San Carlos
SCMG Inland North
Escondido
Poway
SCMG Graybill
San Diego
Carlsbad
Scripps Ranch
Escondido
Sorrento Mesa
Fallbrook
Sharp Community Medical Group (SCMG)
Alpine
Chula Vista
Clairemont
Coronado
Oceanside
San Marcos
Temecula
Vista
SCMG Arch Health Partners
Downtown San Diego
Escondido
East San Diego
Poway
El Cajon
Ramona
Imperial Beach
San Marcos
The source for this data is Quality Compass® 2015 and is used with the permission of the National Committee for Quality Assurance (NCQA). Quality Compass® 2015 includes certain CAHPS® data. Any data display,
analysis, interpretation, or conclusion based on these data is solely that of the authors, and NCQA specifically disclaims responsibility for any such display, analysis, interpretation, or conclusion. Quality Compass® is
a registered trademark of NCQA. CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). Sharp Health Plan achieved the following summary ratings: an 81.8 for Rating of the
Health Plan compared to the state average of 71.1; an 84.2 for Rating of Health Care compared to a state average of 76.7; an 85.6 for Rating of Personal Doctor compared to a state average of 82.3; and an 80.1 for
Health Promotion and Education compared to a state average of 72.1.
1
Coverage area includes but is not limited to the locations in this document. Premier is a preferred premium rate provider network and is available in select ZIP codes throughout San Diego County.
To see if your business qualifies for this provider network, please contact your Sharp Health Plan Account Manager.
2
Hospital Networks
Rady Children’s Health Network
Carlsbad
Chula Vista
Clairemont
Del Mar
Downtown San Diego
Eastlake
East San Diego
El Cajon
Encinitas
Escondido
Fallbrook
Hillcrest
La Jolla
La Mesa
Linda Vista
Sharp Chula Vista
Medical Center
Sharp Coronado Hospital
Sharp Grossmont Hospital
Sharp Mary Birch Hospital for
Women & Newborns
Sharp Memorial Hospital
Sharp Mesa Vista Hospital
Palomar Downtown
Palomar Medical Center
Pomerado Hospital
Rady Children’s Hospital
Tri-City Medical Center
Inland Valley Medical Center
Rancho Springs Medical Center
Mira Mesa
National City
Oceanside
Pharmacies
Point Loma
Poway
Albertsons Sav-on Pharmacy™
Rancho Bernardo
Costco® Pharmacy
San Marcos
CVS/pharmacy®
Scripps Ranch
Sorrento Valley
Temecula
University City
Valley Center
Vista
Greater Tri-Cities IPA
Participating Independent
Neighborhood Pharmacies
Ralphs® Pharmacy
Rite Aid® Pharmacy
Sharp Rees-Stealy Pharmacy
Target® Pharmacy
Vons® Pharmacy
Walgreens® Pharmacy
Carlsbad
Walmart® Pharmacy
Oceanside
Wellpartner®
(Mail-order pharmacy)
Vista
Primary Care Associates Medical Group
Carlsbad
Encinitas
Oceanside
San Marcos
Solana Beach
Vista
Independent Physicians
Over 1,040 Primary Care
Physicians and Specialists
are independently contracted.
Participating physicians are subject to change;
for the most current information, please visit
sharphealthplan.com.
At home, away from home
We know that excellent health care is not enough; it must also be easy to access. The convenience of Sharp Health Plan extends beyond
Greater San Diego and standard business hours. The following benefits are included with every Sharp Health Plan membership.
Best Health®
Best Health is our comprehensive wellness program that provides Sharp Health Plan
members with a variety of resources from meal plans to exercise routines to one-on-one
personalized health coaching.
Get started at sharphealthplan.com/besthealth
Sharp Nurse Connection®
We offer an after-hours nurse advice telephone service for Sharp Health Plan members.
When you have a health question or concern after regular business hours, a single phone call
puts you in touch with a registered nurse.
Get in touch at (858) 499-8300
MinuteClinic®
MinuteClinic is the walk-in medical clinic located inside select CVS/pharmacy stores.
MinuteClinic provides convenient access to basic care, without an appointment.*
For a list of locations, visit MinuteClinic.com/locations
Assist America®
Assist America connects Sharp Health Plan members to doctors, hospitals, pharmacies
and other services when faced with a medical emergency while traveling 100 miles or more
away from home, or out of the country.
Learn more at assistamerica.com
Consider us your personal health care assistant
(858) 499-8300 or 1-800-359-2002 | 8 a.m. – 6 p.m., Monday through Friday
customer.service@sharp.com | sharphealthplan.com
* A $40 copay will apply to most services except flu shots, which have a copay of $10.
SHPC211.1.16 ©2016 SHC