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