MemorialCare offers more value-based products than any other health system in Southern California. Value-based products allow us to reduce waste, avoid overdiagnosis and ensure your employees are receiving the right level of care, while preventing large claims costs to your company.

We reduce the total-cost-of-care by identifying rising-risk and high-risk employees and engaging them in better health. By proactively connecting with these employees, we improve their health and well-being and reduce the cost of their care.

These products include:

  • The Aetna Whole Health Accountable Care Organization (ACO) Plan: Offered as an HMO or PPO, depending on which is best-suited for your needs.
  • The Anthem Blue Cross Vivity HMO Plan: A first-in-the-nation partnership between Anthem Blue Cross, MemorialCare, and six other health systems in Southern California.
  • Direct-To-Employer Plans: An innovative PPO plan for companies that want a direct relationship with the healthcare provider that delivers care to their employees.
  • New in 2020: UnitedHealthcare Alliance HMO, Blue Shield Trio HMO (Long Beach network only), and Blue Shield Tandem PPO.

Contact us to learn more about value-based care.

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Aetna Whole Health ACO

MemorialCare is Aetna’s exclusive Orange County partner for the Aetna Whole Health ACO, a benefit plan for both self-insured and fully-insured companies. Membership in this plan tripled from 2018 to 2019 and building on its success, an HMO version was created in 2019. Aetna Whole Health is available to small, mid-sized, and large companies in Orange and LA Counties.

Why choose the Aetna Whole Health ACO plan?

  • We have an extensive physician network to serve you: MemorialCare Medical Group, Greater Newport Physicians, and Edinger Medical Group.
  • Our proactive care coordinators and case managers use population health data to help patients with chronic or serious conditions better manage their health and – as a result – their health care costs.
  • We actively engage patients and providers to make smarter health decisions.

And the results are in. With Aetna Whole Health, we reduced avoidable emergency department visits by 15%, achieved strong quality results, beat the market in managing population health costs, and increased employee wellness screenings by 30%.

Learn more about Aetna Whole Health.

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Vivity HMO

MemorialCare, Anthem Blue Cross and other top hospital systems have partnered to offer Vivity - an integrated network HMO plan in Los Angeles and Orange Counties. This is a first-in-the-nation partnership and includes:

  • MemorialCare
  • Cedars-Sinai
  • UCLA Health
  • Torrance Memorial Medical Center
  • UCI Health
  • PIH Health
  • Good Samaritan Hospital
  • Huntington Hospital

When Vivity members go to the doctor, have a medical procedure or pick up a prescription, all they pay is their co-pay. They won’t have to worry about meeting deductibles or deciphering complicated medical bills. We've had strong results to date, including a 33% increase in enrollment from 2018 to 2019, and over 50 employers in Southern California have chosen Vivity for their employees.

Contact us to learn more about Vivity.

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Direct-to-Employer

Another option for self-insured companies with as few as 100 employees is MemorialCare Direct, which we developed at the request of employers in our community. This is a Direct-to-Employer (DTE) PPO plan, where your company partners directly with us, rather than a health plan.

Our first DTE arrangement was with The Boeing Company, which began in 2017. Called the MemorialCare Health Alliance, the program was the first of its kind in California. The results so far include reduced inpatient admissions, reduced Emergency Department admissions, and reduced pharmacy spend - all while exceeding patient satisfaction targets. Enrollment in this plan has grown by 33%, leading The Boeing Company to extend our partnership through 2024.

The benefits of the MemorialCare Direct DTE option include:

  • Flexibility in plan design
  • Access to detailed claims reporting and analytics, which our care management teams use to keep your employees healthy
  • Improved quality and cost reduction
  • Joint control of the plan
  • Proven reduction in claims trend

Learn more about direct-to-employer options.

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New Plan Partnerships

We continue to expand our product offerings to ensure you can find the right one for your company and/or client. The new products offered this year include:

  • UnitedHealthcare Alliance HMO
  • Blue Shield Trio HMO
  • Blue Shield Tandem PPO

Learn more about our new partnerships.

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Care Management

We have dedicated programs to proactively ensure the health of your employees and – as a result – your bottom line. These programs include:

  • Pharmacy Management – Prescription drugs account for one of the fastest growing segments of health spending in the U.S. We have a dedicated pharmacy team that reviews drug utilization on an ongoing basis, targets drug programs to minimize cost and waste, performs site-of-care interventions, and advises on formulary issues.
  • Behavioral Health Integration – Healthcare costs for patients with a behavioral health diagnosis are up to three times higher. At MemorialCare, we’ve pursued a collaborative care model that embeds highly-trained behavioral health providers at primary care sites. Currently, three MemorialCare Medical Group sites are now live.
  • Care Management – We also have specialized clinics for patients with diabetes, anti-coagulation issues, or post-hospital discharge issues to help them manage their conditions and reduce the risk of (re-)admission to a hospital.
  • Learn more about our care management programs.