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HEALTHCARE | Healthcare Plans
magnacare.com

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Founded Year

1990

Stage

Unattributed | Alive

Total Raised

$46.46M

Last Raised

$16.46M | 2 yrs ago

About MagnaCare

MagnaCare processes and administers healthcare claims for customers who utilize the company's fully-integrated physician, diagnostic, and hospital preferred provider organizations and workers compensation program. Its plans cover a wide range of organizations, including the self-insured organizations, Taft Hartley Funds, commercial insurers, Third Party Administrators, worker's compensation and no-fault payors, and municipalities.

MagnaCare Headquarter Location

One Penn Plaza 46th Floor

New York, New York, 10119,

United States

516-282-8000

Latest MagnaCare News

With the phase 2 vaccine plan in the offing, regional coordinators say they're ready to go

Dec 17, 2020

The appointed Covid-19 vaccine regional coordinators told Crain's they are ready to meet Gov. Andrew's Cuomo task of submitting a distribution plan for phase two by the first week of January, having had experience with other large-scale vaccination efforts. The governor named the Greater New York Hospital Association as the regional hub for the city, Northwell Health for Long Island and Westchester Medical Center for the mid-Hudson region in his Wednesday briefing. The hubs are tasked with creating a regional distribution plan that would be reviewed and approved by the state, with implementation as soon as late January, Cuomo said. "It will be handled by medical professionals. There will be no political favoritism," he said. "Turning in a plan by the first week of January is a short time frame, but we have experience in this," said Mary Mahoney, vice president of emergency management and clinical preparedness at Northwell Health. Northwell had assisted in vaccination and treatment efforts during the H1N1 pandemic in 2009, and lessons learned then could be adapted for Covid-19, she said. There are, however, new challenges posed by the current pandemic. The Pfizer and Moderna vaccines are new, and patients are required to be observed for 20 minutes after administration, which limits how many patients a medical professional can vaccinate in a given time, Mahoney said. There are also additional requirements for distancing and vaccine preparation, and these logistical challenges will need to be accounted for as coordinators put together their plan. Regional hubs are also expected to work with local governments and organizations to overcome vaccine hesitancy, Cuomo said in his briefing. Many health systems, including Northwell, already have built relationships around testing during the pandemic, and those can be leveraged for vaccination efforts too, Mahoney said. Northwell's team is expected to be assembled next week, Mahoney said. "There are a lot of people anxious to get the vaccine, and we want to be ready come late January," she said. Eric Linzer, president and CEO of the New York Health Plan Association, said that insurance plans have always played an important role in vaccination efforts and are ready to help. "Our members stand ready to work with Gov. Cuomo and his administration, local public health authorities and our partners in the delivery system to get New Yorkers vaccinated," he said. —Shuan Sim   MagnaCare, Mount Sinai partner on total joint replacement program MagnaCare, a third-party insurance administrator, and Mount Sinai Health System have partnered to develop a program for total joint replacement surgery. The program is aimed at improving patient care and experience, and reducing costs for health plan sponsors and their members, MagnaCare and Mount Sinai said. MagnaCare will guide its clients' eligible members to Mount Sinai facilities and providers for total joint replacement procedures, the organizations said. Mount Sinai clinicians will perform the surgery and all associated services—from pre-surgical office visits to follow-up care and physical therapy—under a single, bundled payment. Additionally, each member will be connected to a care guide from Mount Sinai, who will provide information about their procedure, pre-surgery testing and post-surgery needs like transportation and grocery delivery, in addition to other support. "We're continuously looking at programs that could help to lower health care costs for our clients and their members [and] improve the quality of health care members are receiving," said Michelle Zettergren, president of labor at MagnaCare. Midtown-based MagnaCare, part of Brighton Health Plan Solutions, works with self-insured employers and union benefit funds to manage their health plans and create provider networks. It serves some 1 million members. Several years ago Mount Sinai established a program for total joint replacement surgery, designed specifically for labor health funds and their populations, said Lucas Pauls, labor lead for Mount Sinai Health Partners. For a population of about 10,000 members, the estimated need could be about 10 to 20 surgeries a year. Since 2016 Mount Sinai has worked with the 32BJ health fund, completing about 140 surgeries for them a year. Mount Sinai recently began to look to expand its client base. In a fee-for-service system, there is often little follow up after a service is provided, and patients are left on their own, Pauls said. "Mount Sinai is trying to move toward a value-based approach." That includes taking on risk in terms of the program in partnership with MagnaCare, he said. The purchaser is not going to pay more if there is a health care complication, such as an emergency department visit or readmission. The driving force in such a relationship is achieving a high level of service. Elective procedures are ripe for such partnerships, Pauls noted. The total cost through the program is at least 15% below market value, the partners said. As opposed to there being multiple claims and a fragmented approach, it is all covered, Zettergren said. From the employer's perspective, they know what the total cost is going to be. "Total joint replacement has become a very common procedure," Zettergren said. "But for the patients, it is not very common at all. This is life-altering. "When you think about the labor unions we work with, they want to be able to provide their membership with the best service they can have," she added. "Our funds are focused on quality and cost, but they're also very much focused on their membership and making sure their membership has that positive relationship." —Jennifer Henderson   Fast-growing Bushwick pharmacy startup relocates HQ To accommodate its growth, Medly Pharmacy has moved to a three-floor, 30,000-square-foot space in Bushwick, it announced Wednesday. The digital pharmacy startup, founded in 2017, had outgrown its previous space of approximately 2,500 square feet, also in Bushwick. Part of Medly's corporate team had to work out of coworking sites, said Marg Patel, CEO and co-founder of the company. The new location will allow the pharmacy and corporate teams to work in the same space instead of being fragmented, he added. The physical pharmacy occupies about 12,000 square feet; its previous size was about 2,000 square feet. The larger facility allows Medly to fill up to 20 times the number of prescriptions, Patel said. Medly had been filling about 1,000 prescriptions daily, he said. The pharmacy operation has moved into the new headquarters already, although the corporate teams will gradually move in when pandemic conditions have eased up, Patel said. Medly has the lease for 10 years, with the option for reevaluation at five years, Patel said, declining to disclose the cost. The expansion follows Medly's $100 million Series B round in July. Medly pulled in $150 million in revenue in 2019, and the company is expecting double that this year, Patel said. It fulfilled 500,000 prescriptions for 50,000 patients in 2020 across New York City; Miami; Philadelphia; Somerville, N.J.; and Westminster, Md. —S.S. 3 local health care heroes Health care workers have gone above and beyond during the pandemic. In the Dec. 21 issue of Crain's New York Business, we will highlight a few of their stories. Below, learn more about what made Valerie Burgos, Michelle Meneses and Amparo Sullivan New York heroes. Valerie Burgos, intensive care unit nurse During the pandemic, everything about Mount Sinai's intensive care unit changed. "It used to be that we could speak with the family to learn about the admitted patient, or at least a social worker who had spoken with them," said Valerie Burgos, a nurse in the ICU. But at the height of the Covid-19 outbreak, family members and social workers weren't allowed into the ICU, and many patients were sedated or intubated. "It felt like I was missing something, trying to care for someone I knew nothing about," Burgos said. As a result, she came up with an idea to elevate patients to beyond just a person in a bed. It began with a social worker who told Burgos she was going to call a patient's family, and asked if Burgos had any specific questions. "I had just one question: Was there anything the patient would have wanted me to know about him?" she said. The family responded by conveying tons of information: the patient's favorite type of music, hobbies, the names of his family members. "I basically wrote an 'About me' of the patient on walls," Burgos said. That idea caught on throughout the department. She recalled a patient whose heart had stopped, and the doctor saw on the walls that the patient had a new grandchild he would like to meet. "The doctor said, 'We need to keep going. We need to give him more chances to get the heart going,'" Burgos recalled. Unfortunately, however, the patient didn't make it. Burgos' favorite "About me"? "There was a patient who treated his wife like a princess," she said. His job in the relationship was to do all their laundry. When asked what should be conveyed to the patient, his wife said, "You need to get better because the laundry is piling up," Burgos recalled. It was a nice way to bring humor into the room, she said. And for that patient? "We thought we were going to lose him on three occasions. But he actually made it out of the hospital in the end," she said. Michelle Meneses, nurse manager Michelle Meneses was used to managing a team of about 20 nurse practitioners in her role as manager at NYU Langone Orthopedic Hospital. But then came the pandemic, and suddenly she had to onboard an additional 40 nurse practitioners and physician assistants into her workflow as her unit was converted to treat Covid-19 patients. "I had to brief them all within a week," she recalled. Her family life dynamics were affected. "I would leave at 5 a.m. and return at 9 p.m., and when I returned home, my 3-year-old wanted to come hug me, but I had to go through my decontamination process first," she said. It was worse for some of Meneses' colleagues. "I had co-workers who had to send their family away and didn't get to see them for two months," she said. The orthopedics unit treated at least 400 patients during its conversion into a Covid unit, which ended in May. "People were wondering, 'When is this going to end?'" she said. "But we're stronger for it, and we remain ready to do it again if the need arises." Amparo Sullivan, nurse In May a woman in her 80s hospitalized with Covid-19 held the hand of Amparo Sullivan, a nurse at Mount Sinai Queens. "I was telling her that everything will be OK," Sullivan said. "She started telling me that this must be so tough on us and that she appreciates all the help I've been giving her." The woman died soon after, and Sullivan felt compelled to write a letter to her family. "I told them that she inspired me—thinking of us even though I knew she was scared of what was going on," Sullivan said. "I wanted to tell the family that patients were not just a number to us." Members of the family appreciated the handwritten note, and they told Sullivan she was their loved one's "angel." Sullivan pitched the idea to her colleagues of writing letters to patients' families, because many families are not able to visit during the pandemic. The idea was picked up enthusiastically. She recalled one patient who had been brought in by ambulance. The man hadn't wanted to go to the hospital, but his girlfriend insisted, and they had an argument. "He was very upset and said some very harsh words to her," Sullivan said. That turned out to be the last time he talked to his girlfriend. His condition rapidly deteriorated, but before he died he told his nurse that he hadn't meant those words he said to his girlfriend and that he loved her very much. The nurse wrote to the patient's girlfriend, and she wrote back, thanking her. "She thought he was still mad at her after their last conversation, " Sullivan said, adding that the woman said the letter meant the world to her. Writing the letters helps the nurses too. "There's a peace of mind knowing we helped patients communicate to their loved ones during their stay," Sullivan said. —S.S. AT A GLANCE PHASE TWO: The second phase of the Covid-19 vaccine distribution plan could begin in late January, assuming no supply interruptions, Crain's reported Wednesday. Workers in phase two include first responders, school staff, essential frontline workers who regularly interact with the public and individuals at high risk because of other health conditions, according to the state's website. OUTLOOK UPGRADE: Quest Diagnostics, based in Secaucus, N.J., on Wednesday announced it was upgrading its financial outlook for the full year. Net revenue for 2020 is expected to be at least $9.4 billion, up from a range of $8.8 billion to $9.1 billion. Adjusted earnings per share is now expected to be $10.75, instead of between $9 and $10 per share. The increase was led by stronger than expected volumes of Covid-19 testing in the fourth quarter. RECOMMENDED FOR YOU

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