Understanding 'Ohana

Description

In February 2008, 'Ohana Health Plan ('Ohana) was one of two health plans awarded three-year contracts by the State Department of Health to provide services under the Hawai'i QUEST Expanded Access (QExA) program.

'Ohana Health Plan is managed by a local team of experienced managed care professionals and is offered by WellCare Health Insurance of Arizona, Inc.

Team

  • Over 140 associates to be staffed throughout Hawai'i.
  • Over 60 in-house nurses and social workers to be staffed in Hawai'i.
  • Several local offices throughout Hawai'i.

Mission

  • To enhance our members' health and quality of life.
  • To partner with providers and governments to provide quality, cost-effective health care solutions.
  • To create a rewarding and enriching environment for our associates.

Values

  • Partnership
    Members are the reason we are in business; providers are our partners in serving our members; and regulators are the stewards of the public's resources and trust. We will deliver excellent service to our partners.
  • Integrity
    Our actions must consistently demonstrate a high level of integrity that earns the trust of those we serve.
  • Accountability
    All associates must be responsible for the commitments we make and the results we deliver.
  • Teamwork
    With our fellow associates, we expect--and are expected to demonstrate--a collaborative approach in the way we work.

Overview

  • More than 3,800 associates.
  • Founded in 1985 and began offering Medicaid in 1994 (more than 23 years of health care experience).
  • Largest Medicaid- and Medicare-only contractor in the nation.
  • Serving the Medicare population in Hawai'i since 2006.
  • Operates one of the original Medicare Part D plans in Hawi'i

Health Plan Membership

  • Over 2.5 million health plan members of which more than 1.36 million are Medicaid members.
  • Medicaid members in Florida, Georgia, Illinois, Indiana, Missouri, New York and Ohio.
  • Over 2,400 Medicare Advantage and Medicare Prescription Drug Plan members in Hawai'i.

Services

'Ohana services under the managed care program include:

  • Personalized service coordination for members
  • Custom care planning for each member
  • Access to a 24/7 health advisor hotline
  • Services offered by local representatives and providers
  • Expert, local provider relations and operations support
  • Self-directed personal assistance programs
  • HealthConnections program for access to community services
  • Special targeted health programs (to address health care issues such as diabetes, obesity and depression)

Physician Network

  • Partners with more than 67,000 physicians and other health care providers nationwide.
  • Contracted with over 60,000 pharmacies nationwide.

Achievements

Received the Senior Choice Gold Award in 2007 and 2008 for Excellence in Medicare Benefits Value.

Media Contacts

'Ohana Cares
Our Commitment
Leading 'Ohana
Enhancing Care, Improving Lives
Members Who Have Shared
The 'Ohana Way
The Healthy Way
Understanding 'Ohana
'Ohana's Perspective
To Learn More

Philosophy

Our philosophy is to place members and their families at the center of the health care continuum. Each of our members is matched with an 'Ohana service coordinator who works directly with our members and multi-disciplined health care team.