Management Services Organization
Delivering Exceptional Value
Prospect Health manages highly successful IPAs by leveraging our best practices, results-driven administrative services to manage patients under risk arrangements with health plans/CMS.
Founded nearly 30 years ago, Prospect Health (formerly Prospect Medical Systems) has demonstrated its ability to responsibly and effectively manage costs without compromising the quality of care. Leveraging our best-practice, results-driven administrative services for our primary care and specialist physicians, Prospect delivers value to our members and providers.
With the ownership of 17 hospitals by our parent organization, we are highly experienced in provider-hospital partnerships and in the optimization of this critical relationship.
What Makes Prospect Health Unique
- Coordinated care model to drive higher quality/improve outcomes/lower costs
- Economics of scale resulting in better client costs
- Compliance with all state audits and health plan audits/guidelines
- Manages professional and institutional risk for multiple payers
- Extensive physician alignment and healthcare data expertise
- Experience with all insurance products, including commercial, Medicare, Medicaid, PPO and ACO
- Successful transformation and expansion into new markets
Key Facts
- 18 IPAs in three states: CA, AZ and TX
- More than 600,000 managed members
- More than 20,000 primary care and specialist physicians
- Successful culturally focused networks (Korean, Latino, Vietnamese, etc.)
- America’s Physician Groups Elite status for twelve years in a row
- Admits/cases below Milliman guidelines
Services Include
- Comprehensive, state-of-the-art medical management for care at home transition of care; risk stratification
- Provider relationship management
- Credentialing
- Contracting (health plan and provider)
- Claims adjudication
- Customer service
- RAF/quality optimization programs
- Financial services
- Compliance
- Sophisticated, user-friendly systems portals and data analytics
- In-network retention and utilization control
If you'd like to learn more, call us (800) 708-3230. We are located at 600 City Parkway West, Suite 1000, Orange, CA 92868.
You can also reach out to our Senior Manager of Business Development & Strategies, Elisabeth Bozman, directly at elisabeth.bozman@astranahealth.com for more information and assistance.
