PARAMOUNT ADVANTAGE

PARAMOUNT ADVANTAGE - PROGRAM SERVICE ACCOMPLISHMENTSPARAMOUNT ADVANTAGE IS A MEMBER OF PROMEDICA HEALTH SYSTEM, INC. (PROMEDICA), A MISSION-BASED, LOCALLY OWNED, NONPROFIT HEALTHCARE ORGANIZATION. HEADQUARTERED IN TOLEDO, OHIO, PROMEDICA OFFERS COMPREHENSIVE HEALTH SERVICES INCLUDING MEDICAL, SURGICAL, PSYCHIATRIC, REHABILITATIVE, SKILLED NURSING, HOME HEALTH, AND HOSPICE SERVICES IN 28 STATES ACROSS THE COUNTRY AND IS ONE OF THE NATION'S LEADING HEALTH SYSTEMS. OUR STEWARDSHIP OF RESOURCES HAS ENABLED US TO WISELY INVEST IN PATIENT-CENTERED CARE, ADVANCED TECHNOLOGY, INNOVATIVE PROGRAMS, AND FAMILY-ORIENTED FACILITIES THAT HELP TO ENSURE PATIENTS AND AREA RESIDENTS HAVE EQUAL ACCESS TO HIGH-QUALITY, SAFE CARE IN THE MOST APPROPRIATE SETTING, REGARDLESS OF PATIENTS' ABILITY TO PAY. PARAMOUNT ADVANTAGE AND PROMEDICA HAVE ESTABLISHED AND PROMOTED THE FOLLOWING KEY VALUES THROUGHOUT THE ORGANIZATIONS:- COMPASSION WE TREAT PEOPLE WITH DIGNITY AND RESPECT; - INNOVATION WE CONTINUALLY SEARCH TO FIND A BETTER WAY FORWARD; - TEAMWORK WE PARTNER WITH OTHERS BECAUSE WE ARE BETTER TOGETHER THAN APART; - EXCELLENCE WE STRIVE TO BE THE BEST IN ALL WE DO;- LEARNING WE USE THE LESSONS WE LEARN TO IMPROVE OUR MEMBERS' LIVESPARAMOUNT ADVANTAGE IS A MEDICAID MANAGED CARE PLAN (MCP) CONTRACTED THROUGH THE OHIO DEPARTMENT OF MEDICAID (ODM) THAT PROVIDES HEALTH CARE SERVICES TO MORE THAN 255,000 OHIO RESIDENTS IN 54 COUNTIES ELIGIBLE FOR AGED, BLIND OR DISABLED, COVERED FAMILIES AND CHILDREN, OR ADULT EXTENSION MEDICAID BENEFITS VIA A STATEWIDE HEALTH MAINTENANCE ORGANIZATION (HMO) PLATFORM. TO THIS END, ALL MEMBERS SELECT A PRIMARY CARE PHYSICIAN (PCP) AT THE TIME OF ENROLLMENT AND ARE ENCOURAGED TO ESTABLISH A RELATIONSHIP WITH THE PHYSICIAN AS SOON AS POSSIBLE. IF MEMBERS DO NOT CHOOSE A PCP, THEN THEY ARE ASSIGNED ONE. THE MEMBER IS INSTRUCTED TO CONTACT HIS/HER PCP WHENEVER MEDICAL OR BEHAVIORAL HEALTH CARE IS NEEDED. THUS, THE PCP IS INFORMED ABOUT HIS/HER PATIENT'S NEEDS AND CAN MAKE INFORMED, APPROPRIATE DECISIONS REGARDING TREATMENT.CARE MANAGEMENT PROGRAMS SUCH AS DISEASE MANAGEMENT, UTILIZATION MANAGEMENT AND CASE MANAGEMENT PROVIDE MEMBERS EDUCATION ABOUT THEIR CONDITION, ENSURE THEY HAVE ACCESS TO APPROPRIATE CARE, AND ASSIST IN HELPING HIGH RISK MEMBERS MANAGE AND NAVIGATE THEIR CARE IN A SUPPORTIVE, COST EFFECTIVE ENVIRONMENT. ADDITIONALLY, PARAMOUNT ADVANTAGE MEDICAID EARNED A 4 OUT OF 5 RATING IN THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE'S (NCQA) MEDICAID HEALTH INSURANCE PLAN RATINGS FOR 2019-2020. THIS WAS THE HIGHEST OF ALL FIVE MEDICAID MANAGED CARE PLANS IN OHIO. NCQA ACCREDITS AND CERTIFIED A WIDE RANGE OF HEALTHCARE ORGANIZATIONS AND MANAGES THE EVOLUTION OF HEDIS, THE PERFORMANCE MEASUREMENT TOOL USED BY MORE THAN 90% OF THE NATION'S HEALTH PLANS. IT RATES EACH HEALTH PLAN ON DOZENS OF QUALITY MEASURES RELATED TO CONSUMER SATISFACTION, PREVENTION AND TREATMENT.PARAMOUNT ADVANTAGE MEMBERS HAVE ACCESS TO A MOBILE APPLICATION, MEMBER NEWSLETTERS, SOCIAL SERVICES REFERRALS, AND THE ABILITY TO SPEAK WITH THE SAME CUSTOMER SERVICE REPRESENTATIVE WHEN CALLING IN FOR SERVICES. MEMBER MATERIALS ARE PROVIDED IN FOUR LANGUAGES AND TRANSLATION SERVICES ARE PROVIDED IN VIRTUALLY ANY LANGUAGE. FOR MEMBERS AND NON-MEMBERS, AN ON-LINE COMMUNITY RESOURCE GUIDE IS AVAILABLE TO INFORM ABOUT HEALTH AND WELL-BEING SERVICES OFFERED IN THEIR COMMUNITIES. THESE SERVICES ARE ALL DESIGNED TO ENSURE OHIO'S MOST VULNERABLE RESIDENTS RECEIVE APPROPRIATE, COORDINATED CARE. PARAMOUNT ADVANTAGE MEMBER WELLNESS PROGRAMS INCLUDE INCENTIVES DESIGNED TO ENSURE SAFER PREGNANCIES AND DELIVERIES FOR MOTHERS AS WELL AS SCREENING, DIAGNOSIS AND TREATMENT SERVICES FOR ADULTS AND CHILDREN. HEALTHCHECK, AN EARLY AND PERIODIC SCREENING, DIAGNOSTIC AND TREATMENT BENEFIT FOR CHILDREN, ALONG WITH A 24-HOUR NURSING HOTLINE, PROVIDE A BROAD RANGE OF NO-COST PREVENTIVE CARE SERVICES.AS PART OF PROMEDICA, PARAMOUNT ADVANTAGE DEMONSTRATES ITS MISSION AND CORE VALUES BY PROVIDING HIGH-QUALITY HEALTH CARE TO ALL PATIENTS, REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, OR AGE. OUR MISSION IS TO IMPROVE YOUR HEALTH AND WELL-BEING.