PRIORITY HEALTH

PRIORITY HEALTH HMO:PRIORITY HEALTH IS AN INTEGRAL PART OF COREWELL HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM SERVING COMMUNITIES THROUGHOUT MICHIGAN. PRIORITY HEALTH'S MISSION, LED BY ITS COMMUNITY BOARD, STRIVES TO RETURN VALUE TO THE COMMUNITIES SERVED BEYOND THE PROVISION OF HEALTH CARE TO ITS MEMBERS. PRIORITY HEALTH HAS BUILT A LONG HISTORY OF OFFERING MICHIGAN EMPLOYERS AND INDIVIDUALS PROGRESSIVE PRODUCTS AND INNOVATIVE PROGRAMS INTENDED TO KEEP COSTS DOWN AND MEMBERS HEALTHY. ITS BROAD PORTFOLIO OF PRODUCTS AND SERVICES INCLUDES TRADITIONAL MEDICAL PLANS AS WELL AS HSA'S, HRA'S AND OTHER CONSUMER-DRIVEN PRODUCTS. PRIORITY HEALTH HAS CONSISTENTLY MAINTAINED ACCREDITED STATUS WITH A 4.5 OUT OF 5 STAR RATING FOR ITS HMO PRODUCTS FROM THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA), AN INDEPENDENT MANAGED CARE ACCREDITING BODY. PRIORITY HEALTH HAS ALSO MAINTAINED AN "A" (EXCELLENT) FINANCIAL STRENGTH RATING FOR SEVEN CONSECUTIVE YEARS FROM A.M. BEST, A HEALTH INSURANCE RATINGS AGENCY, RECOGNIZING THE FINANCIAL STRENGTH OF THE ORGANIZATION AND FOCUS ON MANAGING THE COST OF HEALTH CARE FOR ITS COMMUNITY.IN EARLY 2020, PRIORITY HEALTH BECAME THE SOLE MEMBER OF TOTAL HEALTH CARE, INC., A HEALTH PLAN BASED IN SOUTHEAST MICHIGAN. THE MEDICAID BUSINESS WAS INTEGRATED INTO PRIORITY HEALTH CHOICE, INC. WHILE THE COMMERCIAL BUSINESS WAS INTEGRATED INTO PRIORITY HEALTH IN 2022. AS PART OF THIS TRANSACTION, A FOUNDATION WAS ESTABLISHED TO WHICH PRIORITY HEALTH COMMITTED $25 MILLION TO FOCUS ON IMPROVING HEALTH IN DETROIT AREA COMMUNITIES. THE FOUNDATION SUPPORTS AND INVESTS IN HEALTH CARE INITIATIVES THAT INCREASE ACCESS, IMPROVE OUTCOMES, AND HAS A MEANINGFUL IMPACT ON THE LIVES OF THE PEOPLE IN AND AROUND THE CITY OF DETROIT. THE FUNDING HAS SUPPORTED MORE THAN 4 MILLION RESIDENTS IN SOUTHEAST MICHIGAN, ADDRESSING SOCIAL NEEDS SUCH AS FOOD INSECURITY, MATERNAL & INFANT HEALTH, HOUSING STABILITY AND MORE.IN OCTOBER 2023, PRIORITY HEALTH LAUNCHED A FIRST-OF-ITS-KIND PHARMACY SAVINGS PROGRAM, PRICEMYMEDS. THROUGH THE PRICEMYMEDS PROGRAM, PRIORITY HEALTH COMMERCIAL & ACA MEMBERS HAVE PHARMACY DISCOUNTS AUTOMATICALLY APPLIED TO THEIR OUT-OF-POCKET PRESCRIPTION COSTS WITHOUT HAVING TO TAKE ANY ADDITIONAL ACTION. THE PROGRAM ALSO EVALUATES MULTIPLE PHARMACY DISCOUNTS WHEN A PRESCRIPTION IS FILLED, ENSURING MEMBERS ARE GETTING THE BEST POSSIBLE PRICE, EVERY FILL. IN ADDITION TO HELPING MEMBERS SAVE ON PRESCRIPTION COSTS, PRICEMYMEDS ALSO ENSURES MEMBERS HAVE A SMOOTH EXPERIENCE. AS A RESULT OF THE PRICEMYMEDS PROGRAM, PRIORITY HEALTH COMMERCIAL & ACA MEMBERS SAVED OVER $2.5 MILLION IN OUT-OF-POCKET PRESCRIPTION COSTS IN 2024.IN MARCH 2024, PRIORITY HEALTH LAUNCHED PRIORITYBABY, A FAMILY-FIRST PROGRAM AVAILABLE TO MEMBERS WITH NEWBORN DEPENDENTS. THE PROGRAM IS DESIGNED TO SUPPORT PARENTS, CAREGIVERS AND THEIR BABIES UP TO THE CHILD'S SECOND BIRTHDAY BY PROVIDING RESOURCES AND ANSWERING COMMON QUESTIONS ABOUT INFANT HEALTH AND SAFETY. THE PROGRAM IS AVAILABLE FOR FULLY AND SELF FUNDED GROUPS, AS WELL AS MEDICAID AND INDIVIDUAL MEMBERS. PARENTS AND CAREGIVERS WHO ARE ENROLLED IN PRIORITYBABY WILL RECEIVE RESOURCES AND SUPPORT COVERING TOPICS SUCH AS IMPORTANT APPOINTMENT REMINDERS FOR BABY, COST AND COVERAGE PLAN INFORMATION, SAFETY EDUCATION AND HEALTH CARE TIPS.IN AUGUST 2024, PRIORITY HEALTH ANNOUNCED A PARTNERSHIP WITH CURAI HEALTH, A LEADING VIRTUAL CARE PROVIDER, TO OFFER FREE VIRTUAL VISITS TO MICHIGAN RESIDENTS 18 AND OLDER WHO ARE WITHOUT HEALTH COVERAGE - AN ESTIMATED 400,000 PEOPLE. THE FREE VIRTUAL VISITS WILL BE AVAILABLE THROUGH JUNE 2025. THIS NEW INITIATIVE SEEKS TO ADDRESS DELAYED CARE AND POOR HEALTH OUTCOMES THAT CAN RESULT FROM THE LACK OF HEALTH COVERAGE, THIS PROGRAM ALSO PROMOTES ACCESS TO CARE AND EXPLAINS STEPS TO ACHIEVING HEALTH EQUITY AND COST SAVINGS FOR THE UNDERINSURED POPULATION WITHIN THE HEALTH CARE SYSTEM.IN SEPTEMBER 2024, PRIORITY HEALTH WAS RANKED NO. 1 IN OVERALL CUSTOMER SATISFACTION AMONG MEDICARE ADVANTAGE PLANS IN MICHIGAN, BASED ON THE RESULTS OF THE J.D. POWER 2024 U.S. MEDICARE ADVANTAGE STUDY. PRIORITY HEALTH ALSO RANKED HIGHEST IN THREE DIMENSIONS OF THE STUDY: PEOPLE (REPRESENTATIVES, CALL CENTER), HELPING TO SAVE TIME OR MONEY, AND EASE OF DOING BUSINESS (BILLING, ACCOUNT CHANGES). THE J.D. POWER U.S. MEDICARE ADVANTAGE STUDY IS AN ANNUAL SYNDICATED BENCHMARKING STUDY PROFILING MEMBER EXPERIENCES WITH MEDICARE ADVANTAGE HEALTH PLANS, EXAMINING THE FULL EXPERIENCE OF MEDICARE ADVANTAGE HEALTH PLAN MEMBERS.IN 2024, PRIORITY HEALTH CONTINUED ITS SIGNATURE CORPORATE RESPONSIBILITY PROGRAM TO ADDRESS THE INCREASING MENTAL HEALTH NEEDS OF YOUTH IN MICHIGAN. PRIORITY HEALTH PARTNERS WITH CANINES FOR CHANGE TO CREATE PRIORITY PUPS A SIGNATURE CORPORATE RESPONSIBILITY PROGRAM OF PRIORITY HEALTH FOR GOOD, WHICH COVERS THE COST OF TRAINED FACILITY DOGS TO BE PLACED IN SELECT SCHOOL DISTRICTS. THE PROGRAM HELPS ADDRESS A VARIETY OF BEHAVIORAL HEALTH NEEDS IN A PLACE WHERE KIDS SPEND A MAJORITY OF THEIR TIME: AT SCHOOL. SINCE THE PROGRAM INCEPTION, MORE THAN 3,800 STUDENTS HAVE UTILIZED PRIORITY PUPS TO EASE THEIR ANXIETY AND STRESS AND SUPPORT THEM IN THEIR LEARNING.IN 2024, PRIORITY HEALTH ACQUIRED PHYSICIANS HEALTH PLAN OF NORTHERN INDIANA, INC. (PHPNI), WHICH SERVES MORE THAN 52,000 MEMBERS IN INDIANA AND OHIO. BOTH PLANS ARE ROOTED IN SERVICE TO COMMUNITIES WITH A FOCUS ON SERVING MEMBERS. THE PHPNI MISSION IS TO CREATE INNOVATIVE SOLUTIONS THAT CONTRIBUTE TO HEALTHIER COMMUNITIES THROUGH CARING AND COLLABORATION WHICH, ALIGNS CLOSELY WITH THE PRIORITY HEALTH MISSION TO IMPROVE HEALTH, INSTILL HUMANITY, AND INSPIRE HOPE. OVER TIME, MEMBERS AND CLIENTS WILL BENEFIT FROM BEING PART OF A LARGER, MULTI-STATE COMPANY. BY EXPANDING ITS REACH, PRIORITY HEALTH AIMS TO IMPROVE ACCESS TO CARE, DRIVE INNOVATION, AND ACHIEVE COST SAVINGS THAT COULD HELP LOWER THE COST OF CARE FOR MEMBERS OF BOTH PLANS.IN 2024, PRIORITY HEALTH WON PINNACLE AWARDS FOR ITS PRIORITYMOM PROGRAM AND HOUSING CHRONIC DISEASE MANAGEMENT PROJECT. PRIORITYMOM IS A DATA-DRIVEN MATERNITY PROGRAM DESIGNED TO SUPPORT EXPECTANT MOTHERS WITH THE GOAL OF REDUCING PRETERM BIRTHS AND POSTPARTUM READMISSIONS, IMPROVING HEALTH OUTCOMES AND REDUCING THE COST OF CARE. MOMS GET PERSONALIZED SUPPORT, HELPFUL RESOURCES, A WELCOME KIT AND A $50 GIFT CARD FOR COMPLETING THE PROGRAM. THE HOUSING CHRONIC DISEASE MANAGEMENT PROGRAM CREATED A PARTNERSHIP BETWEEN PRIORITY HEALTH, COREWELL HEALTH'S MEDICAL GROUP AND START NOW PROGRAM AND COMMUNITY BUILDERS TO CREATE SYNERGY BETWEEN HISTORICALLY FRAGMENTED SOLUTIONS OF PRIMARY CARE SERVICES, HEALTH-RELATED SOCIAL NEEDS, TECHNOLOGY AND HOUSING. THE PROJECT SHOWED STRONG OUTCOMES INCLUDING 58% IMPROVED SDOH SCORES, 35% BETTER QUALITY OF LIFE, 68% OF DIABETICS IMPROVED BLOOD SUGAR AND NEARLY ALL COPD AND HEART FAILURE PATIENTS REACHED GREEN ZONE STATUS AND 97% RETAINED HOUSING AFTER SIX MONTHS.PRIORITY HEALTH'S MAJORITY SHAREHOLDER, COREWELL HEALTH IS A NOT-FOR-PROFIT HEALTH SYSTEM THAT PROVIDES CARE AND COVERAGE WITH AN EXCEPTIONAL TEAM OF 65,000+ DEDICATED PEOPLE-INCLUDING MORE THAN 12,000 PHYSICIANS AND ADVANCED PRACTICE PROVIDERS IN 21 HOSPITALS, 300+ OUTPATIENT LOCATIONS AND SEVERAL POST-ACUTE FACILITIES. COREWELL HEALTH PROVIDES OVER $1 BILLION IN COMMUNITY BENEFIT PER YEAR.THE AFFORDABLE CARE ACT (ACA) ADDED NEW REQUIREMENTS THAT HOSPITAL ORGANIZATIONS MUST SATISFY IN ORDER TO MAINTAIN TAX EXEMPT STATUS UNDER IRC SECTION 501(C)(3). ONE OF THE REQUIREMENTS UNDER THIS ACT IS TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND ADOPT AN IMPLEMENTATION STRATEGY AT LEAST ONCE EVERY THREE YEARS. COREWELL HEALTH COMPLETED SEVERAL IMPLEMENTATION PLANS IDENTIFYING THE COMMUNITY HEALTH NEEDS AND IMPLEMENTATION PLAN GOALS FOR EACH COREWELL HEALTH HOSPITAL. ONE NEED IDENTIFIED IN THE CHNA'S IS ACCESS TO HEALTH CARE, WHICH INCLUDES IMPROVING ACCESS TO AFFORDABLE HEALTH CARE FOR ALL COMMUNITY MEMBERS. IN ADDITION, ALL COMMUNITY MEMBERS SHOULD HAVE ACCESS TO PREVENTIVE CARE AND MEDICAL HOME CARE, INCLUDING UNINSURED AND LOW-INCOME WORKING INDIVIDUALS. COREWELL HEALTH WORKS CLOSELY WITH PRIORITY HEALTH TO ACHIEVE THE IDENTIFIED NEEDS AND GOALS.

PRIORITY HEALTH SENIOR MARKETS (MEDICARE ADVANTAGE AND MEDICARE SUPPLEMENT):PRIORITY HEALTH BEGAN OFFERING MEDICARE ADVANTAGE PLANS IN JULY 2005 AND MEDICARE ADVANTAGE PLANS WITH PRESCRIPTION DRUG COVERAGE IN JANUARY 2006. ITS MEDICARE ADVANTAGE PLANS VARY IN PRICE BASED ON WHERE MEMBERS LIVE AND WHAT BENEFITS THEY NEED. MORE THAN 251,500 MICHIGANDERS HAVE A PRIORITY HEALTH MEDICARE ADVANTAGE PLAN, AND NEARLY 17,500 CHOSE A PRIORITY HEALTH MEDICARE SUPPLEMENT PLAN, ALSO KNOWN AS MEDIGAP. AS A RESULT OF PRIORITY HEALTH'S WORK WITH THE COMMUNITY AND DEDICATION TO DELIVERING HIGH QUALITY COVERAGE, ITS MEDICARE ADVANTAGE HMO-POS AND PPO PLANS WERE ACCREDITED WITH THE NATIONAL CENTER FOR QUALITY ASSURANCE (NCQA), WITH OUR HMO-POS PLANS EARNING A 4.5 RATING OUT OF 5. PRIORITY HEALTH'S MEDICARE ADVANTAGE PLANS WITH PRESCRIPTION DRUG COVERAGE WERE ALSO AWARDED 5 OUT OF 5 STARS BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS). THE MEDICARE STAR RATINGS INDICATE HOW WELL A HEALTH PLAN PERFORMS OVERALL; THE BETTER THE STAR RATING, THE HIGHER QUALITY CARE AND EXPERIENCE IS DELIVERED. OF THE 42 QUALITY AND IMPROVEMENTS METRICS USED TO DETERMINE OUR OVERALL QUALITY RATING OF 4.0, APPROXIMATELY 75% OF THE METRICS WERE EITHER 4 OR 5 STARS. PRIORITY HEALTH IS ABLE TO PROVIDE ITS MEMBERS HIGH QUALITY MEDICARE ADVANTAGE PLANS WHILE REMAINING AMONG THE LOWEST COST PLANS IN THE COUNTRY.MEDICARE ADVANTAGE MEMBERS CAN ENROLL EITHER INDIVIDUALLY, OR THROUGH AN EMPLOYER GROUP. DURING THE 2024 MEDICARE ANNUAL ENROLLMENT PERIOD (AEP). PRIORITY HEALTH'S MEDICARE ADVANTAGE ENROLLMENT INCLUDES ABOUT 251,500 INDIVIDUAL ADVANTAGE MEMBERS OF THE TOTAL INDIVIDUAL MEDICARE ADVANTAGE MARKET, MAKING PRIORITY HEALTH THE LEADER IN MICHIGAN.CHRONIC CONDITIONS ARE LEADING CONTRIBUTORS TO RISING HEALTH CARE COSTS NATIONWIDE. TO ADDRESS THIS, PRIORITY HEALTH LAUNCHED THE MEDICATION THERAPY MANAGEMENT (MTM) PILOT PROGRAM WITH ITS MEDICARE MEMBERS. THE MTM PILOT PROGRAM OFFERED PRIORITY HEALTH MEDICARE MEMBERS THE OPPORTUNITY TO MEET ONE-ON-ONE WITH PHARMACISTS TO REVIEW ALL OF THEIR MEDICATIONS INCLUDING PRESCRIPTIONS, OVER-THE-COUNTER DRUGS, AND HERBAL AND VITAMIN SUPPLEMENTS. COMPLEX MEDICATION REGIMENS CREATE SIGNIFICANT CHALLENGES FOR PATIENTS LIVING WITH CHRONIC ILLNESS, THEIR CAREGIVERS, HEALTH CARE PROVIDERS AND THE HEALTH CARE SYSTEM AS A WHOLE. THE IMPACT OF MEDICATION-RELATED PROBLEMS CAN BE MINIMIZED THROUGH A STRUCTURED MTM PROGRAM THAT USES PHARMACISTS COLLABORATING WITH THE PATIENT AND THE PATIENT'S HEALTH CARE PROVIDERS. RETAIL AND OFFICE-BASED PHARMACISTS WILL COLLABORATE WITH PATIENTS AND PROVIDERS TO ADDRESS DRUG-RELATED PROBLEMS AND COMPLETE COMPREHENSIVE MEDICATION REVIEWS.