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SeeChange Health provides value-based health plans, administrative services and supporting technologies to employers, insurers, and third party administrators. The company’s internally developed value-based plans are designed to reduce health care costs by encouraging individuals to play an active role in the management of their health. When individuals enroll in the plan, they are asked to answer a health questionnaire that includes questions about height, weight, gender, ethnicity, as well as health behaviors, such as smoking. Based on the answers on the questionnaire, the company asks participants to agree to preventive screenings, including cancer screenings and laboratory blood tests to detect health problems. Although participation is voluntary, members who choose to participate are provided with financial incentives, such as reduced co-pays and lower deductibles when they adhere to recommended preventive care and condition specific actions. The overall goal is to encourage members to take advantage of health screenings and health tests to catch problems before they become serious. The company currently sells insurance to employers with two to 200 employees, as well as supporting self-funded customers. SeeChange has launched in Fresno, Monterey, San Benito and Los Angeles and plans to roll out in Santa Clara and Santa Cruz this fall.
Wilke Fleury has been representing SeeChange Health since 2008, both in connection with ongoing regulatory work and legal compliance. Most recently, Wilke Fleury assisted SeeChange with its application to be admitted as a health insurer in the State of California
Molina was founded almost 30 years ago as a community-based clinic. Its mission was to provide health care to those who faced barriers to obtaining quality health care. Today, Molina carries on that mission by providing quality health care to individuals covered under Medicaid, the Children’s Health Insurance Program, MediCare and other government-sponsored health insurance programs. Molina now serves approximately 1.4 million people through health plans in 10 states, as well as 17 primary care clinics in California and 3 in Virginia. Molina attributes its success, in part, to its commitment to quality, care management, disease prevention, cultural sensitivity, member outreach, and low-literacy programs. Molina’s focus on quality has made it one of the most respected managed health care companies in the country. For five consecutive years, all of Molina’s eligible Medicaid plans have been included in “America’s Best Health Insurance Plans”, a report compiled by U.S. News and World Report in collaboration with the respected National Committee for Quality Assurance (NCQA), a non-profit organization dedicated to improving health care quality. In addition, Molina was ranked among the top 15 national managed care firms for 2008-2009 according to InterStudy, a national managed carry research organization.
Since 1994, Wilke Fleury has assisted Molina with its transition from a community-based clinic to a national health plan, from obtaining Molina’s original health plan licensure to providing employment counseling regarding the management of its several thousand employees. Wilke Fleury is proud to be associated with an organization that benefits the neediest members of the communities it serves and looks forward to continuing its relationship in the future.
In 1995, 25 pediatric sub-specialists joined together to form Perinatal and Pediatric Specialist Medical Group, a multi-specialty medical and surgical practice serving Sacramento. The founding physicians were committed to providing comprehensive patient care on a model of preventative medicine and establishing mutually supportive relationships with physicians and hospitals.
In 2002, the group changed its name to “Children’s Specialist Medical Group of Sacramento, Inc.,” to reflect the growing focus on the special needs of children. In the ever changing world of healthcare, however, the initial goals and commitments of the founders have continued and the group has flourished. Through its network of 25 clinics and affiliations with 25 hospitals, “CSMGS” now provides specialty services to residents of Northern California and Western Nevada. CSMGS Care Centers include neonatology, pediatric cadiology, pediatric critical care, pediatric endocrinology and pediatric surgery.
In 2006, CSMGS expanded beyond pediatrics when it developed “Perinatal Associates of Sacramento,” a Care Center of physicians specializing in the management of high risk pregnancies. Working closely together, the doctors of Perinatal Associates of Sacramento and CSMGS’ other specialty Care Centers provide are able to provide comprehensive care for mothers and their babies.
CSMGS’ innovative Bridging Evidence Assessment and Resources, or “B.E.A.R.” Care Center has been active in educating the community regarding child and sexual abuse and provides compassionate and comprehensive medical exams for those who are victims of sexual and child abuse.
Our community is fortunate to have the compassionate care provided by the highly specialized physicians who compose Children’s Specialist Medical Group. They are an integral part of the quality of medical care provided to our most seriously ill children.
Since 1996, Wilke, Fleury has assisted CSMGS in nearly every facet of CSMGS’ practice, providing services and expertise that only a full-service law firm can provide. We have assisted CSMGS in meeting the ever-changing demands of the healthcare environment, drafting complex healthcare agreements, creating innovative ways to affiliate with its hospital partners and working together in the in the recruitment of highly trained specialists. As a full-service firm, we have provided CSMGS legal advice in complex employment, corporate and real estate matters.
Wilke, Fleury is pleased to have been a partner in the growth of CSMGS. We are pleased to have contributed to the enrichment of the comprehensive and quality medical care provided to our community’s most special patients – our children.
Like most of Wilke Fleury’s clients, CVMA expects and demands the range of expertise that only a full-service law firm can provide. Let us know what we can do for you.