Priority Health

What it reported doing in 2024

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 amon

Financial Efficiency

• Mission deployment rate: 97%; rating input score 97
• Program expense ratio: 97.9%; rating input score 98
• Fundraising efficiency: Limited

Transparency & Controls

• Consistency checks: 100%; rating input score 100; 68th percentile among comparable filings
• Pay-setting controls: 0 of 6 controls in place; rating input score 0
  • Compensation committee: Missing
  • Independent consultant: Missing
  • Other Form 990s reviewed: Missing
  • Written employment contract: Missing
  • Compensation survey or study: Missing
  • Board or committee approval: Missing
• Foreign activity oversight: Limited
• Grant itemization coverage: Limited
• Major donor itemization: Limited
• Related-party transparency: Yes; rating input score 100

Accountability

• Independent voting board: 82.4%; rating input score 82; 30th percentile among comparable filings
• Governance controls: 7 of 9 controls in place; rating input score 78
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Pass
  • CEO compensation review process: Fail
  • Other executive compensation review process: Fail
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Pass
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: 0%; rating input score 30; 30th percentile among comparable filings
• Total-asset coverage ratio: 0.4; rating input score 14; 14th percentile among comparable filings
• Liabilities to assets ratio: 0.37; rating input score 48; 48th percentile among comparable filings
• Officer compensation ratio: 0.1%; rating input score 94; 94th percentile among comparable filings

Growth

• Program expense growth: 11.1% per year; rating input score 100; 78th percentile among comparable filings
• Revenue growth: 9.6% per year; rating input score 100; 75th percentile among comparable filings
• Asset growth: 11.6% per year; rating input score 100; 77th percentile among comparable filings