Scan Long Term Care

What it reported doing in 2014

The Arizona companies, SCAN Health Plan Arizona, a Medicare Advantage contractor, and SCAN Long Term Care, a program contractor to the Arizona Long Term Care System (ALTCS) component of the Arizona Health Care Cost Containment System (AHCCCS), the State Medicaid program, are non-profit managed care organizations that were created to serve the health care and independence needs of the senior citizens of Maricopa and Pima Counties, Arizona. The shared mission of the Arizona companies is to find innovative ways to enhance the beneficiaries' ability to manage their health and exert control over where and how they live. We will achieve that mission by developing partnerships that allow us to deliver the right health care, in the right setting, and at the right cost while maximizing the members' ability to remain as independent as possible. SCAN Long Term Care was selected as an ALTCS program contractor in May, 2006 and began program operations on October 1, 2006. The Plan is responsible for arranging, managing and monitoring the full range of health care services (physician, hospital, lab, radiology, durable medical equipment, etc.), not otherwise covered by Medicare, home care services and residential care services required by the ALTCS beneficiaries enrolled in SCAN. The ALTCS program is designed to serve the needs of low income Arizona citizens age 65 or older, blind or disabled and in need of long term care services. The enrollment of participants in the Company's managed care plan initially began on October 1, 2006; the contract was not renewed for the new contract year, which began October 1, 2011. The Company continued to participate in the ALTCS program on a capped contract basis. On December 22, 2011, the Company provided written notice to AHCCCS terminating the ALTCS program contract. On January 23, 2012, AHCCCS notified the Company that the termination would be effective May 1, 2012. On November 4, 2013, AHCCCS released SCAN Long Term Cares financial obligations with respect to the program. SCAN Health Plan Arizona began program operations as a Medicare Advantage contractor effective January 1, 2007. It is responsible for arranging and monitoring the full range of Medicare health services for plan enrollees. The Plan began offering a Medicare Advantage Special Needs Plan (SNP) for beneficiaries who are dually eligible and enrolled in both the Medicare and ALTCS programs. Beginning January 1, 2009, the Plan expanded its Medicare Advantage participation to other Medicare beneficiary populations, through a Medicare Advantage Prescription Drug (MAPD) Plan. In January 2008 the Arizona companies launched the SCAN Connections community resource center designed to link SCAN members, their caregivers and others in the Maricopa County communities with knowledgeable staff who can assist in navigating a complex health care system. The resource center staff build bridges into other community organizations, governmental agencies and health advocacy groups to provide to the community health education and support services focused on geriatric, chronic illness and physically disabled challenges. Services and resources are provided at the SCAN Connections resource center in SCAN's office and at remote community sites. SCAN Health Plan Arizona has grown from no membership at December 31, 2006 and currently serves more than 18,556 enrollees. The SCAN CLASSIC, HEART FIRST and SCAN BALANCE programs allow SCAN personnel, especially the Case Management team, to more effectively coordinate the needed health care services required by SCAN members. From the start of operations, the Arizona companies have devoted nearly 97% of its revenue to the direct provision of health care, home and community based services and long term care residential services. This represents more than $1,186 million of direct care services for these Medicare and Medicaid enrollees. Of the total amount paid for medical and residential services, approximately 23.2% was direc

Financial Efficiency

• Mission deployment rate: Limited
• Program expense ratio: Limited
• Fundraising efficiency: Limited

Transparency & Controls

• Consistency checks: 84.6%; rating input score 85; 3rd 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: Limited

Accountability

• Independent voting board: 0%; rating input score 0; 9th 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: Limited
• Total-asset coverage ratio: Limited
• Liabilities to assets ratio: Limited
• Officer compensation ratio: Limited

Growth

• Program expense growth: Limited
• Revenue growth: -67.8% per year; rating input score 0; 9th percentile among comparable filings
• Asset growth: -74.7% per year; rating input score 0; 2nd percentile among comparable filings