Community Health Choice logo
Please wait while the 2017 Annual Report loads.
Connecting The Dots

CONNECTING
THE DOTS
TO BETTER HEALTH

quote icon

A Few Words

Despite the political upheaval in Washington, D.C., and Texas state budget woes that impacted all health insurers, 2017 was a year that highlights what we do best – connecting the communities we serve to better health. We celebrated our 20th anniversary – 20 years of connecting the healthcare dots for Members. What started out as a small, local health plan for moms and babies has evolved into a health plan that serves over 400,000 Texans annually. Community looks forward to making new connections that serve our Members in the next 20 years and beyond.

Ken Janda,
PRESIDENT AND CEO

Ken Janda

2017 was a year when our greatest asset—our people!— had the chance to truly shine. Community Health Choice continued to grow in membership and improve the quality of the services we provide every day to our Members and Providers.

Together, we will keep striving in 2018 and beyond to achieve our mission of improving the health and well-being of underserved residents of Southeast Texas by connecting them to the health care and social services they need.

Vicki Keiser,
BOARD CHAIR

Vicki Keiser
Ken Janda Vicki Keiser
target icon
people icon

Improve Access to and Coordination of Healthcare for Low-Income Families: Coverage is Essential

We exist for one reason: to improve the health of the community by reducing the number of uninsured people in Southeast Texas. Everyone, no matter their income level, needs coverage to ensure access to and coordination of care. In order to achieve this, we seek out those who would otherwise have difficulty getting coverage.

Medicaid is essential to the health of Texans

In 2017, Community’s Medicaid STAR and CHIP membership grew to over

280,000

Nearly all our Marketplace Members receive reduced premiums

80%

In 2017, 80% of our Marketplace Members received advance premium tax credits (APTCs)

59%

received additional cost-sharing reductions on top of the APTCs

The bottom line: Community is helping to reduce the number of uninsured in our community, which is precisely the reason our organization was created.

Community is proud to have grown or maintained our Marketplace Membership every year since we began offering Health Insurance Marketplace (HIM) plans, despite political challenges to the Affordable Care Act (ACA).

Improving health outcomes through Member education

Redesigned Marketplace EOB

Redesigning the Marketplace EOB into a retention and literacy tool

Redesigned Marketplace ID cards

Redesigning Marketplace ID cards to make deductible easier to understand

Updating the functionality

Updating the functionality of the My Member Account tool to allow Members more access to self-service functions

Updating the Provider search tool

Updating the Provider search tool to make it easier for Members to navigate

chart icon

Reduce the Uninsured and Grow Membership

When Community first began offering Health Insurance Marketplace (HIM) plans in 2014, we had approximately 300 HIM Members. In 2017 we served nearly 150,000 HIM Members, and we wanted to be sure they had all the right tools to stay insured. As with all of our Member communications, these tools are available in multiple languages.

Education Initiative for Marketplace Members

handshakeHarris Health Sponsored
Silver Marketplace Plans

At Community, we are committed to opening doors to high-quality healthcare. With that goal in mind, we entered into a collaboration with Harris Health System and ACA Experts (a broker partner) to transition qualified Harris Health System Patients into the Marketplace. Existing Harris Health Financial Assistance Program Patients whose 2017 income fell between 0% and 150% of the federal poverty level were enrolled in our Silver Marketplace plan for 2018. Their premiums were paid by Harris Health System. This partnership helped us reduce the uninsured population of Harris County by over 10,000!

Application Assistance for
CHIP and STAR Members

In 2017, Community continued efforts to ensure that Medicaid/CHIP members did not lose their coverage due to paperwork issues. Helping our members recertify is one of the most important ways to reduce the uninsured and maintain continuity of care.

heart icon

Engage Members and Providers in Improving Individual and Community Health

Our role in making people healthier goes beyond mailing out Member ID cards and processing claims. We connect our Members with services and incentives to improve their health and well-being.

Jenny Mathai DrPH, CHES
LIFE SERVICES MANAGER

Melissa Cornett
LIFE SERVICES COMMUNITY REPRESENTATIVE

Jenny and Melissa

As Community Health Choice continues to grow, our leaders seek to incorporate new and innovative ways to improve the health of our Members and the community we serve. Addressing the social determinants of health that cause health disparities is an area of focus. In 2017, Community established a new Life Services team within the Community Affairs Department to plan and create Social Determinants of Health (SDOH) initiatives. The team identified three priority initiatives that focus on social factors greatly influencing our Membership: early childhood development, job training, and education.

We spent 2017 laying the foundation for the program by creating a scholarship program that covers all tuition, books, and supplies for eligible Members to attend Houston Community College with the goal of completing a job certification program.

The objective is to help Members achieve economic independence.

scholarship diagram

Jenny Mathai DrPH, CHES
LIFE SERVICES MANAGER

Melissa Cornett
LIFE SERVICES COMMUNITY REPRESENTATIVE

Jenny and Melissa
network icon

Work Together with Providers to Improve Care

Spotlight on Value-Based Care with Catherine Mitchell, Senior Vice President of Strategic Planning & Partnerships

Senior Vice President of Strategic Planning & Partnerships Catherine Mitchell, who joined Community in 2017, got her start in the healthcare industry as a provider relations representative. She has since gone on to hold a number of executive leadership positions, including her prior position as regional vice president of Provider Strategy - Texas at Amerigroup (Anthem) with a statewide focus on Patient Centered Medical Home and Value-Based Payments, so she is very familiar with the challenges faced by our Providers.

Catherine Mitchell

The Provider Engagement Council (PEC)

Community’s PEC is the primary forum through which we incorporate feedback from participating Providers into our operational decision-making. The PEC meets quarterly and serves as a sounding board for Community when considering various administrative, operational or strategic initiatives. It strengthens engagement from and improves transparency in communication with participating Providers, and fosters greater support from the participating Provider community upon implementation of new initiatives.

Community has helped us to grow so we can better serve our patients, and we couldn’t be happier with the experience or the outcome.
Catherine Mitchell
gears icon

Facilitate Care to Members

Helping our Members reach their health goals does not have to be expensive. It all comes down to detecting health problems early and offering smart treatment options.

I keep choosing Community for my health plan because of the care I received during my difficult pregnancies.
Luz Diaz

Members rate Community a top health plan

As a non-profit health plan, our focus is on providing our Members with the highest level of service. We treat our Members like people, not numbers. In 2017, we surveyed over 1,300 Members using a Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. The survey included the STAR population and showed statistically significant satisfaction improvement in four areas:

  • Overall rating of health care

  • Overall rating of personal doctor

  • Getting care quickly

  • How well doctors communicate

Continuing to improve our performance is important to the lasting success of our organization.

90th

NCQA PERCENTILE FOR CUSTOMER SERVICE

Luz Diaz
huddle icon

Participate in the Community Through Active Collaboration

We are proud to be more than just a health insurance company. We are a local non-profit organization striving to make our community a better place to live. It’s what makes us Community.

Helping out after Harvey

On August 25, 2017, Hurricane Harvey slammed into the Texas Gulf Coast and left a trail of devastation in its wake. The Community team, however, worked to serve our Members from our homes and even San Antonio to make sure our Members had access, even during the week that streets were flooded and businesses were closed.

Like so many Texans, our employees volunteered in the streets and in shelters to help the whole community.

After the storm passed, Community took measures to help our Members, who are among the most at-risk families in southeast Texas. Because we knew that many Members would find getting medical care from an in-network provider difficult, we waived our normal pre-authorization requirement for out-of-network urgent medical care. This approach was very different from the norms of the insurance industry.

We also partnered with a telemedicine provider, Teladoc, to provide physician phone consultations, at no charge, for anyone affected by Hurricane Harvey, regardless of their Membership status.

Community Collaborates with GoNoodle

We know how important physical activity is to a child’s development. That’s why we partner with GoNoodle, an interactive program for K-5 classrooms that helps teachers and parents get kids moving with short interactive activities. Desk-side movement helps kids stay engaged and motivated throughout the day.

In 2017, Community Health Choice began offering GoNoodle Plus to every elementary school in Jefferson County.

“We’re so excited to partner with GoNoodle because it teaches students life-long healthy behaviors.” Amber Buchanan, Business Development Manager, Community Health Choice.

thumbs up icon

Create a Positive Culture of Service for Community’s Employees

Employee Satisfaction

At Community, our greatest asset is our employees. A happy, highly-motivated workforce is vital to the health of our Members, our Providers, and our organization. Our goal is to create a workplace and culture where everyone feels that they are a dynamic and essential part of the team.

91%

TAKE GREAT PRIDE IN THEIR JOBS

87%

ARE GLAD THEY JOINED COMMUNITY

95%

LOOK FOR OPPORTUNITIES TO SUPPORT OTHERS THEY WORK WITH

89%

FIND COMMUNITY’S CORE VALUES ARE ALIGNED WITH THEIR OWN

Get to know Yvonne Jones,
our longest tenured employee

Yvonne Jones
financial icon

Maintain Financial Sustainability

In 2017, Community’s revenue grew by an astonishing 32% as we served more Members and additional state programs. At the same time, expenses increased and we incurred a loss of $30 million, about 2% of our revenue of $1.5 billion.

The largest contributor to our loss resulted from action by the federal government. In October 2017, CMS announced that Health Insurance Marketplace cost-sharing reduction (CSR) funding would end immediately, meaning that insurers would not receive reimbursement from the federal government for CSR benefits provided in Q4 of 2017 and beyond. Unfortunately, this decision resulted in a $24 million revenue loss for Community Health Choice for benefits we were contractually obligated to provide our Marketplace members. To improve financial performance, we reluctantly developed our 2018 rates assuming CSRs would not be paid, resulting in higher than desired rate increases for our Members. Sadly, we have had no choice but to join other insurers in filing suit against the federal government to recover the loss.

Revenue

$638M

2012

$667M

2013

$721M

2014

$851M

2015

$1.121B

2016

$1.509B

2017

DOWNLOAD STATUTORY-BASIS STATEMENTS

DOWNLOAD THIS REPORT AS A PDF

Where does a Community Dollar Go?

90%

WAS PAID DIRECTLY TO PHYSICIANS, HOSPITALS, AND OTHER HEALTHCARE PROVIDERS

7%

COVERED ADMINISTRATIVE EXPENSES TO MAINTAIN PROVIDER NETWORK, ASSIST IN COORDINATING MEMBER CARE, PAY PROVIDERS, AND ADMINISTER OUR CONTRACT WITH THE STATE OF TEXAS

3%

WAS RETURNED TO THE STATE OF TEXAS AND FEDERAL GOVERNMENT IN TAXES AND FEES