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Our Company
Mission
To be the trusted health plan of choice for customers, members, partners and our employees.
Vision
To be trusted in the community for our unwavering commitment to high-quality, affordable health care.
Summary
Medica is a non-profit health plan that serves communities in Minnesota, Iowa, Kansas, Missouri, Nebraska, North Dakota, Oklahoma, South Dakota and Wisconsin — the heart of America. As a company, we empower communities by listening to their voices, learning about community needs, and devoting time and resources to help.
Medica partners with the communities it serves in many ways, including the Medica Foundation, a nonprofit, charitable grant-making foundation. The Medica Foundation, which provides more than $1 million in grants annually, generally seeks to fund community-based programs and initiatives that can provide sustainable, measurable improvements in the availability, access and quality of health care.
Our values include:
- Customer Focus
- Excellence
- Stewardship
- Integrity
- Diversity
Learn More About Medica
Medica was founded by physicians in 1975 as Physicians Health Plan. It was the first open-access health plan in the state. In 1991, PHP merged with Share to become Medica. And in 1994, Medica merged with HealthSpan to form Allina Health System, an integrated organization offering both health care coverage and medical services. Medica became an independent health plan in 2001.
Medica provides health care coverage in the employer, individual, Medicaid and Medicare markets. It operates in Minnesota, Iowa, Kansas, Missouri, Nebraska, North Dakota, Oklahoma, South Dakota and Wisconsin.
Medica has several broad, regional networks that serve members across our eight-state service area, including innovative accountable care organization partnerships with leading provider systems. Medica also offers national coverage to employers who have employees outside Medica’s regional service area.
In 2019, Medica generated $4.5 billion in revenue.
As noted above, stewardship is one of our core values. One of the ways we protect our members and ensure responsible stewardship of their premium dollars is by preventing and investigating fraud, waste and abuse.
About Fraud, Waste and Abuse
Medica works diligently to ensure that our member’s premium dollars and government program funds are used for legitimate health care purposes. In addition to investigating allegations of fraud and abuse committed against Medica and our plans, Medica conducts claims analysis to identify providers that submit claims that are outliers when compared to their peers.
Identifying suspected fraud, waste and abuse is important for many reasons, including:
- Our members are put at risk by providers rendering unnecessary services or failing to render proper care
- It impacts our ability to provide quality, cost-effective health care
- There's substantial financial impact
- It drives up cost of healthcare/premiums for our members
Medica employees are trained to heighten their awareness of fraud, waste and abuse and how to report suspected fraud. We also offer multiple ways for our members and community to report fraud waste or abuse.
Learn more about preventing and reporting fraud, waste and abuse
Medica offers an integrated approach for employers and members to improve health and manage the costs of care. Health improvement programs provide personalized solutions that focus on the whole person, and include a comprehensive range of support from healthy lifestyles to chronic disease and complex care management across the continuum of care.
Medica refers to a group of companies held by a non-profit, tax exempt holding company called Medica Holding Company. Its family of businesses include Medica Health Plans, Medica Community Health Plan, Medica Insurance Company, Medica Self-Insured, MMSI, Inc. d/b/a Medica Health Plan Solutions, Medica Health Management, LLC and the Medica Foundation.
Medica is accredited by the National Committee for Quality Assurance (NCQA®) for its Commercial and Marketplace (Affordable Care Act) plans.