HRSA - Sources of Reimbursement

OAT grantee organizations were asked to identify major sources of reimbursement for their projects available in their respective states. Their responses are indicated in this section.

ST	Organization	Medicare	Medicaid	Private Payor (Please Specify)	Other Contract (Please Specify)	Other Source
AK	Alaska Native Tribal Health Consortium	x	x	Blue Cross, Aetna	IHS Contract Health
AK	Alaska Psychiatric Institute (API)	x	x
AL	University of South Alabama		x
AR	University of Arkansas for Medical Sciences	x	x	Cigna, First Health, First Source, Health Advantage, Humana, QualChoice, Premier Care, United Health Care, USAble, Aetna, AARP Healthcare, Arkansas 1^st Source, TRICARE, AR Kids First
AZ	Arizona Board of Regents, University of Arizona	x	x	Although almost all private payors in Arizona reimburse telemedicine services, the patients seen for clinical services in the ADVICE program have been uninsured to date.	Tobacco Tax Funding Indian Health Services
	Banner Good Samaritan Telemedicine Program					N/A
	Maricopa County, Arizona					N/A
CA	Familia Unida Living with Multiple Sclerosis					N/A
	Multi-Dimensional Imaging, Inc. of Newport Beach					N/A
	San Joaquin County Health Care Services					N/A
	Santa Rosa Memorial Hospital					N/A
CO	Avista Adventist Hospital					N/A
CO	University of Colorado Health Sciences Center					N/A
DC	American Red Cross					N/A
DC	Foundation For eHealth Initiative
	CareSpark, TN			Anticipated health plans and employers	State of TN Q 1 & 2, 2006 State of VA planned Q 3 & 4, 2006	Accenture NHIN prototype demonstration, Q1-4, 2006
	Colorado Health Exchange Network, CO					N/A
	Indiana Health Information Exchange, IN					Our initial model relies on data sources to fund delivery of information much as they do now in a “paper” world.
	Maryland/DC Collaborative for Health Information Technology, MD					N/A
DC	Massachusetts Health Data Consortium (MA-SHARE), MA			Blue Cross Blue Shield of MA Harvard Pilgrim Health Care Other TBD	Markle Connecting for Health Record Locator Service Prototype ONCHIT Nationwide Health Information Network (NHIN) Architecture AHRQ-CMS ePrescribing Gateway Pilot Other TBD	Partners Health Care System CareGroup Health Systems Commonwealth of MA Executive Office of Health and Human Services Massachusetts eHealth Collaborative Other TBD
	National Institute for Medical Informatics, WI					N/A
	Santa Barbara County Care Data Exchange, CA					N/A
	St. Joseph’s Hospital Foundation (Whatcom HIE), WA					N/A
	Taconic Educational Research Fund, NY					N/A
FL	BayCare Health System					N/A
	Florida Cancer Research Cooperative, University of South Florida					N/A
	University of Florida College of Dentistry (UFCD)	x	x			Service Contracts
GA	Morehouse School of Medicine					N/A
GA	Ware County Health Department					N/A
HI	Hawai’i Primary Care Association (HPCA)	x		HMSA, AlohaCare, Quest
HI	Moloka’i General Hospital	x	x	HMSA, Blue Cross/Blue Shield
IA	Iowa Chronic Care Consortium		x
IA	Mercy Foundation	x	x	Physicians bill 3^rd party insurance carriers
ID	Clearwater Valley Hospital and Clinics, Inc.					N/A
	Idaho State University, Institute of Rural Health		x
	North Idaho Rural Health Consortium (NIRHC)		x
IL	Northern Illinois University/Fermi National Laboratory		x	Blue, IL; Humana; Signa; Aetna		HRSA
	OSF Saint James—John W. Albrecht Medical Center					N/A
	Saint John’s Hospital		P	P-To Be Determined		IL Department of Public Health
	Southern Illinois University School of Medicine	x	x	Multiple private Insurers	Veteran's Hospital, Mental Health Hospital
IN	James Whitcomb Riley Hospital for Children	x		Anthem, Wellpoint, M-Plan, United Health Care
IN	Health & Hospital Corporation of Marion County					N/A
KS	University of Kansas Medical Center	x	x	Blue Cross/Blue Shield	Contract for service between Crawford County Mental Health Center and KUMC Child-Adolescent Psychiatry.	State-wide Telekidcare dollars
KY	The James B. Haggin Memorial Hospital					N/A
	Marcum & Wallace Memorial Hospital					N/A
	New Horizons Health Systems, Inc.					N/A
	University of KentuckyResearch Foundation—Kentucky TeleCare		x	Atena, Anthem Blue Cross Blue Shield, Beechstreet PPO, UKHMO, CHA Health, Bluegrass Health Network, C&O Employee’s Hospital Association, CCN PPO, CHAMPVA/Tricare, Cigna, Cooperative Care- Bluegrass Care Alliance, Community Health Partnership, Cumberland Health Care, Inc., Direct Care America, Evolution Healthcare Systems, General American, Harrod Community Health Plan, Hospice of the Bluegrass, Humana, National Provider Network PPO, One Health Plan, PPO Next/Healthstar/PHN, United Healthcare	Federal Prison, State prison, State Public Health Dept. for TB Clinic Consultation	Medicare/Medicaid reimbursement only for certain CPT codes All private payor/commercial insurance companies are mandated by State of KY to reimburse for telehealth consultations in same manner as face –to-face consultations.
LA	Southwest Louisiana Health Care Systems		x	Multiple private insurers
LA	Woman’s Hospital	x	x	Aetna, American Lifecare, Blue Cross/Blue Shield of Louisiana, ChoiceCare Network, CIGNA, Community Care Network, Coventry HealthCare, First Heath Network, Humana, Multiplan, PPO Plus, Private Healthcare Systems, United Healthcare of Louisiana		Tricare Prime, Tristan
MA	Massachusetts College of Pharmacy and Health Sciences					N/A
MA	UMass Memorial Medical Center					N/A
ME	Regional Medical Center at Lubec					N/A
MI	Altarum Institute					N/A—Operational funding to be determined in planning process.
	Hillsdale Community Health Center					N/A
	Hurley Medical Center					N/A
	Michigan State University					N/A
	Western Michigan University	x	x			Patient
MN	Fairview Health Services					N/A
MN	University of Minnesota	x	x	Blue Cross/Blue Shield of MN Health Partners Medica Preferred One Workers Compensation Select Care Ucare of Minnesota
MO	The Curators of the University of Missouri	x		Am. Family, Bankers Life, Blue Shield Alliance, Cigna, Gencare, General American, Health Data Svcs. Claim, Healthlink, Healthnet, John Deer Health Care, Missouri Care MC+, Metropolitan, Mercy Health Plan, Preferred Health Plan, Prudential, United Health Care, Ethix PPO, Time Insurance Co., Cooperative Benefit, First Health, Healthsmart Preferred, Humana, National Telephone, NRECA, Proamerica, Waldsworth Publishing	Fort Leonard Wood, Clark Mental Health Ctr.
MT	Benefis Healthcare Foundation					N/A
	Billings Clinic Foundation					N/A
	Deaconess Billings Clinic Foundation	x	x	Blue Cross/Blue Shield of Montana, EBMS, New West Health Services
	Saint Patrick Hospital & Health Foundation	x	x	300+ private payors—EKG interpretation
	Saint Vincent Healthcare Foundation	x	x	Blue Cross/Blue Shield of Montana/EBMS; Paid by other insurances on case by case basis		Patient self pay
	The University of Montana—Missoula					N/A
NC	Duke University Medical Center					N/A
NC	Educational and Research Consortium of Western Carolinas					N/A
ND	North Dakota State University College of Pharmacy	x	x	Blue Cross/Blue Shield		Cash pay patients.
ND	Northland Healthcare Alliance	x	x	Blue Cross Blue Shield of North Dakota. Also have been paid by other commercial payers on a case by case basis.
NE	Good Samaritan Hospital Foundation	x	x	Blue Cross, Starmark, Equitable Life, Three Rivers Benefit Corp, Physicians Mutual, Pioneer, Mutual Protective, Midlands Choice, Union Banders, AARP, TriCare, Cigna, Bankers Life, UniCare Life & Health, CBSA, Midwest Select, Mutual Protective, Thrivent, Options, AARP Healthcare Options, Mutual of Omaha, Mega Health, Medicaid, State Farm, BDPPO, FMH Benefit, Reserve National, Unicare Life & Health, United Health, Allied Benefits
NE	University of Nebraska Medical Center					N/A
NJ	Hackensack University Medical Center					N/A
NJ	Saint Peter’s University Hospital

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