Health Insurance in Virginia

HMO Profile

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ARCADIAN HEALTH PLAN, INC.

Company Information

  • Company Providing Plan:Humana Group
  • Address:P.O. BOX 740036
    LOUISVILLE KY 40201-7436
  • Telephone :502-580-1000
  • Website:WWW.HUMANA.COM
2021
Number of Enrollees: 37,308
PMPM: $1,021
Number of Physicians: 215,734
NCQA Accreditation:

*The data elements noted with an asterisk (*) contain regional-specific values whereas those not noted with an asterisk (*) contain Virginia specific values.

Coverage Areas

Counties

VA - MEDICARE - BOTETOURT, CHESAPEAKE CITY, FRANKLIN, NORFOLK CITY, PORTSMOUTH CITY, ROANOKE, ROANOKE CITY, SALEM CITY, VIRGINIA BEACH CITY, ALBEMARLE, ALEXANDRIA CITY, ARLINGTON, CHARLOTTESVILLE CITY, CHESTERFIELD, COLONIAL HEIGHTS CITY, CRAIG, DINWIDDIE

Cities

Bedford, Buena Vista, Chesapeake, Covington, Danville, Emporia, Fairfax, Franklin, Fredericksburg, Galax, Harrisonburg, Lexington, Lynchburg, Martinsville, Portsmouth, Roanoke, Salem, Virginia Beach, Alexandria, Charlottesville, Colonial Heights, Falls Church, Hampton, Hopewell, Manassas, Manassas Park, Newport News, Petersburg, Poquoson, Radford, Richmond, Suffolk, Waynesboro, Williamsburg, Winchester

Information provided by HMOs to State Corporation Commission Bureau of Insurance.

Administrative Data

2021 2020 2019 2018 2017
Number of Enrollees 37,308 34,110 34,866 34,254 NA
PMPM $1,021 $1,040 $981 $915 NA
Medical Cost Ratio 86% 83% 84% 84% NA
Administrative Ratio 12% 14% 12% 14% NA
Profit/Loss Ratio 3% 4% 4% 3% NA
Number of Physicians 215,734 196,098 186,866 172,688 NA

*The data elements noted with an asterisk (*) contain regional-specific values whereas those not noted with an asterisk (*) contain Virginia specific values.

Financial Data

2021 2020 2019 2018 2017
Premiums Earned $452,224,937 $423,800,286 $404,567,948 $370,599,997 NA
Income $140,538,837 $140,113,520 $134,476,909 $59,729,263 NA
Net Worth $912,923,407 $879,045,229 $716,768,438 $511,484,723 NA

*The data elements noted with an asterisk (*) contain regional-specific values whereas those not noted with an asterisk (*) contain Virginia specific values.

Performance

Access/Availability of Care
Info
Adult Access To Preventive/Ambulatory Health Services 2021 Plan State Avg Nat Avg 90th Pctl.
Adult Access To Preventive/Ambulatory Health Services Year Plan State Avg. Natl. Avg. 90th Pctl.
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Alcohol and Other Drug Dependence Treatment 2021 Plan State Avg Nat Avg 90th Pctl.
Alcohol and Other Drug Dependence Treatment Year Plan State Avg. Natl. Avg. 90th Pctl.
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Prenatal and Postpartum Care 2021 Plan State Avg Nat Avg 90th Pctl.
Prenatal and Postpartum Care Year Plan State Avg. Natl. Avg. 90th Pctl.
Behavioral Health
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Adherence to Antipsychotic Medications for Individuals with Schizophrenia 2021 Plan State Avg Nat Avg 90th Pctl.
Adherence to Antipsychotic Medications for Individuals with Schizophrenia Year Plan State Avg. Natl. Avg. 90th Pctl.
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Antidepressant Medication Management 2021 Plan State Avg Nat Avg 90th Pctl.
Antidepressant Medication Management Year Plan State Avg. Natl. Avg. 90th Pctl.
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Attention-Deficit/Hyperactivity Disorder (ADHD) Medication 2021 Plan State Avg Nat Avg 90th Pctl.
Attention-Deficit/Hyperactivity Disorder (ADHD) Medication Year Plan State Avg. Natl. Avg. 90th Pctl.
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Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence 2021 Plan State Avg Nat Avg 90th Pctl.
Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Follow-Up After Emergency Department Visit for Mental Illness 2021 Plan State Avg Nat Avg 90th Pctl.
Follow-Up After Emergency Department Visit for Mental Illness Year Plan State Avg. Natl. Avg. 90th Pctl.
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Follow-up After Hospitalization For Mental Illness 2021 Plan State Avg Nat Avg 90th Pctl.
Follow-up After Hospitalization For Mental Illness Year Plan State Avg. Natl. Avg. 90th Pctl.
Effectiveness of Care
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Asthma Medication Ratio 2021 Plan State Avg Nat Avg 90th Pctl.
Asthma Medication Ratio Year Plan State Avg. Natl. Avg. 90th Pctl.
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Cardiovascular Disease Management 2021 Plan State Avg Nat Avg 90th Pctl.
Cardiovascular Disease Management Year Plan State Avg. Natl. Avg. 90th Pctl.
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Cervical Cancer Screening 2021 Plan State Avg Nat Avg 90th Pctl.
Cervical Cancer Screening Year Plan State Avg. Natl. Avg. 90th Pctl.
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Common Childhood Illnesses 2021 Plan State Avg Nat Avg 90th Pctl.
Common Childhood Illnesses Year Plan State Avg. Natl. Avg. 90th Pctl.
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Diabetes Care and Management 2021 Plan State Avg Nat Avg 90th Pctl.
Diabetes Care and Management Year Plan State Avg. Natl. Avg. 90th Pctl.
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Immunizations 2021 Plan State Avg Nat Avg 90th Pctl.
Immunizations Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Pharmacotherapy of COPD Exacerbation 2021 Plan State Avg Nat Avg 90th Pctl.
Pharmacotherapy of COPD Exacerbation Year Plan State Avg. Natl. Avg. 90th Pctl.
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Preventive Care 2021 Plan State Avg Nat Avg 90th Pctl.
Preventive Care Year Plan State Avg. Natl. Avg. 90th Pctl.
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Spirometry Testing 2021 Plan State Avg Nat Avg 90th Pctl.
Spirometry Testing Year Plan State Avg. Natl. Avg. 90th Pctl.
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Statin Therapy 2021 Plan State Avg Nat Avg 90th Pctl.
Statin Therapy Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Weight Assessment and Counseling 2021 Plan State Avg Nat Avg 90th Pctl.
Weight Assessment and Counseling Year Plan State Avg. Natl. Avg. 90th Pctl.
Health Plan Stability/Descriptive
Info
Administrative Data 2021 Plan State Avg Nat Avg 90th Pctl.
Administrative Data Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Financial Data 2021 Plan State Avg Nat Avg 90th Pctl.
Financial Data Year Plan State Avg. Natl. Avg. 90th Pctl.
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Years in Business 2021 Plan State Avg Nat Avg 90th Pctl.
Years in Business Year Plan State Avg. Natl. Avg. 90th Pctl.
Member Satisfaction
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Member Satisfaction 2021 Plan State Avg Nat Avg 90th Pctl.
Member Satisfaction Year Plan State Avg. Natl. Avg. 90th Pctl.
Overuse/Appropriateness
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Antipsychotics 2021 Plan State Avg Nat Avg 90th Pctl.
Antipsychotics Year Plan State Avg. Natl. Avg. 90th Pctl.
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Cervical Cancer Screening in Adolescent Females 2021 Plan State Avg Nat Avg 90th Pctl.
Cervical Cancer Screening in Adolescent Females Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Lower Back Pain 2021 Plan State Avg Nat Avg 90th Pctl.
Lower Back Pain Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Respiratory 2021 Plan State Avg Nat Avg 90th Pctl.
Respiratory Year Plan State Avg. Natl. Avg. 90th Pctl.
Info
Use of Opiods 2021 Plan State Avg Nat Avg 90th Pctl.
Use of Opiods Year Plan State Avg. Natl. Avg. 90th Pctl.
Risk Adjusted Utilization
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Acute Hospital Utilization Rate 2021 Plan State Avg Nat Avg 90th Pctl.
Acute Hospital Utilization Rate Year Plan State Avg. Natl. Avg. 90th Pctl.
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Emergency Department Utilization 2021 Plan State Avg Nat Avg 90th Pctl.
Emergency Department Utilization Year Plan State Avg. Natl. Avg. 90th Pctl.
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Plan All-Cause Readmissions 2021 Plan State Avg Nat Avg 90th Pctl.
Plan All-Cause Readmissions Year Plan State Avg. Natl. Avg. 90th Pctl.
Utilization
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Antibiotic Utilization 2021 Plan State Avg Nat Avg 90th Pctl.
Antibiotic Utilization Year Plan State Avg. Natl. Avg. 90th Pctl.
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Mental Health Utilization 2021 Plan State Avg Nat Avg 90th Pctl.
Mental Health Utilization Year Plan State Avg. Natl. Avg. 90th Pctl.
2021 data updated on: 07/05/2023