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American Health Holding

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United States

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1993 (32 Years)

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Company Information

Get to know American Health Holding

Founded in 1993 and a subsidiary of Aetna/CVS Health, American Health Holding, Inc. is a prominent national provider of medical management services. The company specializes in offering a comprehensive suite of programs, including utilization management, case management, disease management, and population health solutions. They serve a diverse client base, such as third-party administrators (TPAs), insurance companies, self-funded employers, and health plans, with a mission to deliver flexible, high-quality services that improve health outcomes and control healthcare expenditures.

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Summarization

American Health Holding Insurance Review

Brief Introduction and Overview of the Company

American Health Holding, Inc. (AHH) is a privately held company established in 1993 by Ivan Gilbert, MD, and Michael Reidelbach in Worthington, Ohio[1]. Over the years, the company has evolved into a prominent medical management organization, recognized for its comprehensive, integrated health management solutions and URAC-accredited programs[4].

Key Highlights of the Company’s Market Position and Reputation

  • Market Position: AHH positions itself as a single-source provider of integrated health management solutions, supporting millions of members across the healthcare continuum[2].
  • Reputation: AHH boasts a high client satisfaction rate, with 98% of clients affirming that its services represent a good value[3].
  • Regulatory Compliance: AHH maintains a strong commitment to regulatory compliance by holding licenses and certifications, including URAC accreditation for its integrated Utilization Management, Case Management, and Disease Management programs[4].

Overview

Year of Establishment and Background Story

  • Year of Establishment: 1993
  • Founders: Ivan Gilbert, MD, and Michael Reidelbach[1].

Key Milestones in the Company’s History and Growth

  • Founding: AHH was established to address the rising healthcare costs and the pressing need for cost containment practices within the healthcare industry[1].
  • Acquisitions:
    • Prodigy Health Group: AHH was acquired by Prodigy Health Group in April 2006[1].
    • Aetna: Prodigy Health Group was subsequently acquired by Aetna, Inc. in June 2011[1].
    • CVS Health: Aetna was then acquired by CVS Health in December 2018[1].
  • Current Status: AHH currently operates as an independent subsidiary of CVS Health[1].

Regulatory Compliance and Licenses

  • URAC Accreditation: AHH is recognized for its URAC-accredited programs in Utilization Management, Case Management, and Disease Management[4].
  • State Licenses: The company maintains the necessary licenses in all required states to operate its services[4].

Insurance Products and Services

Main Insurance Products

Types of Insurance Offered
  • Health Management Services: AHH provides a comprehensive range of health management solutions, encompassing Utilization Management, Case Management, and Disease Management[2][4].
  • Integrated Solutions: The company offers flexible solutions that support integrated health management across the entire healthcare continuum[2][4].
Coverage Options and Policy Details
  • Client Base: AHH serves a vast client base of approximately 3.1 million lives across all 50 states, the Caribbean, and Bermuda[4].
  • Customized Solutions: The company prioritizes client satisfaction by providing customized solutions that maximize cost savings while ensuring the quality and appropriateness of care[4].

Additional Services

Other Services Provided
  • Clinical Expertise: AHH boasts a professional staff of physicians and registered nurses who are highly skilled in cost management issues and quality assurance standards[5].
  • Technology Integration: The company leverages leading proprietary technology to enhance its services and improve outcomes for its clients[4].

Premiums and Pricing

Pricing Structure

Overview of Premium Rates for Different Types of Insurance
  • Cost Savings: AHH's focus is on helping clients maximize cost savings through its flexible medical management services[1][4].
  • Comparative Analysis: While specific premium rates are not explicitly provided, the company's emphasis on cost containment and efficiency suggests competitive pricing[1][4].
Comparative Analysis with Industry Averages

Specific comparative analysis with industry averages is not readily available in the sources. However, AHH's reputation for cost-effective solutions suggests that its pricing may align with industry averages[1][4].

Discounts and Special Offers

Available Discounts
  • Multi-Policy Discounts: No specific information on multi-policy discounts or other available discounts is currently provided[1][4].
  • Promotional Deals: There are no explicit mentions of promotional deals or limited-time offers in the available sources[1][4].

Customer Service and Support

Contact Methods

Available Customer Service Channels
  • Phone: While phone support is likely offered by AHH, specific details are not readily available[3].
  • Email: The company may provide email support, although this is not explicitly confirmed in the sources[3].
  • Live Chat: There is no mention of live chat support in the available sources[3].
Availability of 24/7 Support and Multilingual Assistance

Specific details on 24/7 support and multilingual assistance are not provided in the available sources[3].

Pros and Cons of American Health Holding Insurance

Pros

Advantages of Choosing This Insurance Company
  • Comprehensive Coverage: AHH offers comprehensive health management solutions that prioritize cost-effective, quality care for members[1][4].
  • Client Satisfaction: The company has a strong track record of client satisfaction, with 98% of clients indicating that AHH services are a good value[3].
  • Regulatory Compliance: AHH's commitment to regulatory compliance is evident through its URAC accreditation and state licenses[4].

Cons

Potential Drawbacks or Areas for Improvement

Specific cons or areas for improvement are not extensively detailed in the available sources. However, as a private company, AHH may have less transparency and public scrutiny compared to larger, publicly traded companies[1][4].

Conclusion

Summary of the Main Points Covered in the Review

  • Founding: American Health Holding was established in 1993 by Ivan Gilbert, MD, and Michael Reidelbach.
  • Growth: The company has grown through strategic acquisitions and currently operates as an independent subsidiary of CVS Health.
  • Services: AHH provides comprehensive health management solutions, including Utilization Management, Case Management, and Disease Management.
  • Regulatory Compliance: The company maintains URAC accreditation and is licensed in all required states.
  • Client Satisfaction: AHH enjoys a high client satisfaction rate and is recognized for its flexible solutions and clinical expertise.

Recommendations on Who Would Benefit Most from the Company’s Insurance Offerings

  • Self-Insured Companies: Companies actively seeking to manage their healthcare costs effectively would benefit from AHH's services.
  • Third-Party Administrators: Organizations looking for comprehensive health management solutions would find AHH's offerings valuable.
  • State and Local Governments: Government entities managing health programs for their employees or constituents could benefit from AHH's expertise.

Frequently Asked Questions about American Health Holding Insurance

Answers to Common Questions about the Company’s Policies, Claims Process, and More

  • Q: What types of health management services does AHH offer?

    A: AHH offers a range of services including Utilization Management, Case Management, and Disease Management.

  • Q: How does AHH help clients maximize cost savings?

    A: AHH achieves cost savings through its flexible medical management services and its utilization of proprietary technology.

  • Q: Is AHH URAC-accredited?

    A: Yes, AHH is URAC-accredited for its integrated Utilization Management, Case Management, and Disease Management programs.

References

  • [1] https://www.americanhealthholding.com/OurDifference/History
  • [2] https://leadiq.com/c/american-health-holding/5a1d842624000024005ea1cd
  • [3] https://www.americanhealthholding.com
  • [4] https://www.americanhealthholding.com/ourdifference
  • [5] https://ohiolifesciences.org/business-directory/114771/american-health-holding-inc/

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