CommunityCare's Oklahoma roots run deep as the managed care organization owned and operated by Saint Francis Hospital (founded 1960) and St. John Medical Center (founded 1926).
In the early 1980s, managed care came to Oklahoma in the form of health maintenance organizations (HMOs). Hospitals and physicians in metropolitan areas began taking notice of changes in the way healthcare was being delivered on local and national levels.
In 1983, in an effort to maintain market share and become a player in the managed care arena, St. John Medical Center developed CompMed Preferred Provider Organization (PPO). St. John and Bartlett Memorial Hospital in Sapulpa were the only two hospitals in the network. CompMed remained independent from other PPOs and contracted directly with insurance carriers, third party administrators (TPAs) and large self-insured national and local employers.
In 1984, St. John created two additional managed care products, ExcelCare and the Employee Assistance Program (EAP). ExcelCare offers utilization management and quality assurance services. The EAP helps employees and their family members cope with problems of daily life by providing referrals to a wide array of behavioral health providers. Both of these programs were designed to support and increase market share for CompMed.
During the same time period, Saint Francis developed HealthFirst PPO. HealthFirst contracted directly with insurance carriers and local employers while subcontracting its provider network to other PPOs.
In January 1985, the managed healthcare industry began to grow rapidly. CompMed signed its first insurance carrier contract and General American Life Insurance Company became its first strong partner. Later that year, contracts were obtained from Provident Life and Mass Mutual.
In mid-1985, CompMed was asked to participate as a PPO benefit for the City of Oklahoma City. Contracts were negotiated with Mercy Health Center and St. Anthony Hospital. In 1986, the network expanded and additional opportunities increased in the Oklahoma City area. To handle the increased business, CompMed established an office in Oklahoma City. Insurance carriers and TPAs saw CompMed as an emerging statewide network, which resulted in additional payor contracts, large self-insured employer contracts and requests to expand CompMed into the rural areas of the state. Later that year, CompMed formed its own TPA service, Hospital Claims, Inc. (HCI). HCI was formed to pay claims for the self-funded benefits plan for St. John Medical Center employees.
In 1990, Mercy Health Center in Oklahoma City became interested in ownership of the CompMed Oklahoma City network and negotiated a contract. Included in the agreement were management contracts for services provided by CompMed/Tulsa to CompMed/OKC. The two networks would have reciprocity and be viewed as one network when contracting with insurance carriers, TPAs and employers. All claims repricing, utilization management and reports would be a function of the CompMed/Tulsa location.
Also in 1990, CompMed applied for Accreditation through the American Association of Preferred Provider Organizations (AAPPO). By 1991, the evaluation process was successfully completed and CompMed became the first accredited PPO in Oklahoma and only one of 20 in the nation at that time. CompMed was re-accredited two years later.
In 1993, healthcare reform came into the national spotlight. In response to proposals supported by the Clinton administration, many of the healthcare providers began forming new alliances. One such alliance was a joint venture between Saint Francis Hospital and St. John Medical Center, which resulted in CommunityCare HMO.
CommunityCare HMO was the first of its kind in Tulsa and had 30 employees located at 4720 S. Harvard. As the policies and procedures for CommunityCare HMO were developed, it began to make good business sense to merge Saint Francis' HealthFirst PPO with St. John's CompMed. As a result of the merger, Preferred CommunityChoice PPO became operational in April 1994.
The first HMO employer contract with The Hardesty Companies was written on June 1, 1994. In July 1994 the State of Oklahoma offered CommunityCare HMO as one of the choices to the state employees in the Tulsa area. Later that year, employees from Saint Francis and St. John were offered CommunityCare HMO or Preferred CommunityChoice PPO.
Effective January 1995, Mercy Health Center and St. Anthony Hospital became owners in CommunityCare HMO and eventually in CommunityCare Managed Healthcare Plans of Oklahoma.
July 1995 brought a new product offering from CommunityCare. The state of Oklahoma began moving its Medicaid recipients to a managed care program called SoonerCare. CommunityCare became a part of the program.
In 1996, CommunityCare began offering a Medicare Advantage plan called Senior Health Plan. Senior Health Plan is a Medicare HMO for Medicare eligible beneficiaries. Dick Bushaw, a long time Tulsa resident and our first member, signed up on July 1, 1996, his 65th birthday. Senior Health Plan also has a senior center at 4720 S. Harvard that allows members to meet with sales representatives face to face and learn more about Senior Health Plan.
In October 1996, we ventured into the Worker's Compensation arena with our own Worker's Comp PPO network and a Certified Workplace Medical Plan called WorkNet of Oklahoma.
By December 1996, we had outgrown our location at 4720 S. Harvard. We moved to the present location at Sixth and Denver into a nine-story building that had previously been occupied by Amerada-Hess Oil Company. Soon after, the parking lot was bursting at the seams. The building owner, St. John Medical Center, decided to build a four story-parking garage, which was completed in June 1998.
In 1997, CommunityCare HMO was awarded Accreditation with Commendation from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). In 2000, CommunityCare HMO was re-accredited for three more years. CommunityCare HMO was then re-accredited in 2003.
In July 1997, CommunityCare reached 50,000 HMO members.
In 1997 CommunityCare introduced a series of ads using a "tree and roots" theme. The ads made the statement: "Would you prefer a health plan provider with a few branch offices in Oklahoma or one with all its roots right here?" The theme was very successful and carried through to marketing materials, displays and corporate logos. 2001 saw the launch of a new advertising campaign using nursery rhymes to communicate the advertising message. Jack and Jill, Old Mother Hubbard and Humpty Dumpty were rewritten to focus on the positive attributes of CommunityCare. Several years later, the slogan "Oklahoma's best choice for healthcare" was added to CommunityCare's advertising.
Also, in 1997, a holding company, CommunityCare Managed Healthcare Plans of Oklahoma, was formed to be the parent company for all CommunityCare product lines.
Other CommunityCare membership milestones included the 10,000th Senior Health Plan member in September 1998 and our 100,000th HMO member in February 1999.
In 1999, we also began marketing CommunityCare Plus, a POS product. This product offers HMO style benefits with an out-of-network option. This allows members to receive HMO style benefits but still have access to out-of-network benefits for higher copays and deductibles.
In 2000, CommunityCare began offering CommunityCare Life and Health Insurance Company PPO Plan, a PPO product for employers with 50 or more employees (now also available to small groups), that utilizes the Preferred CommunityChoice network. A partnership with Private Healthcare Systems (PHCS), a national provider network, provides coverage for employees who are located outside the Preferred CommunityChoice network.
Mercy Health Center's ownership in CommunityCare ended in October 2000 and St. Anthony Hospital's ownership ended in September 2001.
Senior Health Plan celebrated the 20,000th member in July 2002.
Springer Clinic, Northeast Oklahoma's oldest and largest multi-specialty medical clinic, joined CommunityCare HMO in 2002. Preferred CommunityChoice welcomed INTEGRIS Health facilities to its network of providers in Oklahoma City. The Family Medical Care group and Hillcrest HealthCare System joined the network of providers in the Tulsa area in 2003. Deaconess Hospital joined CommunityCare HMO's network in October 2004, and INTEGRIS Health joined the HMO network in January 2005.
The SoonerCare Plus program was terminated in Spring 2003.
Also, in 2003, CommunityCare Managed Healthcare Plans of Oklahoma introduced two new products. The first new product was CommunityCare Medicare Supplement for Medicare eligible beneficiaries. The second new product was CommunityCare Employer's Choice, which is a plan that provides managed benefits for self-funded employers.
The Individual Deductible Employer Advantage (IDEA) plans were introduced in 2004. These high deductible health plans are tailored to fit any company's specific needs and help companies keep their premiums low. CommunityCare HealthShare HRA was introduced in 2005.
CommunityCare began offering a PPO plan for small employer groups in 2006.
In 2009, CommunityCare introduced its Individual Health Plan to the market. This product provides individual healthcare coverage for individuals up to age 64 ½.
In 2013, CommunityCare began offering individual plans through the federal Health Insurance Marketplace and small group plans through the Small Business Health Options Program (SHOP) Marketplace.
In 2014, CommunityCare created a new company, CommunityCare Government Programs. This company began offering Advantage Medicare Plan in 2015.
In the fall of 2017, CommunityCare worked with a creative firm to develop a new logo for the organization. A clean, crisp dark green and cool gray logo was selected. For the first time, CommunityCare began using a mark resembling a cross as part of the logo.
After 20 years at 218 W. Sixth Street, CommunityCare relocated to Williams Center Tower II in December 2017. The company leased space on the plaza level along with Floors 18-23. This facility allowed CommunityCare to offer employees the benefit of an onsite fitness center.
In 2018, CommunityCare celebrated 25 years as an organization.
CommunityCare has more than 450 employees.