Welcome to the Health Plan of Michigan Providers Site Map page.
Here, health care providers and professionals are invited to browse through this section of the Health Plan of Michigan website designed especially for you. You may use the links on top or on the left to quickly find the information you need. Sections are divided for ease of use and areas of interest are linked together under a common topic.
If at any time you would like to view pages specific to our company or members of the HPM network, simply use the main navigation button at the top of the page. To return to this page, click the Provider's site map link in the navigation bar on the following pages.
Additionally, you may view our Privacy Policies, Job Opportunities, Report Fraud/Abuse or submit a Complaint. For more information about Health Plan of Michigan, click here; or contact us.
All of us at Health Plan of Michigan hope you enjoy your visit and if you'd like to send us feedback on your visit today, please email us at email@example.com
Health Plan of Michigan, Inc. is a Medicaid Qualified Health Plan and HMO that contracts with the Michigan Department of Community Health (MDCH) to provide health care services. Health Plan of Michigan initially resulted from the merger of two clinic plans, Central Michigan Health Plan (CMHP) and American Preferred Provider Plan of Michigan, Inc. (APPPM). CMHP was founded by physicians at the Jackson Northwest Clinic located in Jackson, Michigan in December of 1996. In August of 1997 Dr. David B. Cotton acquired a majority position in CMHP and assumed fiscal and administrative responsibility for the Plan which had approximately 1400 members. CMHP acquired American Preferred Provider Plan of Michigan, Inc. in January of 1999. Health Plan of Michigan became operational as a company in May of 1999. In January of 2000 Health Plan of Michigan acquired the Michigan membership of Family Health Plan of Ohio. Health Plan of Michigan now covers over 85,000 beneficiaries in 32 counties and has operated as a full service HMO since January of 2000. Health Plan of Michigan became NCQA accredited in May of 2002. Despite all of the above changes Health Plan of Michigan (HPM) remains a physician owned and physician managed health plan.
HPM is a health maintenance organization (HMO), which provides a wide range of Medicaid covered benefits for its enrollees including most provider services as well as hospital and emergency room access. HPM's philosophy and business plan is to primarily function as a care management and preventive care organization. The HPM option is currently available to eligible Medicaid recipients residing in the Plan's service areas which covers most of the Ohio border and includes the counties of Allegan, Barry, Berrien, Branch, Calhoun, Cass, Eaton, Genesee, Hillsdale, Huron, Jackson, Kalamazoo, Kent, Lenawee, Livingston, Macomb, Manistee, Monroe, Montcalm, Muskegon, Newaygo, Oakland, Oceana, Ogemaw, Oscoda, Ottawa, Roscommon, Sanilac, St. Clair, St. Joseph, Tuscola and Van Buren.
Health Plan of Michigan is fully accredited with the National Committee for Quality Assurance (NCQA). NCQA, a non-profit, independent organization, is considered the premier source for information about the quality of the nation's managed care plans.
NCQA Accreditation is designed to help employers and consumers distinguish between health plans based on quality. Accreditation is an on-site and off-site, rigorous and comprehensive evaluation process through which NCQA assesses the quality of the core systems and processes that make up a health plan. Accreditation evaluates not only those core systems and processes, but the results that the health plan actually achieves on key dimensions of care and service. NCQA began accrediting managed care organizations in 1991, in response to the need for standardized, objective information about the quality of health plans. NCQA's accreditation program is voluntary, and has been embraced by purchasers, consumers and health plans as an objective measure of quality. To learn more about NCQA and the standards that Health Plan of Michigan has met in order to achieve accreditation please go to the NCQA website at www.ncqa.org.
Michigan's Department of Community Health has the stated goal of enrolling all Medicaid recipients in a managed care organization. To that end, the State of Michigan has issued three Requests for Proposal for Comprehensive Health Care. In direct response to these RFPs, HPM has developed a comprehensive provider network that includes over 1,000 primary care providers, over 4,000 specialists and 53 hospitals.
It is HPM's intention to serve both its enrollees and providers in all current service areas and to continue to expand its presence throughout the State of Michigan.
The State of Michigan has decided to use the nationally recognized HEDIS measures as its primary yardstick of quality for health plans serving the Medicaid population. HPM's goal is to be one of the top 5 health plans in the State in each of the HEDIS measures. This goal is consistent with HPM's overall goal of becoming one of the best care management companies in Michigan Medicaid.