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FirstCarolinaCare and Carle Agree to Partnership

| Date Posted: 11/12/2019

FirstCarolinaCare Insurance Company (FCCI) and Health Alliance - a member of the Carle health system (Carle) – have agreed to the terms of a joint venture to provide health insurance products in North Carolina.


FCCI is a not-for-profit insurance company which is a wholly-owned subsidiary of FirstHealth of the Carolinas (FHC), headquartered in Pinehurst, North Carolina. Carle is a not-for-profit integrated health system based in Urbana, Illinois. Similar to FCCI, Health Alliance is a provider-owned insurance company covering approximately 230,000 commercial and Medicare Advantage members. Health Alliance has membership in Illinois, Washington, Iowa, Ohio and Indiana.


Under the terms of the agreement, Carle will become the majority owner of FirstCarolinaCare. FHC will continue to have an active role in FCCI as a minority owner and will continue to have seats on the FCCI Board, giving it a voice into FCCI’s continued growth in North Carolina. Together, the plans will serve approximately 255,000 members.


“We are excited to partner with Carle,” said Mickey W. Foster, CEO of FirstHealth of the Carolinas. “The partnership will enhance FirstCarolinaCare’s ability to provide comprehensive and competitive insurance products to our group insurance clients and our Medicare Advantage members. Our partnership with Carle will assist FCCI in improving our operational capabilities while strategically positioning both organizations for the future.”


Licensed by the North Carolina Department of Insurance in 2000, FCCI provides group health insurance coverage to more than 200 businesses across the state. The company began offering a Medicare Advantage with prescription drug (MAPD) product in 2013 under the name FirstMedicare Direct. The company’s MAPD plan serves nearly 7,000 members in Moore, Lee, Hoke, Montgomery, Chatham, Scotland, Richmond, Wake, Buncombe, Henderson, Transylvania, McDowell, Yancy, Madison and New Hanover counties. 


“Carle is committed to achieving the best possible care for those we serve and that means partnering in new ways as health care evolves. We are thrilled to join forces with FirstCarolinaCare to strengthen the ways we support members together. As a vertically integrated system, Carle specializes in identifying options throughout the care continuum to best serve members when and where they need it. FirstCarolinaCare shares our vision of continuous improvement to achieve top-decile care. By partnering with health plans, providers, researchers and innovators, we are striving to deliver world-class care and service, and we look forward to doing that together,” said Dennis Hesch, executive vice president, chief financial and strategy officer for the Carle health system and chief executive officer for Health Alliance Medical Plans.


FirstCarolinaCare will maintain its own identity and brand and will continue to be locally managed by its current leadership. FirstCarolinaCare and Health Alliance will continue as two separate companies and retain their respective names in the markets they each serve.


FirstCarolinaCare will maintain operations in Pinehurst and will continue to be accessible for its members. The transaction is expected to be finalized by Dec. 31, 2019, pending state and federal regulatory review and closing conditions.


“Our employees and the name will remain,” said Craig Humphrey, president of FirstCarolinaCare. “The intent of this transaction is to bring us the added operational capabilities and capital to serve members.  As provider-led health plans, both FCCI and Carle share a commitment to deliver the best value for high-quality products to the unique populations that we serve. The transaction will be seamless for members. There will not be any disruption to the benefit or to the provider network, and no change in our high touch personal service to our groups and members.”


“Partnering with Carle means sharing best practices, resources, care management solutions, and learning new ways to engage members in their health with a big focus on wellness,” added Humphrey.  


“The health of the communities we serve has always been a priority for FirstHealth and FCCI,” continued Foster. “Our partnership with Carle will take our health and wellness efforts to a new level. FirstHealth was ahead of the curve when we started our own insurance company nearly 20 years ago. Our leadership at that time had the foresight to know that health, wellness and prevention go hand in hand, and this new partnership is a continuation of that foundation.”


About FirstHealth: FirstHealth of the Carolinas, a private, not-for-profit health care network, is headquartered in Pinehurst. Its more than 5,200 employees serve 15 counties in the mid-Carolinas. Licensed for four hospitals with 610 beds and also including facilities for inpatient and outpatient rehabilitation, a hospice, a palliative care program, a home care program, community outreach programs, behavioral services, fitness facilities, primary and convenient care practices, a hospitality house, EMS and critical care transport services, a non-profit insurance plan, a philanthropic foundation and a host of other services, FirstHealth demonstrates a commitment to treating the whole patient and to providing quality health care for the entire community – especially those in need. The flagship, Moore Regional Hospital is ranked Top in State and Nation for Major Orthopaedic Surgery based on Quantros' CareChex® 2019 Hospital Quality Ratings Analysis (HQRA), and is a Blue Center of Distinction for maternity, cardiac care, knee and hip replacement and bariatrics.


About FirstCarolinaCare Insurance Company: A wholly owned subsidiary of FirstHealth of the Carolinas, FirstCarolinaCare offers a wide range of health benefit plans for businesses throughout the FirstHealth service area. In addition to providing coverage alternatives for local businesses, FirstCarolinaCare provides a Medicare Advantage product for Medicare-eligible individuals in Moore, Montgomery, Richmond, Hoke, Lee, Chatham, Scotland, Wake, Buncombe, Henderson, Transylvania, McDowell, Yancy, Madison and New Hanover counties.


About Carle: Based in Urbana, Illinois, the Carle health system is vertically integrated with more than 7,000 employees in its hospitals, physician group, health plan and associated healthcare businesses including the Carle Illinois College of Medicine, the world’s first engineering-based medical school. The system’s flagship Carle Foundation Hospital ranks as one of America’s 50 Best Hospitals by HealthGrades and for more than 10 years has held Magnet® designation, the nation’s highest honor for nursing care. The system includes the 433-bed Carle Foundation Hospital, a Level I Trauma Center and Level III perinatal services center, the 24-bed critical access Carle Hoopeston Regional Health Center, the 118-bed Carle Richland Memorial Hospital, Carle Physician Group with more than 1,000 doctors and advanced practice providers, and Health Alliance. Health Alliance, Carle’s health insurance company, is a leading provider-driven health plan serving Illinois, Iowa, Indiana, Ohio and Washington. In 2019, Health Alliance was awarded “Highest Member Satisfaction among Commercial Health Plans in the Illinois/Indiana Region” in the J.D. Power 2019 Member Health Plan Study.

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