To: Dr. Chris Cochran
From: Ather Ahmed
Date: 12/9/2004
Re: Visit to
In this memo, I will speak about our visit last week to Nevada Care, which is a HMO. I will briefly speak about the history of Nevada Care, the speakers, and SWOT analysis comparing Sierra Health Services with Nevada Care, and overall assessment of Nevada Care.
Nevada Care is a HMO started up
in 1991. Since then, Nevada Care has become 80,000 members strong with outlook
of greater growth in the future. Nevada Care states that they are the fastest
growing and largest HMO in the state of
Sean Balmos was the first speaker to talk about Nevada Care. In his brief lecture, Sean gave an overview of the accounting/claims department issues that an HMO has to go through on a daily basis.
The second speaker was Heather, who was the Supervisor of Data Management. Her job consist of properly encoding, filing, and networking mainly medical records, and ensures the operations are preformed properly in an orderly manner.
The third speaker was Kristy, manager of the Special investigations unit. Her job is to ensure no fraudulent cases are filed by patients or providers. Kristy is also in charge of learning current fraudulent schemes to prevent the organization from new fraudulent schemes that may arise.
Deb Fuller was the fourth speaker, who is in charge of the business development department at Nevada Care. I found her lecture to be highly educational. She spoke mainly about the joint commission, and the routes she took to achieve her position as a business development manager. Mrs. Fuller is also responsible for proper accreditation issues which may arise, and maintain that all compliances are up to date. As a side note, I feel that Mrs. Fuller provided excellent information to the student body, which I feel that if these concepts to be applied, will be highly beneficial to any future administrator.
Larry Hurst was the last speaker, who is the Director of Government Affairs. Mr. Hurst’s purpose is to ensure proper reforms are enacted to benefit the health care system, assure that there are no reforms which will affect the HMO system. Any legislation which benefits society as a whole, Mr. Hurst tries to rally up support for that bill, vise versa for bills that can have adverse effects.
SWOT Analysis
The strengths of Nevada Care
include the membership of IMX Inc., which provides healthcare services to over
1 million members. In addition, Nevada Care is a multi-state HMO, practicing in
the state of
Foreseeable weakness for Nevada
Care includes their privately held
corporation status, where if they need funds, they cannot raise it by offering
shares of the company. Instead, Nevada Care would have to take out a loan,
creating a deficit. This can be particularly important if a few major companies
decide to switch their HMO to another provider. The main competition for Nevada
Care is Sierra Health Services with larger volume of membership, their share in
the market including serving 13 northeastern states, and a contact with the U.S
Military. Nevada Care is fairly new to
Opportunities are always
available regardless, mainly due to the explosive growth in
The only threat I see is Sierra
Health Services. Their domination within southern
Overall, I feel that Nevada Care certainly has a future. Growth of this organization looks very promising; however I feel that this organization will not satisfy my goals and objectives I have for my future as a health care administrator. Therefore, I wouldn’t really consider doing my practicum at Nevada Care.