Payor Partnerships

Absolute Total Care
Aetna Medicare Advantage
CMS
Devoted Health
Absolute Total Care

Absolute Total Care’s Health Coverage Solutions for South Carolinians

Absolute Total Care is a health maintenance organization that provides healthcare services to the people of South Carolina. Established to deliver quality healthcare through local, community-based partners, Absolute Total Care has a commitment to improving the health of the community one individual at a time through affordable and reliable health care plans. Absolute Total Care is a wholly owned subsidiary of Centene Corporation, providing services that are not limited to medical, home health, disease management and behavioral health. Absolute Total Care operates in all 46 counties in the state of South Carolina.

In South Carolina, Wellcare offers a range of Medicare products. Our Medicare Advantage plans offer affordable coverage beyond Original Medicare, including a range of benefits such as dental, hearing, and vision services; transportation and fitness services; Spendables® Cards; and other wellness programs to help our members live better, healthier lives. Wellcare's standalone PDPs help cover the cost of prescription drugs including low monthly premiums and copays; access to a broad pharmacy network; and convenient delivery of medications. Not all benefits are available in all plans, view plans in your area.

  • Medicare Advantage Prescription Drug plans (MAPD); Medicare Advantage only plans (MA); Dual Eligible Special Needs Plans (DSNP); Prescription Drug Plans (PDP)
  • Learn more about Wellcare

Wellcare By Absolute Total Care combines Medicaid and Medicare Advantage benefits into one easy-to-use Dual Special Needs Plans (D-SNP) with no premiums or cost-sharing. Members receive all Medicare benefits as well as all Medicaid benefits through the Absolute Total Care Medicaid program.

Ambetter from Absolute Total Care is Centene‘s Health Insurance Marketplace product in South Carolina. Ambetter Health exists to improve the health of its beneficiaries through focused, compassionate and coordinated care. Our approach is based on the core belief that quality healthcare is best delivered locally.

Aetna Medicare Advantage

Southeastern Health Partners and Aetna have established a partnership that will help provide a collaborative care approach to more than 16,000 Aetna Medicare Advantage members across the Upstate of South Carolina.

This partnership demonstrates Southeastern Health Partners’ commitment to providing patients with the best care. It focuses on prevention and wellness and reduces unnecessary emergency room visits and hospital readmissions – saving money for all involved. Southeastern Health Partners and Aetna’s new agreement promotes efficient and high value health care by ensuring that members receive the right care at the right time with the best possible outcomes.

Learn more about the relationship between Aetna and Southeastern Health Partners.

CMS

CMS logo

The Centers for Medicare & Medicaid Services (CMS) is a federal agency in the US Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.

CMS also has other responsibilities, including:

  • The administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
  • Quality standards in long-term care facilities (nursing homes) through the survey and certification process.
  • Clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments (CLIA).

Learn more about the relationship between CMS and Southeastern Health Partners. 

Devoted Health

Devoted Health Plans logo

Devoted Health is an all-in-one healthcare company on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family.  To learn more, visit devoted.com.

Operations Partnerships

Premier
Milliman MedInsight
Premier

Premier logo

Premier is a leading healthcare improvement company, uniting an alliance of more than 4,400 U.S. hospitals and health systems and approximately 225,000 other providers and organizations to transform healthcare. With integrated data and analytics, collaboratives, supply chain solutions, consulting and other services, Premier enables better care and outcomes at a lower cost.

 

Premier plays a critical role in the rapidly evolving healthcare industry, collaborating with members to co-develop long-term innovations that reinvent and improve the way care is delivered to patients nationwide. To optimize performance in population health models, Premier has designed the Population Health Management Collaborative (PHMC) with a three-part methodology – connecting people, data and knowledge. As a member of PHMC, the Southeastern Health Partners have partnered with Premier’s Best In KLAS in Value-based Care award winning team of subject matter experts, applied Premier’s Intelligence Solution - the collaborative’s unique, transparent analytics and benchmarking tool, and networked with over 55 other collaborative Medicare ACOs to share learnings and leading practices.

 

Learn more about Premier’s Strategic Collaboratives

Milliman MedInsight

Milliman MedInsight logo

Southeastern Health Partners and Milliman MedInsight have partnered to enhance healthcare analytics and develop proactive solutions to improve the quality of care across our provider network.

 

Founded in 1998, Milliman MedInsight® is a leading provider of healthcare data and analytics, trusted by over 300 payers, providers/ACOs, employers, and government agencies worldwide. Their comprehensive suite of analytics and data solutions empowers organizations to leverage healthcare data for informed decision-making and improved clinical and financial outcomes. With deep industry expertise and advanced technology, they deliver actionable insights into healthcare utilization, costs, quality, and performance. From risk management to value based care, Milliman MedInsight empowers stakeholders to navigate the complexities of the healthcare landscape and achieve sustainable success.

 

Read how SEHP maximized the power of integrated data with Milliman MedInsight.