Case Study 2

Emergence of Total Health Care Provider Plan HMO from Rehabilitation

The Ohio Department of Insurance retained AIM as the Deputy Rehabilitator of Total, a 45,000 member Medicaid HMO to determine its level of financial impairment and recommend a course of action. After evaluating operations and myriads of issues, we presented a plan to restructure operations and ultimately ascertain the net amounts owed providers.  AIM's next task was to identify and pursue cash generating measures including sale of the HMO's membership to another HMO, recovery of Medicaid reimbursements, sale of two building and securing wrongfully denied reinsurance. Fully achieving these critical success factors, AIM succeeded with Total paying in full all providers and creditors.  Upon Total’s release from rehabilitation, it was then merged with another organization as we had negotiated.

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