Form 990 for tax year 2023

Totals

Total revenue

$91,166,122

Total expenses

$112,199,464

Contributions and grants received

$0

Grants paid

$0

Program service revenue

$90,344,273

Investment income

$821,849

Other revenue

$0

Total assets, end of year

$37,034,980

Total liabilities, end of year

$20,685,467

Net assets or fund balances, end of year

$16,349,513

Program services expenses (Part IX)

$109,543,910

Management and general expenses

$2,655,554

Fundraising expenses

$0

Program service expenses (Part III)

$109,543,910

Program services were 97.6% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Mission and programs · 2023

• UNIVERSITY OF MICHIGAN HEALTH MEDICARE IS A NON-PROFIT HEALTH MAINTENANCE ORGANIZATION (HMO). UNIVERSITY OF MICHIGAN HEALTH MEDICARE USES A PRIMARY CARE CONCEPT FOR DELIVERING HEALTH CARE IN A HEALTH DELIVERY NETWORK (HDN) STRUCTURE. IT ARRANGES FOR THE PROVISION OF COMPREHENSIVE OUTPATIENT AND INPATIENT MEDICAL AND SURGICAL SERVICES TO MEMBERS ON THE BASIS OF A FIXED PREPAID SUM WITHOUT REGARD TO THE FREQUENCY OR EXTENT OF SERVICES FURNISHED TO ANY PARTICULAR MEMBER. UNIVERSITY OF MICHIGAN HEALTH MEDICARE'S COMMITMENT IS TO DEVELOP AND DELIVER QUALITY MANAGED CARE PRODUCTS AT A REASONABLE COST FOR ITS MEMBERS. UNIVERSITY OF MICHIGAN HEALTH MEDICARE IS WHOLLY OWNED BY UNIVERSITY OF MICHIGAN HEALTH PLAN. UNIVERSITY OF MICHIGAN HEALTH PLAN IS PRIMARILY A COMMERCIAL HMO. ALONG WITH UNIVERSITY OF MICHIGAN HEALTH MEDICARE, UNIVERSITY OF MICHIGAN HEALTH PLAN OPERATES UNIVERSITY OF MICHIGAN HEALTH INSURANCE COMPANY, A COMMERCIAL INSURANCE COMPANY AND UNIVERSITY OF MICHIGAN HEALTH SERVICE COMPANY, A THIRD PARTY ADMINISTRATOR. ALL STAFFING FUNCTIONS AND REPORTING ARE ACCOMPLISHED THROUGH THE USE OF THE SAME STAFF AS UNIVERSITY OF MICHIGAN HEALTH PLAN. UNLESS SPECIFICALLY NOTED, ALL REFERENCES TO U OF M HEALTH PLAN APPLY TO U OF M HEALTH PLAN, U OF M HEALTH INSURANCE COMPANY, U OF M HEALTH SERVICE COMPANY AND U OF M HEALTH MEDICARE. U OF M HEALTH PLAN'S SERVICE AREA INCLUDES THE MICHIGAN COUNTIES OF INGHAM, EATON, CLINTON, SHIAWASSEE, MONTCALM, GRATIOT, IONIA, JACKSON, HILLSDALE AND PORTIONS OF ISABELLA, SAGINAW, WASHTENAW, AND LENAWEE. U OF M HEALTH INSURANCE COMPANY OFFERS PRODUCTS ACROSS MICHIGAN. AS OF DECEMBER 31, 2023, THERE WERE APPROXIMATELY 28,100 ENROLLEES IN U OF M HEALTH PLAN'S COMMERCIAL HMO, 25,300 IN TPA, 2,300 IN U OF M HEALTH INSURANCE COMPANY, AND 8,300 ENROLLEES IN UM HEALTH MEDICARE. THE U OF M HEALTH PLAN NETWORK IS APPROXIMATELY 3,068 PRIMARY CARE PHYSICIANS, 5,503 SPECIALTY CARE PHYSICIANS, 3,906 ALLIED HEALTH PROFESSIONALS, 3,482 BEHAVIORAL HEALTH PROVIDERS AND 746 ORGANIZATIONAL PROVIDERS THAT INCLUDE 60 HOSPITALS. U OF M HEALTH PLAN CONTRACTS WITH VARIOUS HDNS WHO PROVIDE HEALTHCARE SERVICES TO MEMBERS. U OF M HEALTH PLAN'S COMMITMENT IS TO DEVELOP AND DELIVER QUALITY MANAGED CARE PRODUCTS AT REASONABLE COSTS FOR ITS MEMBERS. U OF M HEALTH PLAN'S SUCCESS IN MANAGING HEALTH CARE IS DUE IN PART TO THE EXTENSIVE NETWORK OF PARTICIPATING PROVIDERS IN THE HDN NETWORK. THE HMO/HDN CONTRACTUAL ARRANGEMENTS ALLOW U OF M HEALTH PLAN TO ARRANGE FOR HEALTHCARE TO PATIENTS COVERED BY THE STATE OF MICHIGAN'S MEDICAID BENEFIT PLAN. THIS ARRANGEMENT ALLOWS THE MEMBERS TO ACCESS A WIDE VARIETY OF INDEPENDENT PROVIDERS WITHIN EACH HDN INCLUDING PHYSICIANS, HOSPITALS, PHARMACIES, SKILLED NURSING FACILITIES, AND ALLIED HEALTH PROFESSIONALS. U OF M HEALTH PLAN MEMBERS MAY ALSO RECEIVE CARE FOR SERVICES FROM A NONPARTICIPATING PROVIDER IF SUCH REFERRAL IS RECOMMENDED BY AN HDN PARTICIPATING PHYSICIAN AND THE SERVICE REQUIRED FOR TREATMENT, AS DETERMINED BY HDN, IS NOT AVAILABLE WITHIN THE HDN'S NETWORK. U OF M HEALTH PLAN OFFERS A VARIETY OF HEALTHCARE PROGRAMS, OR PRODUCTS TO GROUPS AND INDIVIDUALS. U OF M HEALTH PLAN OFFERS CHOICES THAT PROVIDE COVERAGE WITHIN THE NETWORK OF CONTRACTED HDN PROVIDERS, LIMITED COVERAGE OUTSIDE OF THE U OF M HEALTH PLAN NETWORK, VARIOUS LEVELS OF DEDUCTIBLES, CO-PAYMENTS, AND COVERAGE LIMITS, ALL OF WHICH ARE DESIGNED TO BE RESPONSIVE TO CUSTOMER NEEDS. U OF M HEALTH PLAN MEASURES THE QUALITY OF CARE PROVIDED TO ITS ENROLLEES THROUGH ANNUAL REVIEW OF INDICATORS SUCH AS: - DISEASE MANAGEMENT PROGRAM PARTICIPATION AND OUTCOMES. - QUALITY OF CARE CONCERNS. - HEDIS MEASURES - THE HEALTH PLAN EFFECTIVENESS DATA AND INFORMATION SET (HEDIS) IS A GROUP OF NATIONALLY RECOGNIZED MEASURES OF HEALTH PLANS PERFORMANCE IN A VARIETY OF CLINICAL AND NON-CLINICAL AREAS. U OF M HEALTH PLAN USES THE EFFECTIVENESS OF CARE MEASURES TO DETERMINE PROGRESS AND IMPROVEMENT IN AREAS SUCH AS: - DIABETES, - ASTHMA, - DEPRESSION AND FOLLOW-UP AFTER MENTAL HEALTH ADMISSIONS, - BREAST AND CERVICAL CANCER SCREENING, - USE OF BETA-BLOCKERS AFTER HEART ATTACKS, - CHILD AND ADOLESCENT IMMUNIZATIONS, - CHOLESTEROL MANAGEMENT, - CONTROLLING HIGH BLOOD PRESSURE, - SMOKING CESSATION, - PRENATAL AND POSTPARTUM CARE, AND - TREATMENT OF CHILDHOOD RESPIRATORY INFECTIONS. U OF M HEALTH PLAN MEASURES THE QUALITY OF SERVICE PROVIDED TO ITS ENROLLEES BY THE REVIEW OF PERFORMANCE MEASURES RELATED TO: - ACCESS AND AVAILABILITY OF PROVIDERS, - ENROLLEE COMPLAINTS AND APPEALS, - CUSTOMER SERVICE TELEPHONE ACCESS PERFORMANCE, AND - MEMBER ASSESSMENT: THE CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (CAHPS) SURVEY GIVES A GENERAL INDICATION OF HOW WELL THE ORGANIZATION MEETS MEMBERS' EXPECTATIONS. THE U OF M HEALTH PLAN QI PROGRAM IS ULTIMATELY ACCOUNTABLE TO THE BOARD OF DIRECTORS. IN 2021 U OF M HEALTH PLAN RECEIVED "FULL ACCREDITATION" STATUS FROM URAC FOR BOTH HEALTH PLAN ACCREDITATION AND HEALTH PLAN ACCREDITATION WITH HEALTH INSURANCE MARKETPLACE. URAC ACCREDITATION SIGNIFIES AN ISSUER HAS UNDERGONE AND PASSED A RIGOROUS AND INDEPENDENT REVIEW OF ITS OPERATION, INCLUDING THE QUALITY OF CARE AND LEVEL OF SERVICE PROVIDED TO ENROLLEES. ACCREDITATION HEALTH PLAN STANDARDS INCORPORATE MARKET TRENDS AND ADDRESS MAJOR POLICY ISSUES WHILE ALIGNING WITH CORE REQUIREMENTS FOUND IN THE AFFORDABLE CARE ACT. U OF M HEALTH PLAN HAS BEEN ACCREDITED BY URAC UNDER THE HEALTH PLAN STANDARDS SINCE 2012. THE CURRENT ACCREDITATION IS EFFECTIVE THROUGH JULY 1, 2024 AT WHICH TIME REACCREDITATION WILL OCCUR.

  Expenses $109,543,910 · Revenue $90,344,273

As filed on the 2023 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

• REGENTS OF THE UNIV OF MICHIGAN

  501C3 · SCHOOL · MI

• WEST MICHIGAN RADIATION ONCOLOGY

  501C3 · HOSPITAL · MI

• METROPOLITAN HOSPITAL (UMH WEST)

  501C3 · HOSPITAL · MI · controlled entity

  Directly controlled by UM HEALTH

• UM HEALTH

  501C3 · SUP ORG · MI

  Directly controlled by UM

• METROPOLITAN FOUNDATION

  501C3 · SUP HOSP · MI · controlled entity

  Directly controlled by METRO HOSP

• SPARROW HEALTH SYSTEM

  501C3 · HEALTH · MI · controlled entity

  Directly controlled by UM HEALTH

• UNIVERSITY OF MICHIGAN HEALTH PLAN

  501C4 · INSURANCE · MI · controlled entity

  Directly controlled by UM HLD LLC

• SPARROW FOUNDATION

  501C3 · FUNDRAISE · MI · controlled entity

  Directly controlled by SHS

• SPARROW COMMUNITY CARE

  501C3 · HOME HLTH · MI · controlled entity

  Directly controlled by SHS

• EDWARD W SPARROW HOSPITAL

  501C3 · HLTH CARE · MI · controlled entity

  Directly controlled by SHS

• SPARROW CLINTON HOSPITAL

  501C3 · HLTH CARE · MI · controlled entity

  Directly controlled by SHS

• SPARROW IONIA HOSPITAL

  501C3 · HLTH CARE · MI · controlled entity

  Directly controlled by SHS

• SPARROW SPECIALTY HOSPITAL

  501C3 · LT ACUTE · MI · controlled entity

  Directly controlled by SHS

• SPARROW CLINICAL RESEARCH INSTITUTE

  501C3 · RESEARCH · MI · controlled entity

  Directly controlled by SHS

• SPARROW CARSON HOSPITAL

  501C3 · HLTH CARE · MI · controlled entity

  Directly controlled by SHS

• PHYSICIANS HEALTH NETWORK

  501C4 · HMO · MI · controlled entity

  Directly controlled by UM HLD LLC

• SPARROW EATON HOSPITAL

  501C3 · HLTH CARE · MI · controlled entity

  Directly controlled by SHS

• SPARROW EATON HOSPITAL AUXILIARY

  501C3 · FUNDRAISE · MI · controlled entity

  Directly controlled by SHS

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Provenance

Return type

form_990

Tax year

2023

Filed

15 November 2024

IRS schema version

2023v5.0

Source object

202403209349313205

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

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