Among the many companies offering health maintenance organization (HMO) plans in Florida, Simply Healthcare Plans Inc., based in Coral Gables, stands out for at least two reasons.
First, all 6’ 9” of Earvin “Magic” Johnson, one of professional basketball’s greatest players as well as an entrepreneur, philanthropist, motivational speaker and advocate for HIV/AIDS prevention, is their highly visible spokesman. He is also a shareholder and member of their board of directors.
Second, Simply Healthcare, a minority-owned HMO founded in 2010, has grown spectacularly.
When Miami-based private equity investor Miguel “Mike” Fernandez set up the company four years ago by combining two other HMOs to form Simply Healthcare, the firm had about 38,000 insured in Miami-Dade and Broward counties, a few dozen employees and 2010 revenues of $38million.
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Today, while still a small player compared to national health insurance companies, it has more than 202,000 members, serves 60 Florida counties and employs 821 statewide — 300 of whom were added in the last year. The company’s members are supported by more than 10,000 affiliated primary and specialty physicians, more than 165 hospitals and hundreds of other ancillary providers and participating pharmacies, the privately held firm says.
Simply Healthcare’s revenues rose to $458million last year, up from $182million in 2012, and are expected to reach around $1billion in 2014.
Fernandez, chairman of MBF Healthcare Partners, is the majority shareholder of Simply Healthcare, while Johnson and others are minority shareholders.
The company already has gained recognition. The Greater Miami Chamber of Commerce named Simply Healthcare the Outstanding Minority Business of the Year for 2013 in the category of companies with 50 or more employees, and the Beacon Council, Miami-Dade County’s economic development organization, gave the company its 2014 award in the healthcare category. In addition, the council also gave its top 2014 individual award to Fernandez, Simply Healthcare’s founder.
The federal government’s Centers for Medicare & Medicaid Services (CMS) also awarded the company a four-star rating (out of five), based on how well it administers benefits and how members rate its performance.
Simply Healthcare is a Florida-licensed HMO for people enrolled in Medicaid and Medicare. The company offers a variety of plans, including different Medicaid options to low-income families, 13 Medicare Advantage plans and a special program for HIV/AIDS patients.
It currently covers more than 162,000 Medicaid recipients, more than 30,000 Medicare members and about 10,000 HIV/AIDS patients. The company has continued to grow its Medicare membership overall despite some reductions announced in service areas outside Miami-Dade Country earlier this year.
How has Simply Healthcare grown so quickly?
“It’s been a number of things,” said Lourdes Rivas, who took over as Simply Healthcare’s CEO in early 2013. “We have tremendous growth opportunities in Florida — about 3.3 million Medicaid-eligible recipients, 2.3 million Medicare recipients and about 25,000 persons living with HIV/AIDS on Medicaid,” said Rivas, who previously held executive positions at other companies in Fernandez’s MBF Healthcare Partners group. “We were the first to offer a special plan for HIV/AIDS patients on Medicaid,” she added.
While Simply Healthcare does not participate in the Affordable Care Act (Obamacare) healthcare exchange, the number of its Medicaid members grew sharply this year after the state opened up Medicaid to private companies and the firm signed up new clients.
Competitors — including Humana, Molina, Sunshine, Florida Blue and others, some of them national companies — have also seen increases in membership.
As part of its growth plan, Simply Healthcare initially reached out to underserved communities in Miami-Dade and Broward counties, including Haitians, Jamaicans, African Americans and Hispanics, and then expanded to other counties.
“We have a very strong brand,” said Rivas, who was born in Cuba and arrived in Miami when she was 2 years old. “We do a lot of commercials, we support the arts and we have a lot of feet on the street meeting with communities and providers. And Magic Johnson, who joined the company as an investor and advocate in 2012, has brought us a lot of attention,” said Rivas, who earned a bachelor’s degree in psychology from Florida International University.
“And we continue to grow because we have not lost sight of the customer,” added Rivas, whose first job was teaching a class in behavior management at Nutrisystem.
“There are a lot of competitors out there. If we had not provided good care and good services, we would not have been able to grow as we did. Between 92 and 95 percent of our revenue goes to caring for people — checkups, tests, medications, hospitals and nursing homes.”
Said Johnson, during an interview at the company’s Coral Gables headquarters: “We’re not just building a business. We care about the patient.”
Johnson’s presence has provided a touch of magic for Simply Healthcare. Johnson and his broad, captivating smile appear in TV ads, on billboards and on the sides of buses to promote Simply Healthcare.
A highly popular figure, even among kids too young to have seen him play as a superstar in the National Basketball Association and the Olympics, Johnson meets frequently with audiences in Florida to talk about the benefits of Simply Healthcare. He also advocates for the prevention and treatment of HIV/AIDS, encourages youngsters to continue their education and tells audiences that they can overcome life’s obstacles, grow and succeed.
In 1991, Johnson announced that he had contracted HIV, and since then has been an outspoken advocate of preventing HIV/AIDS.
Why is he working with Simply Healthcare? “I decided to invest after talking with Mike [Fernandez, the company’s founder], and we decided to take care of HIV and AIDS patients with a specialty plan,” said Johnson.
“The idea was to do good and impact the community by helping to save people’s lives through the business,” said Johnson, who also supports a range of community programs nationwide through The Magic Johnson Foundation, a public charity.
Parts of South Florida have some of the highest incidences of HIV/AIDS patients in the country, especially among African Americans, he noted.
On his frequent visits to Florida from his home in Los Angeles, Johnson, an inspiring speaker, talks to church audiences, students, medical professionals and other community groups. He tells them about the benefits of Simply Healthcare, the value of education, preventing HIV/AIDS and, if necessary, coping with the disease and overcoming it to live a full life.
One of Johnson’s main messages is to avoid contracting HIV/AIDS by practicing safe sex. Another is that by obtaining good medical treatment, people with HIV/AIDS can lead normal lives.
“I can go out to the community and answer questions, and make some people know what I’m doing with my health,” said Johnson, who appears to be in excellent condition today.
“I take my two pills a day, eat well and work out five days a week. A positive attitude is key — you can live a very long time and have a productive life,” said the man who was voted one of the 50 greatest players in NBA history.
Johnson enjoys talking to young people in disadvantaged communities. “They can see that I was just like them. I was born poor but I didn’t have poor dreams. Education is the key,” he said.
In addition to its relationship with Johnson and his business promotion company, Magic Johnson Enterprises, Simply Healthcare also partners with the University of Miami to provide services to the HIV/AIDS population in Florida.
As part of its growth strategy, Simply Healthcare has invested millions of dollars to add and train new employees, as well as to expand its outreach, sales and member support system.
Looking to the future, the company is studying an expansion into states beyond Florida, Rivas said, especially in areas where their specialized programs could help unattended HIV/AIDS populations.
Both patients and providers give Simply Healthcare high marks.
Dr. Eleonor Pimentel, who practices internal medicine in Coral Gables, has been with Simply Healthcare for two years.
“My patients receive very good service under Simply Healthcare Plans,” said Pimentel. They have a large network of hospitals and specialists that are very important to our patients. We have a good relationship with the company. They have a streamlined process to get authorizations and referrals quickly for our patients.”
Enma Proano, a retiree and Medicare recipient, said she is pleased with the firm “because they provide a lot of services” and because “the specialists in the plan are very good.”
Proano, who has been with Simply Healthcare for about two years, changed from another plan after seeing the company’s ads.
“When my primary doctor started accepting Simply, I knew I had to switch. I have a wonderful relationship with my primary care doctor and that is most important to me,” Proano said.
“I give them a high rating. I’ve been very happy.”
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Simply Healthcare Plans Inc.
Business: A Florida-licensed health maintenance organization (HMO) for people enrolled in Medicaid and Medicare, the company offers a variety of plans, including different Medicaid options, 13 Medicare Advantage plans and a special program for HIV/AIDS patients. Simply Healthcare has a network of over 10,000 primary and specialty care doctors, more than 165 hospitals and hundreds of other providers and participating pharmacies throughout Florida.
Headquarters: 1701 Ponce de Leon Blvd., Coral Gables
Founder: Mike Fernandez
CEO: Lourdes Rivas
Ownership: Founder Mike Fernandez is the majority shareholder through his private equity firm, MBF Healthcare Partners; Earvin “Magic” Johnson and others are minority shareholders.
Partnerships: with the University of Miami and Magic Johnson Enterprises to provide services to the HIV/AIDS population
Insured: More than 202,000 Medicare and Medicaid members in 60 Florida counties, most of them in South Florida
Revenues: $458 million in 2013, up from $182 million in 2012
Source: Simply Healthcare Plans