Castellana Physicians Services, LLC (Castellana), part of the MMM Holdings, LLC group in Puerto Rico, provides cutting-edge support services to medical groups, primary physicians, and subspecialists, among others.
Castellana has been an association of independent providers (IPA, for its acronym in English), which has been dedicated exclusively to providing services to physicians who care for the elderly and disabled population of Puerto Rico. Currently, Castellana consists of four independent IPAs, with over 500 primary physicians (PCP).
Castellana is a leading company in the Medicare Advantage industry. Its operations are recognized for being pioneers in implementing a coordinated comprehensive health model based on high quality standards, achieving outstanding results.
Castellana’s Mission is to optimize medical practice to promote highly cost-effective and excellent patient services.
PRIMARY PHYSICIANS
SUB-SPECIALISTS
Our History
YEAR
Achievements: largest IPA-MA in Puerto Rico
More than 550 primary doctors. Around 276 subspecialist doctors. Increase in membership
- 12,373 new lives
- Over 8,600 during AEP
- 30 new PCPs in our network
- Recognitions from MSO
- Castellana Sureste – First place in greater retention in membership
- Castellana Metro Norte – First place in Highest total sales growth
- Castellana Noreste – Second place in Highest total sales growth
- Castellana Physicians Services – Greater commitment to special projects. Effective management of our regions, improving key indicators. This year the focus is to continue working hand in hand with you to optimize the results of your practices.
YEAR
Change of administration, new management team in the IPA, new projects.
YEAR
Implementation of Loyalty Program, for the recovery of our Suppliers.
Hurricane María, many of our suppliers and affiliates were affected by the passage of the hurricane. The IPA Castellana was the leader in supporting our clients and employees quickly and efficiently.
YEAR
Integration of several groups to the IPA
- EME Group Professional
- Comprehensive Geriatric Care Group
- Provider Network Corp.
- Comprehensive Geriatric Bayamón
YEAR
Castellana’s Board of Directors was formed to provide strategic support based on mission, vision and values.
YEAR
Castellana hired a preferred network of providers (IPA PPN) with over 200 subspecialists to increase opportunities for better collaboration and coordination in health care and cost-effective outcomes.
YEAR
Castellana strengthened its operations infrastructure towards a first quality service by implementing innovative medical and network management programs.
Castellana moved its facilities to facilitate access to its customers and employees. Making good use of the advantage in the real estate market, the new address is home to more modern facilities, which allow accommodating groups of suppliers, promoting better brand recognition.
YEAR
Castellana became part of the MMM Holdings family of companies and continued to be operated as an independent health care entity, meeting the needs of its providers, patients and communities.
In addition, the founders of Castellana, Mrs. Lillian Fuertes, Dr. Miguel Sosa Padilla and Dr. Luis Rodríguez Carrasquillo, continued to contribute in quality management, customer service and strategy.
This transaction strengthened the relationship of the Network with the MMM group in Puerto Rico.
Dr. Raúl F. Montalvo serves as Acting President of Castellana.
YEAR
Castellana worked with her doctors to support MMM and PMC in their efforts to receive the Accreditation of the National Committee of Quality Assurance (NCQA, for its acronym in English). MMM and PMC became the first – and currently are the only – health plans in Puerto Rico with such accreditation.
YEAR
Castellana was hired as an IPA by the newly established MSO of Puerto Rico, LLC (MSO), which offers services to the entire network of MMM Healthcare, LLC (MMM) and PMC Medicare Choice, LLC (PMC) providers and the entire community medical MSO offers administrative support to Castellana and other medical groups.
YEAR
PMC Medicare Choice became part of the MMM family, as independent plans under the same parent company. Castellana and her contracts with the doctors were amended to also serve the PMC affiliates.
YEAR
Castellana reached an agreement with the recently founded Medicare and Mucho Más (MMM) – a Medicare Advantage plan – which would unite its roads in a solid relationship of success and growth.
Castellana developed the Metro Este Network, including PCPs, subspecialists, hospital facilities, ancillary services, among others.
Later in the same year, the Metro East Network was certified by the Centers for Medicare and Medicaid Services (CMS).
Mission and Vision
Mission:
- Optimize medical practice to promote highly cost-effective services and excellence to the patient.
Vision:
- Help MMM and PMC achieve the 5 Star Rating.
- Have recognized doctors and work teams to follow the best practices of the industry and be highly empathic and sensitive.
- Expand our business lines profitably.
- Adopt effectively the use of technology.
- To be an IPA that enjoys full loyalty from our business partners.
- Distribute more shared savings.
- Have the healthiest and longest-living patients in the nation.
Values:
- All our actions benefit the organization.
- We promote creativity and innovation in the pursuit of compliance with our Vision and Mission.
- We do not disclose confidential and sensitive information.
- We serve with a great sense of urgency.
- We own the situations that bring us, and we make sure to solve them.
- We arrived on time and prepared to all our meetings. I pay attention without interrupting and distracting.
Regionals Meetings
Meetings are held every month from each of the regions that make up Castellana and the Sub IPA Specific topics that impact the region are discussed, such as: Quality, Adequate Documentation, Pharmacy, Preferred Networks, Finance, Hiring, Discussion of sample strategies For these meetings, VP of Castellana, Medical Directors of the Region, Manager, Executives of the Region, and staff of each department as required in the agenda participate.
- Regional North Metro
- Northeast Regional
- Regional East
- Southeast Regional
- Sub-IPA
Special Events
We share our achievements at special events:
We are committed to recognizing the effort and work of our suppliers who have chosen us as their Castellana IPA.
Activities include:
- Area meetings
- Excess distribution
- Educational workshops – credit hours
- Symposium
As part of our agenda of activities in the providers section you will be able to find the meetings that have been convened scheduled.
Today
Castellana’s medical groups manage health care for 1/3 of the Medicare Advantage lives under MMM and PMC through MSO of Puerto Rico, LLC; with a provider network of over 500 primary physicians (PCPs) and over 200 IPA sub-specialists.