iCare Health Solutions
iCare Health Solutions, a VSP Vision Care subsidiary, is a Florida-based integrated eye care specialty network and third-party administrator serving Medicare Advantage, Medicaid, and dual-eligible health plans through 3,600+ providers, 56 retail locations, and HEDIS, UM, and TPA services.
- Company typePrivate
- Founded1984
- HeadquartersMiami, United States
- Headcount501–1,000
- GTM typeB2B
- OfferingServices
What iCare Health Solutions does
iCare Health Solutions, LLC is an integrated specialty network and third-party administrator of comprehensive ocular care services, headquartered in Tampa, Florida and operating as a wholly-owned subsidiary of VSP Vision Care since November 2021. Founded in 1984 by Sidney J. Stern, OD, the company contracts with Medicare Advantage, Medicaid, and dual-eligible health plans across Florida to deliver network management, utilization management, HEDIS diabetic retinal outreach, MSO services, and full administrative services (TPA) including claims processing, EDI transmissions, and provider credentialing. It serves a roster of more than 11 named health plan partners — including Aetna, Humana, United Healthcare Medica, Florida Blue, Molina, Optum, CarePlus, Coventry, and AvMed — covering 3 million+ managed members through 3,600+ contracted optometry and ophthalmology provider locations, 37+ MSO partnerships, three owned ambulatory surgery centers, and 56 Optical Outlets retail locations acquired in August 2023.
The company's technology stack centers on the eHealthDeck provider portal, a HIPAA-compliant diagnostic interpretation portal for teleretinal imaging, and a proprietary iCare clinical criteria system developed with board-certified sub-specialists. Its teleretinal screening program uses non-mydriatic fundus cameras to capture diabetic retinal images in primary care offices, clinics, health fairs, and member residences, with images uploaded for provider review via the diagnostic portal. The company holds NCQA Utilization Management Accreditation (2023, reaccredited March 2026), HITRUST Risk-based 2-year (r2) certification (November 2023), and full HIPAA compliance, and has helped five Florida Medicare Advantage plans earn CMS Five-Star ratings for the HEDIS Diabetic Retinal Exam measure in 2019 and 2020.
Revenue is generated through B2B managed services contracts with health plans — typically multi-year, fee-for-service or per-member-per-month arrangements covering network management, HEDIS outreach, UM, and TPA — supplemented by retail revenue from Optical Outlets and surgical revenue from the three owned ambulatory surgery centers in South Florida. Pricing is contracted individually with health plan partners and not publicly disclosed. The company is led by CEO Lee Stern, with a leadership team that includes a Chief Medical Officer, Chief Compliance Officer, and Chief Business Development Officer responsible for government-market managed care partnerships nationwide, indicating organizational intent to extend beyond its current Florida-only footprint under the VSP Vision Care umbrella.
iCare Health Solutions firmographics
Firmographics- Name
- iCare Health Solutions
- Legal name
- iCare Health Solutions, LLC
- Website
- https://myicarehealth.com
- Company type
- Private
- Founded year
- 1984
- Operating status
- Operating
- Headcount range
- 501–1,000 employees
- Short description
- iCare Health Solutions, a VSP Vision Care subsidiary, is a Florida-based integrated eye care specialty network and third-party administrator serving Medicare Advantage, Medicaid, and dual-eligible health plans through 3,600+ providers, 56 retail locations, and HEDIS, UM, and TPA services.
- Ownership category
- akta.pro rank
iCare Health Solutions industry classification
Industry- Product category
- Managed Ocular Health Services
- NAICS
- Offices of Optometrists (62132), Offices of All Other Health Practitioners (62139)
- SIC
- Ophthalmic Goods (3851), Services-Offices & Clinics Of Doctors Of Medicine (8011), Services-Specialty Outpatient Facilities, Nec (8093)
- akta.pro primary industry
- Ophthalmology & Vision Telemedicine Platforms (HLALAGAL)
- akta.pro secondary industry
- Virtual Specialty Care Platforms (tele-stroke, tele-ICU, tele-derm, tele-cardiology) (HLALABAD)
Keywords
Where iCare Health Solutions is headquartered
LocationHeadquarters
- HQ city
- Miami
- HQ country
- United States
- HQ region
- North America
Offices3 records
Markets served
iCare Health Solutions business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure, Supply Chain
Revenue model
- Third-Party Administration (TPA) Services: iCare provides comprehensive TPA services including claims processing, utilization management, compliance and delegation, customer care, EDI transmissions, membership management, and provider contracting to health plans on a fee-for-service or per-member-per-month basis.
- Network Management Fees: Revenue generated from managing provider networks on behalf of health plans, including credentialing, contracting, and ongoing network maintenance for optometrists and ophthalmologists across Florida.
- HEDIS Outreach and Diabetic Retinal Screening Programs: HEDIS diabetic retinal exam outreach and screening services provided to health plan partners to improve Star ratings and compliance measures, with no cost to contracted health plan members.
- Utilization Management Services: Ophthalmologic utilization management services including prior authorization, medical review by sub-specialized ophthalmologists, and coverage criteria development, sold as a turnkey solution to health plans.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Other | Multi-year contract | No publicly available pricing tiers; services are contracted individually with health plan partners. |
Go-to-market motion1 record
Distribution channels5 records
Marketing channels5 records
iCare Health Solutions product offering
Product offeringCore offering
iCare Health Solutions is an integrated specialty network and third-party administrator of comprehensive ocular care services for health plans serving Medicare Advantage, Medicaid, and dual-eligible populations. The company sells Network Management, HEDIS Diabetic Retinal Outreach Programs, NCQA-accredited Utilization Management, Administrative Services (TPA), and MSO Services to health plans, MSOs, and provider groups through contracted B2B relationships supported by its proprietary eHealthDeck provider portal and HIPAA-compliant teleretinal diagnostic platform.
Product overview
iCare Health Solutions is an integrated specialty network and administrator of comprehensive ocular care services. The company operates as a platform of interconnected managed care solutions for health plans and providers, comprising HEDIS Diabetic Retinal Outreach Program, Diabetic Retinal Health Programs & Services, Utilization Management, Network Management, Administrative Services (TPA), and MSO Services. The eHealthDeck portal serves as the provider-facing technology platform for prior authorization and coverage criteria access. Services are delivered through a statewide network of optometrists and ophthalmologists in Florida, serving Medicare Advantage, Medicaid, and dual-eligible populations.
Differentiator
Problem solved
Functional benefit
Products and services
- HEDIS Diabetic Retinal Outreach Program Customized HEDIS outreach program providing Eye Exams for Patients with Diabetes (EED) to non-compliant members, including dilated exams via vision care providers and non-dilated teleretinal screenings across multiple access points. Designed for Medicare Advantage and Medicaid health plans to close HEDIS DRE gaps and improve Star ratings.
- Diabetic Retinal Health Programs & Services Suite of retinal screening and analysis services for provider practices and MSOs, including the Eye Exam for Patient with Diabetes (EED) at the practice, a camera loan program for MSOs and large practices, and diagnostic interpretation services for practices with existing camera equipment. Targeted at MSOs, large ophthalmology/optometry practices, and health plan partners.
- Utilization Management NCQA-accredited ophthalmologic utilization management service delivering ocular clinical utilization benchmarks, prevention of service duplication, monitoring of medically necessary criteria, and coverage criteria development and implementation. Sold as a turnkey solution to Medicare Advantage, Medicaid, and other health plans.
- Network Management Turnkey specialty network of eye health professionals providing comprehensive eye care management combining routine eye care, medical eye care, and surgical care through board-certified, fellowship-trained optometrists and ophthalmologists. Sold to health plans serving Medicare Advantage, Medicaid, and dual-eligible populations.
- Administrative Services (TPA) Comprehensive third-party administration services including claims processing, utilization management, compliance and delegation, customer care, EDI transmissions, membership management, and provider contracting, delivered through proprietary software. Sold to health plans on a fee-for-service or per-member-per-month basis.
- MSO Services Management Services Organization services partnering with Florida MSOs to extend specialty care and management cycles including optometry, ophthalmology, emergency eye care services, HEDIS screenings, and telemedicine. Sold to MSOs seeking integrated specialty ocular care delivery.
- eHealthDeck Secure web portal where providers access prior authorization lists by health plan, iCare Criteria documentation, and utilization management determinations; also serves as the iCare member sign-in platform. Sold as the technology interface underpinning iCare's contracted provider network.
Quantifiable outcome
- 5 health plan partners achieved CMS Five-Star rating for HEDIS DRE measure for two consecutive years (2019–2020)
- +3 more outcomes
Companies that use iCare Health Solutions
Customer profileNamed customers11 records
Segments3 records
Ideal customer profiles3 records
iCare Health Solutions technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
AI capability3 records
Feature4 records
iCare Health Solutions partnerships and signals
Strategic signalPartnerships
13 partnerships are on record, tiered core and minor.
- Optical OutletscoreiCare acquired Optical Outlets in August 2023. As one of Florida's largest optometric retailers with 56 locations and 550+ employees, Optical Outlets operates as part of iCare, strengthening iCare's retail presence. Ron Amster named General Manager. Founded in 1987 by Dr. Robert Lewenson.
- AetnacoreHealth plan partner using iCare's network and HEDIS management services. Aetna's Director of Network Development cited iCare's innovative HEDIS management capabilities for improving diabetic vision outcomes for members.
- HumanacoreKey health plan partner using iCare's integrated HEDIS programs and diabetic retinal outreach. Humana's Vice President of Provider Partnership cited iCare as an industry leader with technical innovation to improve vision outcomes.
- CoventrycoreMedicare Advantage health plan partner that achieved CMS Five-Star rating for HEDIS DRE measure through iCare's outreach program. Partner in diabetic retinal exam patient outreach.
- United Healthcare Medica HealthcarecoreMedicare Advantage partner that achieved CMS Five-Star rating for HEDIS DRE measure through iCare's diabetic retinal exam outreach program.
- CarePluscoreFlorida-based Medicare Advantage partner that earned CMS Five-Star rating for HEDIS Diabetic Retinal Exam measure with help from iCare's DRE patient outreach program.
- Preferred Care PartnerscoreMedicare Advantage partner that benefited from iCare's customized outreach DRE solutions, contributing to Five-Star quality ratings.
- AvMedminorHealth plan partner listed on iCare's partner page, providing health insurance plans in Florida.
- Florida BlueminorHealth plan partner listed on iCare's partner page, Florida's largest health insurer.
- Molina HealthcareminorHealth plan partner listed on iCare's partner page, serving Medicaid and Medicare populations.
- Clear Health AllianceminorHealth plan partner listed on iCare's partner page, serving Florida markets.
- OptumminorHealth plan partner listed on iCare's partner page, part of UnitedHealth Group.
- AvailityHealth information network and technology partner listed on iCare's partner page for EDI transmissions and data exchange.
Scale indicators13 records
Recent moves6 records
Expansion highlights6 records
iCare Health Solutions competitors and assessment
Company assessmentMarket position
Competitive moat5 records
Key risks6 records
Key highlights7 records
Customer concentration
iCare Health Solutions social profiles
Digital presenceiCare Health Solutions compliance and trust
Trust signalCompliance3 records
iCare Health Solutions financial estimates
Financial estimateRevenue estimate
Valuation estimate
iCare Health Solutions leadership team
Management profileNumber of profiles
Profiles10 records
iCare Health Solutions subsidiaries and ownership
Company hierarchySubsidiaries1 record
iCare Health Solutions funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
iCare Health Solutions M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about iCare Health Solutions
What does iCare Health Solutions do?
iCare Health Solutions is an integrated specialty network and third-party administrator of comprehensive ocular care services for health plans serving Medicare Advantage, Medicaid, and dual-eligible populations. The company sells Network Management, HEDIS Diabetic Retinal Outreach Programs, NCQA-accredited Utilization Management, Administrative Services (TPA), and MSO Services to health plans, MSOs, and provider groups through contracted B2B relationships supported by its proprietary eHealthDeck provider portal and HIPAA-compliant teleretinal diagnostic platform.
Is iCare Health Solutions a public or private company?
iCare Health Solutions is a private company. It is classified as corporate owned and is currently operating.
When was iCare Health Solutions founded?
iCare Health Solutions was founded in 1984. It employs 501 to 1,000 people.
Where is iCare Health Solutions based?
iCare Health Solutions is headquartered in Miami, United States, in the North America region.
How does iCare Health Solutions make money?
Four revenue lines are on record. Third-Party Administration (TPA) Services are the primary driver. The others are network Management Fees, HEDIS Outreach and Diabetic Retinal Screening Programs and utilization Management Services.
Does iCare Health Solutions have an API?
No public API is recorded for iCare Health Solutions.
What industry is iCare Health Solutions in?
iCare Health Solutions's product category is Managed Ocular Health Services. Its primary akta.pro industry code is HLALAGAL, Ophthalmology & Vision Telemedicine Platforms, with a secondary code of HLALABAD, Virtual Specialty Care Platforms (tele-stroke, tele-ICU, tele-derm, tele-cardiology). Its NAICS code is 62132 and its SIC code is 3851.