But since 2012, Corizon has lost statewide contracts covering 84,000 inmates in Maine, Maryland, Minnesota and Pennsylvania.
In Maine, a state audit said: “Some prisoners did not receive standard medical services, such as physicals, dental services or sick call response within the timeframe required.” In Maryland, Corizon appears to have been underbid by Wexford in 2012. In Corizon's home state of Tennessee, it provides behavioral healthcare to prisoners. But in January, it lost the medical-care contract to Centurion, even though Corizon had a lower bid.
The contracts Corizon lost in the five states will be worth more than $1.2 billion over the next five years.
Corizon also has notched some wins. In February, Alabama renewed its contract, even though the state has been sued by the Southern Poverty Law Center over what the civil-rights group says is inadequate prison healthcare. Corizon isn't named as a defendant. But the company is joining with mental healthcare contractor MHM Correctional Services in paying for the state's defense under the terms of its contract.
Last year, Corizon won a three-year $1.1 billion contract to provide care at Missouri's state prisons, and it got an extension of its contract for Indiana's prisons, while adding some large new local jail contracts.
But those gains have been overshadowed by its difficulties in keeping old contracts and winning new ones. New York City's deputy health commissioner recently said the city was “examining potential new strategies” after complaints about quality of care at Rikers Island led city commissioners to question the contract with Corizon.
Julie Jones, Florida's secretary of corrections, acknowledged to state lawmakers this year that Corizon and Wexford, which split care responsibilities in the state's prisons, have done an inadequate job.
Florida Republican state Sen. Greg Evers, chairman of the state Senate Criminal Justice Committee, recently told the Tampa Bay Times he was concerned that deaths in Florida prisons had gone up 10% since healthcare was privatized two years ago. Florida Democratic state Sen. Jeff Clemens called media reports about the companies' recent care record “disturbing to my sense of humanity.”
Corizon is responsible for the care of 74,000 Florida inmates, while Wexford has a contract covering 15,000 in the state. Jones recently said she will move to rebid the contracts, worth $229 million a year for Corizon and $48 million through the end of 2017 for Wexford.
Corizon also faces a battle to serve jail inmates in the District of Columbia, where it won a bidding process but still needs approval from the District Council. The contract would pay Corizon $66 million over three years to take over from Unity Health Care, a not-for-profit that also runs health clinics for low-income patients in the District.
The bad press about lawsuits around the country and quality-of-care questions may derail Corizon's D.C. contract effort. “There's a pretty strong bloc of us here who don't want to see it happen,” said council member David Grosso, citing questions about Corizon's care in New York City. “Why should the District of Columbia repeat the mistakes that other places have made?”
Corizon changed leadership in October 2013, with Myers, who previously had served on the board at Valitas and worked as chief medical officer at managed-care company WellPoint, taking over from Hallworth. Stuart Campbell stepped down as president and was replaced last year by Scott Bowers, who previously worked at UnitedHealthcare. While the company declined to comment on the reasons for the leadership changes, they came shortly after an earlier 2013 downgrading of Valitas by Moody's and after the loss of the Maine, Maryland, Pennsylvania and Tennessee state correctional contracts.
Corizon officials and some outside observers say many problems the company faces are inherent in caring for inmates, many of whom have substance abuse, mental health and other chronic health problems. Prisoners also can be hostile to authority, said Dr. Sylvia McQueen, Corizon's vice president of clinical services. And Corizon's doctors and nurses have to accommodate themselves to institutional security priorities.
“Some (inmates) just don't want to be bothered” with interacting with healthcare providers, said McQueen, whose first exposure to the correctional system came when her father was jailed while she was growing up in Washington, D.C.
Myers said that's why it makes sense for correctional agencies to bring in Corizon, which through its predecessor companies has decades of experience and can use its size to save money and improve care. It can, for example, use data it collects about treatments that work in one location to create best practices in others.
While some local officials have cited the number of lawsuits filed against the company—there have been more than 1,300 in five years—as a reason for concern, Corizon officials say litigation isn't a good indicator of quality of care behind bars.