Largest Provider Sponsored Health Plans

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25 biggest providersponsored health plans include some of

2 hours ago Healthcarefinancenews.com Show details

27 rows · 25 biggest provider-sponsored health plans include some of the nation's biggest systems Susan Morse , Managing Editor Healthcare provider-sponsored health plans are gaining in popularity, with nearly 300 plans owned by health systems now on the market, according to the 2016 Directory of Health Plans by Atlantic Information Services, an

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Largest Health Insurance Companies of 2021 ValuePenguin

3 hours ago Valuepenguin.com Show details

However, the health insurance industry is dominated by five companies. In order, the top health insurers by market share are Anthem, Centene, UnitedHealthcare, Humana and Health Care Service Corp. (HCSC), and together they control nearly 44% of the market.. All of these providers offer basic health

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Category: Provider sponsored health plans definitionShow more

The Performance of Providersponsored Health Plans

5 hours ago Aha.org Show details

plans (PSHPs) versus the three largest non-provider-sponsored health plans (NPSHPs) in their markets, based on publicly reported data for the period 2011-2013. There were 50 PSHPs, including one that competed in multiple markets, and 86 NPSHPs, many of whom competed in multiple

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80 ProviderSponsored Health Plans: UPMC Health Enrollment

9 hours ago Garnerhealth.com Show details

12 of the 15 largest provider-sponsored MA Plans cover more lives outside of MA than they do in MA. 17 For example, while Geisinger enrolls 87,000 Medicare beneficiaries in its MA plans, it insures 384,000 individuals in its non-MA group, individual, and Medicaid plans.

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ProviderSponsored Health Plans Deloitte US

3 hours ago Www2.deloitte.com Show details

Putting a plan into action. Many health care providers are weighing a move into the health plan space. Already, there are more than 220 provider-sponsored plans in the United States—and they represent less than 10 percent of the market—so many more are likely to follow.

Estimated Reading Time: 3 mins
Occupation: Retired-Principal | Deloitte Consulting LLP

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ProviderSponsored Health Plans: Cautions and Opportunities

3 hours ago Hfma.org Show details

Lia Winfield, PhD, is a senior analyst, Leavitt Partners, LLC, Salt Lake City.. Footnotes. a. Baumgarten, A., “ Analysis of Integrated Delivery Systems and New Provider-Sponsored Health Plans,” Robert Wood Johnson Foundation, June 2017. b. Keckley, P.H., “ Provider-Sponsored Plans: Current Trends and Strategic Implications for Hospitals and Health Systems,” Futurescan: Healthcare

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The ins and outs of providersponsored health plans

7 hours ago Healthcarefinancenews.com Show details

[Also: See how the largest provider-sponsored health plans are performing] "We have a checklist of about 80 items and nine functional areas," he said of Valence. "There's a lot more functions to running a health plan than a managed shared savings plan." To have a claims platform, a system needs at least 250,000 members.

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Largest U.S. health insurers by membership Statista

8 hours ago Statista.com Show details

Largest non-profit health systems in U.S. as of 2017, by hospital number; Largest non-profit health systems in U.S. as of 2017, by revenue; Italy: health

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Analysis of ProviderSponsored Health Plan Profitability

8 hours ago Rwjf.org Show details

Conclusion. Researchers find the current health plan environment is not conducive to profitability for new provider-sponsored plans. Given proposed cuts to Medicaid and changes to individual plans in the American Health Care Act, the future of the remaining provider-sponsored plans could face even greater uncertainty.

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Top 6 Factors for Success in ProviderSponsored Health Plans

1 hours ago Healthpayerintelligence.com Show details

The number of provider-sponsored health plans is growing among physician groups and hospitals. This website uses a variety of cookies, which you …

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Quick Guide to ProviderSponsored Health Insurance Plans

3 hours ago Company.getinsured.com Show details

A provider-sponsored plan is a health insurance company owned by a health system, physicians group, or hospital. There are many ways to describe the concept of providers getting into the health insurance game. McKinsey and Company uses the term “provider-led health plan” and Deloitte prefers “provider-sponsored plan.”.

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Providerled health plans: The next frontier—or the 1990s

5 hours ago Healthcare.mckinsey.com Show details

Provider-led health plans are operating in most states Exhibit 2 of 7 Total exceeds 107 because some provider-led health plans offer coverage in multiple states and/or in more than one line of business. Source: Plan websites Distribution of provider-led health plans in each state, number of plans offered 0 1 2–3 Hawaii California (5) Oregon

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Guide to the Latest Trend of Providersponsored Health Plans

5 hours ago Westernhealth.com Show details

Provider-sponsored health plans (PSHPs) are trending in the health care field, with more employers than ever before choosing them over traditional fee-for-service plans. These provider plans can save employers money – they manage costs efficiently while still providing quality health care to their members. A PSHP is a health plan sponsored by

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ProviderSponsored Health Plans (PSHPs) AHA

4 hours ago Aha.org Show details

The Performance of Provider-sponsored Health Plans. Dec 4, 2015. In this study, the research team sought to compare the performance of provider-sponsored health plans (PSHPs) versus the three largest nonprovider- sponsored health plans (NPSHPs) in their markets, based on publicly reported data for the period 2011-2013.

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Guide to the latest trend of providersponsored health plans

9 hours ago Bizjournals.com Show details

By Western Health Advantage. Apr 1, 2019. Provider-sponsored health plans (PSHPs) are trending in the health care field, with more employers than …

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Health Plans GuideStone

2 hours ago Guidestone.org Show details

GuideStone plans include access to Teladoc, the first and largest telehealth provider in the United States. Teladoc is available with no out-of-pocket co-pays for those on PPO plans and protection plans. Individuals in High Deductible Health Plans are covered at 100% for Teladoc services after reaching their yearly deductible.

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Provider Sponsored Health Plans: 4 Challenges freshbenies

6 hours ago Freshbenies.com Show details

1. Health care success doesn’t guarantee health plan success. There’s a common mistake providers make when launching their new health plan: they bring a group of their physician and care-delivery leaders to run the plan.
2. Provider dominance doesn’t equate to network adequacy. My health system’s in-patient market share consistently hovered around 24 percent, which made them the largest health system in their region.
3. Narrow networks are challenging for groups. Despite trends toward narrowing provider networks, it was still incredibly challenging to sell a narrow network product.
4. It’s a long road to financial success. The plan I worked for has been in operation for over ten years and has still never turned in a profit. This lack of financial success is not unique.

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Use of Tiered Networks by Employer Sponsored Health Plans

3 hours ago Hcfo.org Show details

Grant Description: What is the current or planned use of tiered hospital and/or physician networks in employer-sponsored health plans?In such networks, an individual's out of pocket cost differs depending on the "tier" to which the provider is assigned. This creates a financial incentive for individuals to select among providers based on the price, maximizing choice for individuals while still

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Providersponsored health plans Positioned to win the

9 hours ago Www2.deloitte.com Show details

Provider-sponsored health plans Positioned to win the health insurance market shift i An MCO’s core LOB is the LOB with the greatest enrollment share as a percentage of the MCO’s total enrollment. Executive summary If you search for a list of area health plans offering insurance coverage, chances are good that you may see your health

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Marketplace health insurance plans and prices HealthCare.gov

6 hours ago Healthcare.gov Show details

Important: 2022 plans and prices will be available shortly before Open Enrollment starts November 1. The plan and price information available now is only for 2021. If you qualify for a Special Enrollment Period to enroll in or change coverage for the rest of 2021, you can view 2021 plans and prices now. Use this quick screener to find out if

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Health Plans by State UHCprovider.com

7 hours ago Uhcprovider.com Show details

Health Plans by State. print Print. January 11, 2021 at 3:00 PM CT. Find COVID-19 vaccine availability for your state or territory. Use this list of local health departments open_in_new to learn about availability in your area. Availability may vary by location and time. We encourage you to check back often as information becomes more available.

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A ProviderSponsored Health Plan Is A Hospital’s Natural

3 hours ago Revcycleintelligence.com Show details

Realizing the financial and care quality benefits of a provider-sponsored health plan has proven to be a challenge for hospitals and health systems. But Geisinger Health Plan’s CFO stressed that it is very doable. Hospitals and health systems need a large membership base, he advised. The Pennsylvania-based health plan has nearly 600,000 members.

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SelfFunded Plans :: The Health Plan

1 hours ago Healthplan.org Show details

1. The Health Plan has certified coders, registered nurses, and clinical technicians to review and process claims. We accurately and efficiently process claims, in excess of 1.6 million a year, consistently with established benefit structures. We accept both electronic and paper claims. Within 24 hours, 100 percent of our claims are paperless. THP has the ability to administer any pricing methodologies: Reference Based Pricing, Medicare Based Pricing, DRG, Bundled Payments, Fee Schedules, Usual & Customary Rates, etc.

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Trends and Considerations with ProviderSponsored Health …

1 hours ago Hfmatxgc.org Show details

^A provider-sponsored plan is a health insurance company owned by a health system, hospital or physician group. … Health Plan/Provider Joint Ventures - Combining Texas Health [s high-quality providers and investment in population health management with Aetnas health plan

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10 things to know about providersponsored health plans

6 hours ago Beckershospitalreview.com Show details

1. Kaiser Foundation Health Plan. Kaiser Foundation Health Plan, Inc., a nonprofit managed healthcare company, was founded in 1937, according to a Navigant report.
2. UPMC Health Plan.
3. Healthfirst. Healthfirst was founded in 1993 and is sponsored by various hospitals and medical centers in New York City. Healthfirst has more than 900,000 members and a network of more than 24,000 physicians.
4. Health Alliance Plan. Negotiations between Detroit.- based Henry Ford Hospital, Metropolitan Hospital and Health Centers, and Metro Health Plan, Inc., resulted in Health Alliance Plan in the late 1970s, according to the HAP website.
5. Priority Health. Founded in 1992, Priority Health, the health plan of Grand Rapids, Mich.- based integrated health system Spectrum Health, has plans that covermore than 600,000 people.
6. SelectHealth. SelectHealth was founded in 1984 by Salt Lake City-based nonprofit Intermountain Healthcare. As of 2012, the plan's medical enrollment was 528,000.
7. Sentara Health Plans. Virginia Beach, Va.- based Sentara Health Plans, the health insurance division of Sentara Healthcare, operates as Optima Health. The plan was founded in 1984, and as of 2012 its total U.S. medical enrollment was 445,000.
8. Metroplus Health Plan. MetroPlus Health Plan, Inc., a prepaid health services plan founded in 1985, New York City Health and Hospitals offers low or no-cost health insurance to those who are eligible in Manhattan, Brooklyn, Queens and the Bronx.
9. Presbyterian Health Plan. Albuquerque, N.M.- based Presbyterian Health Plan, the health plan of Presbyterian Healthcare Services, is the largest healthcare provider in New Mexico and was founded in 1985.
10. North Shore-LIJ Health Plan. North Shore-Long Island Jewish Health Plan is a Medicaid Managed Long-Term Care plan. Services covered by North Shore-LIJ Health Planinclude care coordination, personal care, housekeeping and other household tasks, home-delivered meals, rehabilitation therapies, private duty nursing, dental care, medical and surgical supplies, social day care, and foot care, according to a North Shore-LIJ Health Plan brochure.

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Insurance Coverage and Pricing Sanvello

6 hours ago Sanvello.com Show details

Sanvello Premium is available globally and is included in health plans or sponsored by employers for over 40 million Americans.If your health plan or employer covers Sanvello, this means you have free access to all self-care content and tools within Sanvello.

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ProviderSponsored Health Plans: Executives Give Perspectives

8 hours ago Bhmpc.com Show details

Executives identified the following capabilities as most important for provider-sponsored health plans: Patient engagement/customer service tools such as monitoring and call centers/schedulers; and. Analytics tools and skills to identify high-risk, high-cost and other important populations, as well as cost and quality performance trends.

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Section 14: Employer Practices and Health Plan Networks

Just Now Kff.org Show details

Firms with 1,000-4,999 and with 5,000 or more workers are more likely to include a high-performance or tiered provider network in their health plan with the largest

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Most private insurers are no longer waiving costsharing

2 hours ago Healthsystemtracker.org Show details

Across the two largest health plans in each state and D.C. (102 plans), 73 plans (72% of 102 plans) are no longer waiving out-of-pocket costs for COVID-19 treatment. Almost half these plans (50 plans) ended cost-sharing waivers by April 2021, which is around the time most states were opening vaccinations to all adults.

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Health Net Plans for Large Groups California Health Net

Just Now Healthnet.com Show details

Health Net CanopyCare HMO offers convenience and affordability to large groups in the San Francisco Bay Area. With its broad array of benefit design options, CanopyCare HMO offers employees access to care at five prominent medical groups with 5,000+ physicians, 22 contracted hospitals, and …

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17.5 million Americans leave "free" retirement plan money

9 hours ago Cnbc.com Show details

17.5 million Americans leave 'free' retirement plan money on the table, survey finds 17% of workers with access to an employer-sponsored plan don't the nation's largest provider

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Why it's so hard for providersponsored plans to turn a profit

4 hours ago Advisory.com Show details

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1. For the report, Allan Baumgarten, an independent research consultant specializing in health care policy, conducted more than 25 interviews with leaders of health care provider systems and provider-sponsored health plans, as well as academics, consultants, and others who specialize in provider system strategies. How to talk to your providers about data Baumgarten and RWJF researchers also collected and analyzed data from state regulatory filings on about 145 provider-sponsored health plans that operated in the United States in 2015 and 2016. The researchers also prepared case studies on the experiences of several provider-sponsored health plans. For each case study, the researchers interviewed between three to five leaders from the studied health plans and provider systems, as well as market observers. The researchers also collected data on enrollment and prices for the three plans and their competitors.

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Health Plans Archives AIS Health

4 hours ago Aishealth.com Show details

About 73% of health insurance markets in the metropolitan statistical areas were highly concentrated in 2020, while in 46% of those markets, a single insurer’s market share reached at least 50%, according to the 2021 edition of an annual report from the American Medical Association. The consolidation trend is also pronounced with providers, a trend that is likely to be accelerated due to

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4 key trends for payers and providers in 2021 Healthcare

9 hours ago Healthcaredive.com Show details

12.29.235

1. Providers — especially those heavily reliant on fee-for-service reimbursement — were walloped last yearwhen they were forced to halt services to help stem the spread of the virus. Though, if there is an upside, it may have given the extra push providers need to jump into more value-based payment arrangements, a move many hope will ultimately curb health spending in the U.S. as payers reimburse for improved outcomes as opposed to volume. "One of the greatest ironies in all this is that because of COVID-19, people are realizing that there's just as much — if not more — risk in staying in an antiquated, fee-for-service model than there is in embracing an alternative," Rita Numerof, president of Numerof and Associates, said. At the same time,as a result of the challenges from the pandemic, health systems have openly acknowledged they are on the hunt for health insurer dealsand partnerships. A recent report from consultancy firm Kaufman Hall echoes that sentiment, noting it expects a dri...

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Healthcare in Utah Utah Department of Health

6 hours ago Health.utah.gov Show details

Applying for Health Insurance. Affordable Care Act (ACA) Health Insurance Enrollment Help. Health Insurance Marketplace: Learn more about health insurance plans available at the Health Insurance Marketplace at Healthcare.gov.; In-Person Assistance: For in-person help with applying for insurance, call 2-1-1 or visit Take Care Utah to find a trained assister near you.

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Most new providersponsored health plans not profitable

9 hours ago Healthcaredive.com Show details

A new Robert Wood Johnson Foundation report found that only four of 42 recently formed provider-sponsored health plans were profitable in 2015. Some of the plans

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What You Should Know About Provider Networks

3 hours ago Marketplace.cms.gov Show details

A provider network is a list of the doctors, other health care providers, and hospitals that a plan contracts with to provide medical care to its members. These providers are called “network providers” or “in-network providers.” A provider that isn’t contracted with the plan is called an “out-of-network provider.”

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Health systems starting to reembrace providersponsored

7 hours ago Healthcare-conversation.com Show details

The failure of provider-sponsored health plans (PSHPs) in the 1990s isn’t hindering health systems from reconsidering their worth, as inpatient volumes — and the revenues they generate — continue to drop. Confidence is higher now than it was 20 years ago due to the wide availability of technology to manage risk under value-based reimbursement.

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How ProviderSponsored Health Plans Can Find Consumer Success

2 hours ago Healthpayerintelligence.com Show details

December 05, 2017 - Provider-sponsored health plans (PSHPs) are seen as a way for provider organizations to compete with commercial payers while lowering their own costs and …

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Comparisons of Health Insurance Systems in Developed …

Just Now Bu.edu Show details

discussion on coverage for the largest segment of the population in all developed countries: workers sponsored and employer sponsored insurance. Unlike many comparisons, we try to emphasize the general complexity of diverse intermediaries in many health insurance systems, consumers, providers, health plans and sponsors can be viewed as

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FEHB Handbook OPM.gov

5 hours ago Opm.gov Show details

FEHB Program Handbook Introduction General Overview. The Federal Employees Health Benefits (FEHB) Program became effective in 1960. It is the largest employer-sponsored group health insurance program in the world, covering over 8 million Federal employees, retirees, former employees, family members, and former spouses.

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The Decline of EmployerSponsored Health Insurance

6 hours ago Commonwealthfund.org Show details

Job-based health insurance is the largest single source of health care coverage in the United States and it is not what it used to be for many people. Encouraged by federal tax subsidies worth an estimated $250 billion in 2013, many U.S. employers provide coverage as part of their compensation plans; employer-sponsored insurance covers more

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Healthfirst LinkedIn

4 hours ago Linkedin.com Show details

Healthfirst is a provider-sponsored health insurance company that serves more than 1.5 million members in downstate New York. Healthfirst offers top-quality Medicaid, Medicare Advantage, Child

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Health care in the United States Wikipedia

2 hours ago En.wikipedia.org Show details

Health care in the United States is provided by many distinct organizations, made up of insurance companies, healthcare providers, hospital systems, and independent providers. Health care facilities are largely owned and operated by private sector businesses. 58% of community hospitals in the United States are non-profit, 21% are government-owned, and 21% are for-profit.

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The Medicare Advantage Startups: Unicorns or Donkeys? by

2 hours ago Medium.com Show details

PSP = Provider-Sponsored Plan; 5-star plans grow at 10x the rate. To make matters worse, growing enrollments in health systems is incredibly slow without 5-stars (see Figure).

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Section 14: Employer Practices and Health Plan Networks

Just Now Kff.org Show details

Twelve percent of firms with 50 or more workers that offer health benefits include a high-performance or tiered provider network in their health plan with the largest enrollment, a similar

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2 Overview of the Government Health Care Programs

Just Now Nap.edu Show details

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eBrief: How can providersponsored health plans succeed in

3 hours ago Multimedia.3m.com Show details

Title: eBrief: How can provider-sponsored health plans succeed in the new insurance marketplace? Author: 3M Health Information Systems Subject: This eBrief discusses the challenges an organization can face in managing a provider-sponsored plan (PSP) and how PSPs can address those challenges to succeed in the value-based care market.

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Frequently Asked Questions

Are there any provider-sponsored health insurance plans?

The proliferation of public and private exchanges gives providers today many new ways to market themselves to consumers. Expansion of managed care into Medicare and Medicaid has put additional resources on the table. Proliferation of EMRs and other silo-busting platforms have made clinical data sharing easier.

Who are the largest healthcare providers in the United States?

But while many small systems have their own plans, the 25 largest plans by enrollment are largely dominated by some of the biggest healthcare providers in the United States. The list below shows those 25 plans, according to the latest AIS numbers. They are based on 2016 enrollment.

Are there any hospitals that have their own health plan?

July 16, 2018 - Many hospitals and health systems are bypassing the ultimate opportunity to gain greater control of the outcomes and costs of their patients. That opportunity is developing their own provider-sponsored health plan, according to Geisinger Health Plan’s Chief Financial Officer.

How many companies have self funded health plans?

Fifty-nine percent of companies in the United States self-fund their plans. No longer just for large corporations. Self-funded plans from The Health Plan can cover companies with as few as 25 employees. Control costs. Pay medical claims as incurred or deposit expected costs each month.

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