Baptist Health and Humana have ended a months-long conflict over providing health insurance to Kentuckians through Medicare Advantage and commercial insurance plans, the companies announced Thursday.
Starting April 1, Baptist doctors will again accept these patients as “in-network.” This means patients will not be subject to potentially higher costs or service limitations.
The news, which affects tens of thousands of Kentuckians, including many state retirees, was announced via a separate press release.
“After several months of fruitful negotiations, Humana is pleased to reach a new multi-year agreement with Baptist Health Kentucky,” Humana Medicare regional president Eric Bohannon said in a release. .
Mr Baptist welcomed the move as good for patient care.
“We are committed to improving the health of our communities, and our goal is to ensure that all of our patients receive the high-quality, timely care they need,” said Baptist Health's Chief Medical Officer. said Dr. Isaac J. Myers II, Director of Integration.
The news release did not detail how Baptist Health resolved the differences that led to Humana being removed as a network provider for physicians on Sept. 22.
But Medicare Advantage plans, which oversee health care for many Medicare enrollees, including about 102,000 Kentucky government retirees, continue to grow. source of conflict The relationship between health care providers and the private insurance companies that serve them.
baptist I quoted Delays in payment or denial of treatment by private insurance companies that result in disputes.
“The concerns we face with Medicare Advantage plans are similar to those expressed by many health care providers across the country, and the hospital associations that represent them. applicable standards that result in the denial or delay of medically necessary care to patients,” Baptist spokeswoman Kit Frenlove Barry said in an email statement in January.
Baptist also comes into effect from January 1st terminated contract United HealthCare and Wellcare for Medicare Advantage cover services including doctor and hospital care. That is, all such care is considered out-of-network.
Barry said Thursday that Baptist has not reached an agreement with United or WellCare.
The expansion of Medicare Advantage plans, which currently covers about half of the nation's people 65 and older, claims patients are suffering from practices such as denials of medical care, delays while care is authorized, and other restrictions. That's raising concerns among health care advocates. .
Among them is Kaye Tilleau, a longtime Louisville health care reform activist who told the Lantern in January that such a plan would sacrifice Medicare benefits for seniors. .
“For-profit interests are destroying patient care,” Tillow said.
Insurers offering Medicare Advantage plans claim they offer better care at lower costs and, in some cases, additional benefits for seniors.
