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TMCNet:  Humana extends agreement with Baylor to provide services for Medicare members

[December 14, 2012]

Humana extends agreement with Baylor to provide services for Medicare members

Dec 14, 2012 (Datamonitor via COMTEX) -- Humana Inc., a healthcare benefits company, has expanded agreement with Baylor Health Care System, a not-for-profit service provider, under which the Humana's Medicare Advantage health plan members will have in-network access to the inpatient, outpatient and emergency services provided by Baylor Health Care in Dallas, Tarrant, Collin, Denton and Ellis counties effective December 15, 2012.

Seniors and other beneficiaries eligible for of Medicare who sign up for a Humana Medicare Advantage health maintenance organization (HMO) or preferred provider organization (PPO) health plan during the Medicare Annual Election Period (AEP), ending December 7, 2012, will have in-network benefits during the 2013 plan year.

Humana's commercial members and individual medical members (HumanaOne) already have in-network access to Baylor Health Care System. Baylor Health Care System services and facilities included in the agreement are: 30 hospitals that are owned, operated, joint ventured or affiliated with Baylor Health Care System; 26 ambulatory surgical/endoscopy centers; 193 HealthTexas locations; 83 satellite outpatient facilities - imaging, rehabilitation and pain; 3 senior health centers; 3 retail pharmacies, said Humana.

In addition, Humana has signed an agreement with the newly-formed Baylor Quality Alliance, a clinically-integrated model recently launched by Baylor Health Care System that includes the 600 HealthTexas employed physicians and 900 independent physicians in an accountable alliance with the Baylor Health Care System hospitals.

The agreement aligns incentives under a new contract structure that rewards physicians affiliated with Baylor Quality Alliance for improved quality and efficiency outcomes for Humana's Medicare Advantage members, said Baylor.

"We are excited to partner with both Baylor Health Care System and Baylor Quality Alliance to substantially increase health care options for our Medicare Advantage members who live in North Texas," said George Smith, Humana's president of senior products for the Southwest Region. "This partnership is unique and provides Humana members health care choices in ways that improve quality, efficiency, cost and coordination among providers." "We are always looking to expand our reach in the communities we serve," said Gary Brock, COO, Baylor Health Care System. "We're pleased to offer our high quality, award-winning facilities and services to Humana members through this new agreement." Republication or redistribution, including by framing or similar means, is expressly prohibited without prior written consent. Datamonitor shall not be liable for errors or delays in the content, or for any actions taken in reliance thereon

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