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Humana Inc. (NYSE: HUM), one of Texas’s leading health benefits companies, announced today that the company’s Medicare Advantage health plan members will have in-network access to the inpatient, outpatient and emergency services provided by Baylor Health Care System in Dallas, Tarrant, Collin, Denton and Ellis counties effective Dec. 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 Dec. 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
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.
“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, M.D., 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.”