September 22, 2023


Passion For Business

Humana, Kelsey-Seybold team to expand Humana’s Medicare Advantage provider network

Picture: Raymond Gehman/Getty Pictures

Key insurance company Humana has partnered with multi-specialty team follow Kelsey-Seybold Clinic, signing an in-community agreement that Humana hopes will enable expanded obtain to benefit-dependent care through a broadening of its Medicare Advantage provider community in the Houston spot.

The insurance company expects the go will increase obtain to care to contain members of its Medicare Advantage HMO ideas.

Beneath this agreement, which gets to be efficient Jan. 1, 2022, Houston-spot members of Humana Medicare Advantage HMO ideas will have in-community obtain to care at additional than 26 hassle-free Kelsey-Seybold Clinic areas, as effectively as obtain to additional than five hundred suppliers in 55 health care specialties throughout the Houston-Galveston area.

What’s THE Effect

Members of the MA HMO ideas will have obtain to Kelsey-Seybold’s coordinated well being providers, with numerous specialties increased by superior technologies, such as electronic health care record systems, which strive to eradicate replicate health care testing.

Humana has pressured that the new romance will emphasize the insurer’s emphasis on benefit-dependent care, which consists of additional own time with well being experts and individualized care, as effectively as obtain to proactive well being screenings and plans focused on protecting against sickness.

The insurance company has also promised to leverage technologies these kinds of as data analytics to link physicians and aid coordination of care. And it has pledged reimbursement to physicians that is linked to well being results, relatively than the rate-for-support design of reimbursement dependent on quantity of providers.

Humana has also stated it expects improved care for men and women dwelling with long-term circumstances.

THE Much larger Trend

The year has been a fast paced a single for Humana in conditions of pursuing partnerships with different businesses. In June, the insurance company signaled its intent to get Just one Homecare Remedies, or onehome, in an energy to mature its existence in the benefit-dependent residence health care house. Money conditions of the deal have been not disclosed, however the insurance company expects it will not have a significant effect on its financials for the year.

In July, Humana and Signify Overall health started doing the job collectively with the Alamo Place Group Network to guidance Humana Medicare Advantage members in San Antonio through AACN’s local community means and by connecting individuals in want with well being-associated social providers these kinds of as food stuff, transportation, housing and money guidance. It marked the latest energy in Humana’s 6-year Daring Aim marketing campaign to handle well being-associated social requires.

Also in July, Anthem, Humana and SS&C Technologies entered into a joint venture named DomaniRx to acquire a promises adjudication and pharmacy benefits manager cloud system, according to documents filed by SS&C Technologies with the Securities and Exchange Commission. SS&C Technologies holds an eighty.2% curiosity, and Humana and Anthem each and every hold a minority curiosity, according to the agreement filed with the SEC on July fifteen.

Humana logged a web revenue of $588 million for the duration of the 2nd quarter. And when that’s considerably a lot less than the $one.eight billion posted a year ago at this time, when clients have been deferring care, it nonetheless conquer expectations many thanks in huge element to slipping COVID-19 procedure prices for its members.

Humana also stated that “strong fundamentals” throughout its business strains have played a element, especially as the enterprise continues to navigate the impacts of the coronavirus pandemic.

ON THE Record

“Kelsey-Seybold Clinic, each effectively-regarded and highly regarded in the Greater Houston spot, has a longtime heritage of offering quality and coordinated health care to clients,” stated Bill White, Texas Medicare president at Humana. “This is a significant development for Humana in Houston, and we are grateful to be capable to present our Humana Medicare Advantage HMO members an more superior quality health care option as we continually work to help make it less complicated for our members to achieve and keep their finest well being.”

“Delivering superior quality, coordinated care for individuals dwelling in the Houston-Galveston area is what Kelsey-Seybold Clinic is regarded for, and what we are most very pleased of,” stated Kenneth Janis, main working officer at Kelsey-Seybold Clinic. “Expanding obtain to care for Medicare suitable clients in this area is an significant action in enhancing the well being and wellness of all Houston and encompassing spot citizens and we search ahead to welcoming their members at our clinics.”

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