Mercy Health reaches contract agreement with Humana

The lobby of Mercy Health's Springfield Regional Medical Center. BILL LACKEY/STAFF

Credit: Bill Lackey

Credit: Bill Lackey

The lobby of Mercy Health's Springfield Regional Medical Center. BILL LACKEY/STAFF

After warning patients last month that Medicare Advantage and Managed Medicaid plans under Humana might be going out of network toward the end of the year, the local hospital system Mercy Health reversed course after reaching a deal with insurance provider.

Mercy Health and Humana had a previously stated Dec. 1 deadline to come to an agreement to keep Humana’s Medicare Advantage and Managed Medicaid plans in-network, which they were able to reach this week.

Effective Dec. 1, this new contract agreement will allow 7,458 patients across Clark and Champaign counties to keep in-network coverage to Mercy Health providers and facilities, according to the hospital system.

Through this agreement, Mercy Health hospitals, physicians, urgent care clinics, ambulatory surgery centers and other care sites will continue to be in-network for all patients covered by Humana’s plans.

“We understand how stressful negotiations like these can be for patients. Our priority throughout this process has been to protect our patients from uncertainty and disruption,” said Adam Groshans, president, Mercy Health – Springfield.

With this agreement, Humana patients can continue to rely on Mercy Health for uninterrupted access to their providers and Mercy Health services, he said.

“We deeply appreciate your patience and resilience, and we remain committed to delivering compassionate, high-quality care now and into the future,” Groshans said.

In October, Mercy Health representatives said the reimbursements the hospital system got from Humana were not enough to provide safe, quality care.

Humana has also had persistently high claims denial rates, according to a previous post on Mercy Health’s website.

A Humana spokesperson did not immediately respond to a request for comment on Monday, but a previous statement from the health insurer said it was working on finding a path forward that balances affordability, care quality and long-term sustainability for its members.

“We are working in good faith to reach a resolution that avoids disruption and maintains access to trusted care,” Humana officials said in an October statement.

For more information, visit mercy.com/humana-updates.

Mercy Health has 23 hospitals and hundreds of clinics, urgent care and medical centers across Ohio and Kentucky, including locations in Springfield, and Butler and Warren counties.

With more than 14 million members nationwide, Humana Inc. is a Fortune 500 health care company based in Louisville, Ky., specializing in Medicare Advantage, Medicaid, group health insurance, and specialty health services.

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