Several health insurers in April announced contracts to bring in new business, while others made headlines for contract negotiations related to their provider networks.
Among the former:
UnitedHealthcare in Centennial, Colo., a subsidiary of UnitedHealth Group, will administer Colorado's self-funded health insurance plans, which are offered to about 32,000 state employees and their dependents. The five-year contract is effective July 1. State employees who choose UnitedHealthcare coverage will be able to access Connected Care. This telehealth program designed to remove geographic barriers to accessing healthcare services will launch this year in rural Colorado in collaboration with the hospital system Centura Health. UnitedHealthcare describes the debut of the program as the "first step" in its effort to create a national telehealth network. UnitedHealthcare currently handles healthcare services for almost 650,000 Coloradans.
Los Angeles-based Health Net of California Inc., a subsidiary of Health Net Inc., will administer CalViva Health, the California Medicaid (i.e., Medi-Cal) plan for 100,000-plus residents of Fresno, Kings and Madera counties. The contract has an annual value of about $225 million, reports Payers and Providers. Health Net signed the contract, which will take effect in the fourth quarter of 2010, with the Fresno-Kings-Madera Regional Health Authority. Health Net currently serves more than 702,000 residents in 10 California counties, as well as more than 150,000 Healthy Families and Healthy Kids beneficiaries in 35 counties. Health Net plans to open new offices in Kings and Madera counties to serve CalViva Health customers and contracting providers.
Among the latter:
Keystone Mercy Health Plan, a Medicaid managed care plan that is a joint venture between Independence Blue Cross of Philadelphia and Mercy Health System in Conshohocken, Pa., has reached an eleventh-hour agreement to renew its contract with Crozer-Keystone Health System after the Springfield, Pa.-based health system agreed to a $9 million rate reduction, reports the Philadelphia Business Journal. Previously, Keystone had sought a $12 million reduction in annual payments to Crozer-Keystone.
The Georgia Department of Insurance will require Blue Cross Blue Shield Healthcare Plan of Georgia to allow Northeast Georgia Cancer Care of Athens to participate in its HMO networks to meet the intent of the state's any-willing-provider law, reports the American Medical News. The ruling is specific to this case, but Insurance Commissioner John Oxendine has reserved the right to extend it to other HMOs operating in the state. The insurer is evaluating the legal implications of the decision.
To learn more:
- read this Denver Business Journal article
- read this UnitedHealthcare press release
- read this Payers and Providers article
- read this Health Net press release
- read this Philadelphia Business Journal article
- read this American Medical News article