We have another business decision quoted here, it’s the algorithms that create the profitable business models and it’s happening all over the US. Outside of health insurance too this is happening with new contracts as costs are zeroed down and one place of work closes and another one opens. Perhaps with this severance here the HMO can get themselves situated to be purchased by a rival insurance company? Who knows but that stuff goes on. The contract affects approximately about 20 practices and the current contract ends August 31st.
IPAs Helping Doctors Transition With Health IT Technologies - Prepares IPAs for Potential Future Health Insurer Acquisitions-Subsidiary Watch
Moves like this continue to erode the patient/doctor relationship for profit and if it is not a contract like this one, then we have something else happening to where doctors are turning away patients due to contracted rates. When part A above occurs with the insurer buying IPAs and HMOs it usually calls for a new contract and you can ask almost any physician and see that their compensation does not go up when this occurs and some get a P4P carrot which may or may not be attainable and those contracts vary from one to another. At any rate with seniors having to switch physicians it’s causing a lot of stress and additional phone calls and other interruptions at the practices, not to mention a whole new line of data coding for billing. BD
Doctors in U.S. Turning Away Insured Patients–It All Has To Do With Contracts Negotiated, Renewals and Changes In the Payment and Other Related Algorithms
JACKSONVILLE, Fla. -- Nearly 7,200 Humana Medicare Advantage HMO customers are getting a surprise letter in the mail.
Starting today, June 29, Humana is telling its members that it has terminated services with the UF primary care physician group.
The Humana/UF agreement ends Aug. 31 and they want to give members sufficient notice, said Mitch Lubitz, a spokesperson for Humana. "The patients are not losing coverage or benefits." said Lubitz.