A potential network dispute between two major players in Florida has come to a resolution, for the time being.
Humana and Hospital Corporation of America have agreed to extend in-network access for another two years in Florida--ensuring access for Humana's 1.5 million members in the state, but creating long-term questions after the acquisition by Aetna is complete.
Approximately 1 million Humana Medicare members in Florida, plus another 500,000 in Medicaid, and commercial plans, were briefly facing uncertainty over access to HCA's 46 hospitals and surgery centers in the Sunshine State. Humana members in greater Tampa Bay would have faced particular hurdles in a region where HCA operates 22 hospitals and surgery centers.
Now, that crisis has been averted. Humana and HCA have agreed to a two-year contract that will cover all Humana customers, including those with new Affordable Care Act individual plans.
"Our mission is to continue to provide accessible, affordable care to our communities," Mike Schultz, president and CEO of Florida Hospital West Florida Region, told the Tampa Bay Times. "This new agreement with Humana allows us to continue meeting the health care needs of the community."
What happens after that two years, though, remains another piece of uncertainty. Humana is set to be acquired by Aetna, in a $37 billion deal, and the new Aetna will be the nation's second largest insurer.
With 3 million members in Florida, the new Aetna will likely be the third largest insurer in the state, behind Florida Blue and UnitedHealthcare. The new insurer will certainly mean changes for providers, if not outright hard-nose negotiations. One of Aetna's chief health reform strategies has been value-based narrow networks, often co-branded as Aetna Whole Health, which will likely increase to Medicare Advantage populations in Florida.