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Humana, Tenet Healthcare reach new deal restoring in-network access

Tenet's CEO said the exclusion of Humana patients had an adverse effect on the system with adjusted patient admissions dropping.

Beth Jones Sanborn, Managing Editor

Tenet Healthcare and Humana have announced a new multi-year agreement that will give Humana members in-network access to Tenet's hospitals, outpatient centers and employed physicians. The new contract runs through May 2023.

THE IMPACT

A previous agreement between the Dallas-based health system and Humana ended in September and the lapse between the two agreements caused some chaos, with consumers in several states scrambling to find in-network facilities, according to one report.

Tenet's CEO said the exclusion of Humana patients had an adverse effect on the system, saying their adjusted patient admissions dropped by 2.5 percent on a same-hospital basis and decreased 0.8 percent when Humana-insured patients were excluded, the report said.

THE TREND

Tenet and Cigna also reached a new, multi-year agreement on January 1, after 11 months of negotiations. It was on the day beneficiaries would have lost in-network coverage.

Another contract dispute between UnitedHealthcare and Envision was settled in December 2018, ending a long-standing dispute over ER payment rates.

WHAT ELSE YOU NEED TO KNOW

Tenet Healthcare Corporation includes 115,000 employees and operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities.

The company's subsidiary Conifer Health Solutions offers technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans.

ON THE RECORD

Ron Rittenmeyer, Tenet's executive chairman and chief executive officer, said, "We are pleased to have reached this agreement with Humana, and look forward to continuing to provide their members with high-quality care and trusted service today and into the future."

"This agreement with Tenet Healthcare ensures continued in-network access to Tenet facilities and physicians for Humana members, and it reflects our ongoing commitment to provide a broad range of high-quality health care options for the people we serve," said George Renaudin, senior vice president at Humana.

Twitter: @BethJSanborn
Email the writer: beth.sanborn@himssmedia.com

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