Dive Brief:
- Humana and Tenet have announced a new agreement wherein the health insurer's members will have in-network access to hospitals, outpatient centers and physicians employed by the Dallas-based hospital system. Tenet has also reached a multi-year agreement with Anthem Blue Cross for its California facilities.
- Tenet and Humana in particular have had a rocky relationship the past few years. They failed to reach an agreement in 2016, leaving Humana members unable to get covered care at facilities owned by Tenet, the country's largest for-profit hospital operator. The companies finally negotiated a contract again in the summer of 2017.
- Tenet's contract with Humana will run through 2023. The terms of its contracts with both payers have not been disclosed.
Dive Insight:
The Humana-Tenet agreement will be beneficial for both companies, especially Tenet, which experienced a rough Q3 after suffering a blow to admissions. Reporting a net loss of $9 million to investors, CEO Ronald Rittenmeyer called the quarterly earnings "unacceptable."
Tenet has been looking to follow the outsourcing trend for revenue cycle management. Rittenmeyer has said recently that the company is looking "aggressively" at offshoring more than 1,000 jobs across the entire system over the next year and a half.
The Humana agreement could help lift some of the operator's sagging admission rates. Humana, which has been riding steady on the crest of the Medicare Advantage wave, could see a boost to some of its trailing enrollment rates in fully-insured commercial plans, Medicare Part D and Medicaid.
"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," George Renaudin, senior vice president at Humana, said in a statement.
Humana caught a $700,000 fine from the Texas Department of Insurance in October for failing to maintain an adequate network of anesthesia services in three of the state's largest metropolitan areas, putting patients at risk of paying higher out-of-pocket costs.
The news follows an overall trend of increased partnerships among payers and providers. According to an Oliver Wyman report published in June, the pace of partnerships between the two healthcare segments is the fastest its been in the six years Oliver Wyman has tracked payer-provider agreements.