1 week Ago By Gretchen Teske [email protected]
MercyOne Genesis and health insurance provider Humana failed to come to an agreement before the Jan. 1, 2025, deadline, leaving many without in-network access to their regular providers. In a statement on MercyOne Genesis' website, the hospital said this impacts patients who are covered by a Humana Medicare Advantage plan for the 2025 benefit year.
"For months, we've worked diligently to find common ground with Humana to ensure your access to MercyOne remains uninterrupted. We rely on fair payment from health insurers so we can sustain the high-quality care patients like you depend on and need," the statement read. " We will not give up trying to reach a fair agreement with Humana.
We know how important it is for you and your family to continue receiving care from the trusted doctors, nurses, and staff at MercyOne." All MercyOne and MercyOne Genesis hospitals, facilities and employed providers are impacted by these contract negotiations, according to a Frequently Asked Questions page. For those who have scheduled appointments or procedures on or after Jan.
1, 2025, MercyOne suggests calling Humana at the number on the back of the health insurance card to determine whether they will cover the procedure through Continuity of Care provisions. On its own website , Humana says MercyOne's parent organization Trinity Health "has made significant financial demands that will ultimately increase health care costs for patients." The insurance provider says it has offered "fair and reasonable" rates to Trinity.
The lack of agreement impacts around 100,000 people across multiple states, according to Humana. News of the hospital system and health care providers being at odds was not new in 2024. In May, MercyOne Genesis announced it was having difficulty coming to an agreement with United Healthcare.
Both entities were pointing the finger at one another, citing greed. On a website set up by United Healthcare to provide information at the time, the insurance company blamed MercyOne for "demanding significant price hikes for our employer-sponsored and Medicare Advantage health plans that would increase health care costs by $42 million over the next three years." Genesis, which completed its merger with MercyOne last year, countered United Healthcare's claims on a website of its own.
Genesis put the blame for price hikes on United Healthcare, further stating United has shared "inaccurate and misleading information." Hours before the new year, MercyOne announced it reached an agreement with insurance provider Aetna, a CVS Health company. The announcement came just before the Jan.
1, 2025, deadline to reach an agreement between the two companies..
