Memorial Hermann drops Humana Medicare Advantage

Houston-based Memorial Hermann Health System is no longer in network with Humana's Medicare Advantage plans, effective Jan. 1.

The 17-hospital system told Houston Public Media that it continues to participate in Humana's commercial network. Humana told the outlet that its Medicare Advantage members who are actively receiving treatment at Memorial facilities, can "continue care until treatment is completed."

In November, Memorial Hermann issued termination notices after the reimbursement dispute came to an impasse. It is unclear how many people are affected by the dispute. Along with its hospitals, Memorial has 6,700 affiliated physicians across 260 care delivery sites. Humana is the country's second largest MA insurer, with 5.9 million members as of Nov. 1.

At least 15 hospitals or health systems nationwide dropped some or all contracts with Medicare Advantage plans in 2023, citing excessive prior authorization denial rates or slow payments from insurers. While the trend is not an occurrence in the majority of the nation's health systems, hospital executives and state associations have been more candid recently with their critiques of the program. Several health systems are also expanding their own Medicare Advantage subsidiaries in 2024.

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