Memorial Hermann in ‘negotiations impasse’ with Humana as their network contract expires January 1 | Houston Public Media

Memorial Hermann Health System patients with Humana insurance plans could be forced to pay out-of-network fees or find new doctors in order to continue paying in-network prices for medical services, if the two companies fail to resolve a contractual dispute before the end of the year.

Memorial Hermann, the Houston area’s largest hospital system, said Wednesday it is at an impasse in negotiations with Humana because their existing agreement will expire Jan. 1, 2024. The health care provider and its employed physicians have issued layoff notices for Humana. Medicare Advantage HMO and PPO networks, Memorial Hermann said in a statement to Houston Public Media.

“Over the years, we have developed long-standing partnerships with payers like Humana, and our goal is to ensure that our patients who rely on us for their care continue to have in-network access to healthcare facilities and providers. Memorial Hermann they know and trust,” Memorial Hermann said. “Nothing is changing for our patients at this time. They can and should continue to seek care from their trusted Memorial Hermann providers and facilities as they normally would.”

Memorial Hermann and Humana, based in Louisville, Kentucky, both said Wednesday they remain open to “good faith discussions” in hopes of reaching a new agreement and avoiding network disruption for their mutual customers . Neither company responded to questions about how many patients could be affected if the current contract expires without a new agreement in place.

“Humana strives to provide access to a broad range of healthcare providers,” the insurance company said in a statement. “We remain open to further good faith discussions with Memorial Hermann Health System and its affiliates regarding continued participation in the network to avoid network disruption for our members.” At the same time, we must ensure that our hospitals and contracted doctors provide quality and cost-effective services. effective care to keep health coverage and out-of-pocket costs as affordable as possible for our health plan members.

Memorial Hermann also found itself in a contractual impasse with Cigna in 2020 and Blue Cross Blue Shield in 2022 before ultimately reaching agreements with both insurance companies. This latest impasse led to the temporary network closure of nearly 200,000 patients with Blue Cross Blue Shield plans before a new agreement with Memorial Hermann was reached days later.

If Memorial Hermann and Humana are unable to reach a new contract, the health care provider said it “participates in several other Medicare Advantage networks, and we hope there are options that could help our patients maintain access to their trusted physicians employed and affiliated with Memorial Hermann”, ancillary facilities and services.