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5 Baptist Health Hospitals Dropping Humana in Florida Effective January 1, 2011

Posted Aug 08 2010 11:35pm

This change does not affect plans that are provided by employers.  On July 29th, a letter was sent out to the affected patients.  January 1, 2011 is the effective date unless something gets updated between now and then and sometimes this does happen.  image

Cuts to Medicare Advantage were cited as the reason for the change.  Some hospitals in the system will continue to cover patients and I am guessing here some business intelligence software was utilized to come up with where they could afford to hang on and where they could not.  It is interesting in reading comments in papers as such from consumers as they really don’t get the full effect of healthcare reform and do what we have always done, find a scape goat to blame, even though the system as it was before any reform was crumbling as technology and algorithmic formulas are controlling how business is done at hospitals so a lot of this would have transpired anyway.  I know that is a hard nut to swallow but it’s the truth on what is happening today so blaming the administration doesn’t get you anywhere and a good point to read up on is the subsidiary actions of the insurers and you will get your eyes opened in a hurry as there’s a lot that works behind the scenes and it’s complicated. 

The insurers created this and the government is trying to work within a very massive system that takes a chunk of profits out of every healthcare claim that is filed, what the consumer does not see and is not aware of.  BD 

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Starting next year Baptist Health's five hospitals in Northeast Florida will no longer accept Humana's Medicare HMO -- fallout, both entities assert, from the federal health-care overhaul.

Neither party wanted to divulge specifics about the failed contract negotiations. But both were quick to cite as a key factor the federal government's planned cutbacks to Medicare Advantage.

Humana Medicare HMO members will continue to have access to the following facilities: Flagler Hospital in St. Augustine, Orange Park Medical Center in Orange Park, and Shands Jacksonville, Memorial Hospital Jacksonville, St. Luke's Hospital and St. Vincent's Medical Center in Jacksonville.

But for elective procedures and treatments, Nassau members face quite a haul. The closest alternative, Shands Jacksonville, is 25 miles from Nassau's biggest town, Fernandina Beach.

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