Contact Center Industry News

TMCNet:  Humana Expands Agreement with Baylor Health Care System and Newly-Formed Baylor Quality Alliance

[December 04, 2012]

Humana Expands Agreement with Baylor Health Care System and Newly-Formed Baylor Quality Alliance

DALLAS --(Business Wire)--

Humana Inc. (NYSE: HUM), one of Texas's leading health benefits companies, announced today that the company's Medicare Advantage health plan members will have in-network access to the inpatient, outpatient and emergency services provided by Baylor Health Care System in Dallas, Tarrant, Collin, Denton and Ellis counties effective Dec. 15, 2012.

Seniors and other beneficiaries eligible for of Medicare who sign up for a Humana Medicare Advantage health maintenance organization (HMO) or preferred provider organization (PPO) health plan during the Medicare Annual Election Period (AEP), ending Dec. 7, 2012, will have in-network benefits during the 2013 plan year.

Humana's commercial members and individual medical members (HumanaOne®) already have in-network access to Baylor Health Care System. Baylor Health Care System services and facilities included in the agreement are:

  • 30 hospitals that are owned, operated, joint ventured or affiliated with Baylor Health Care System
  • 26 ambulatory surgical/endoscopy centers
  • 193 HealthTexas locations
  • 83 satellite outpatient facilities - imaging, rehabilitation and pain
  • 3 senior health centers
  • 3 retail pharmacies

In addition, Humana has signed an agreement with the newly-formed Baylor Quality Alliance, a clinically-integrated model recently launched by Baylor Health Care System that includes the 600 HealthTexas employed physicians and 900 independent physicians in an accountable alliance with the Baylor Health Care System hospitals. The agreement aligns incentives under a new contract structue that rewards physicians affiliated with Baylor Quality Alliance for improved quality and efficiency outcomes for Humana's Medicare Advantage members.

"We are excited to partner with both Baylor Health Care System and Baylor Quality Alliance to substantially increase health care options for our Medicare Advantage members who live in North Texas," said George Smith, M.D., Humana's President of Senior Products for the Southwest Region. "This partnership is unique and provides Humana members health care choices in ways that improve quality, efficiency, cost and coordination among providers."

"We are always looking to expand our reach in the communities we serve," said Gary Brock, chief operating officer, Baylor Health Care System. "We're pleased to offer our high quality, award-winning facilities and services to Humana members through this new agreement."

Humana is one of Texas's leading health benefits companies with more than 200,000 Medicare Advantage members, 465,000 commercial health plan members and 1.2 million specialty benefits members.

About Baylor Health Care System

Baylor Health Care System is a not-for-profit, faith-based supporting organization providing services to a network of acute care hospitals and related health care entities that provide patient care, medical education, research and community service. Baylor recorded more than 2.8 million patient encounters, $4 billion in total operating revenue, $5.2 billion in total assets and $502 million in community benefit in fiscal year 2011 (as reported to the Texas Department of State Health Services). Baylor's network of more than 300 access points includes 30 owned/operated/ ventured/affiliated hospitals; joint ventured ambulatory surgical centers; satellite outpatient locations; senior centers and more than 180 HealthTexas Provider Network physician clinics.

About Humana

Humana Inc., headquartered in Louisville, Kentucky, is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.

More information regarding Humana is available to investors via the Investor Relations page of the company's web site at, including copies of:

  • Annual reports to stockholders;
  • Securities and Exchange Commission filings;
  • Most recent investor conference presentations;
  • Quarterly earnings news releases;
  • Replays of most recent earnings release conference calls;
  • Calendar of events (including upcoming earnings conference call dates and times, as well as planned interaction with research analysts and institutional investors);
  • Corporate Governance information.

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