Humana adds St. Mary’s to provider network

Humana has reached a deal to offer access to health care services offered at St. Mary’s Medical Center in Grand Junction to members with Medicare Advantage plans.

The Kentucky based insurance company announced that it had reached an agreement with SCL Health, the faith-based organization that operates St.Mary’s and a total of seven other hospitals in Colorado, Kansas and Montana.

With more than 350 beds, St. Mary’s operates the largest hospital between Denver and Salt Lake City. The agreement covers inpatient, outpatient and emergency services.

“The return of SCL Health to Humana’s network offers our members in Grand Junction a wide range of new options for accessing care with their Medicare Advantage plans. St. Mary’s Medical Center is highly respected throughout the community, and we are delighted to be affiliated with them, ” said Mark Iorio, Colorado market vice president for Humana senior products.

Michael Taylor, executive vice president and chief operating officer of hospital operations for SCL Health, said the arrangement adds to the available options for people making health care decisions. “We are a person-centered organization committed to being one of the best in the country, and we extend a warm welcome to Humana seniors who may be interested in choosing us to deliver their care.”

Humana provides coverage to 1.5 million individuals through Medicare Advantage plans, privately run, federally-funded versions of the Medicare program for people over age 65 and the disabled.

The company offers value-based incentives tied to performance improvement and supports population health management for Humana members and SCL Health patients in Colorado. The incentives are designed to promote quality outcomes based on standard measures for such services as cancer screening, diabetes control and high-risk medications.

Aetna, a health insurance company based in Connecticut, recently announced plans to acquire Humana in a stock and cash deal valued at $37 billion. If the deal closes as expected during the second half of the year, the combined Aetna-Humana will be the second largest insurer by revenue. Insurers have been eager to do more business with government payers due in part to surging enrollment in Medicare Advantage plans under health care reforms.