Updates on Humana-Trinity Health contract negotiations

• Humana is committed to providing our Medicare Advantage members with access to high-quality, effective and affordable care.
• Humana Medicare Advantage members are being notified that our contract with Trinity Health will end if a new agreement is not reached before it expires effective Jan. 1, 2025.
• If the contract is not renewed on Jan. 1 due to Trinity Health’s financial demands, more than 100,000 Humana members across multiple states will be forced to switch to new doctors and specialists in order to continue accessing in-network benefits.
• As a leader in healthcare, we are deeply invested in providing and expanding access to high-quality healthcare for our Medicare Advantage members while working to minimize their out-of-pocket costs.
• Humana has engaged in good-faith discussions and put forth proposals that would reimburse Trinity Health at fair and reasonable rates.
• When health systems like Trinity make significant financial demands during contract negotiations, it’s important to understand that these requests will ultimately increase healthcare costs for patients.
• Humana remains open to renewing the contract with Trinity Health if it is fair for both sides. Regardless, Humana maintains a strong network of high-performing providers that will help ensure our members continue to receive high-quality, effective, and affordable care.

• Trinity claim: Our request to Humana is simple: to be paid fairly and in line with other providers in our market.
  
  Fact: Trinity Health is currently paid in line with other providers in the markets they serve and their current financial demands will ultimately increase healthcare costs for patients.
  
  
• Trinity claim: We need Humana to provide reimbursement that covers the true cost of care.
  
  Fact: Trinity is paid fairly for the services it provides, at rates that are commensurate with and in some cases higher than original, fee-for-service Medicare.
  
  
• Trinity claim: Humana keeps raising premiums and out-of-pocket costs for its members, like you, to boost their profits.
  
  Fact: Trinity’s financial demands would ultimately have the effect of increasing healthcare costs for our members. Humana has engaged in good-faith discussions and put forth proposals that would reimburse Trinity at fair and reasonable rates—all with a goal of minimizing out-of-pocket costs for patients. Our focus remains on ensuring our Medicare Advantage members have access to high-quality, effective and affordable care.

Surveys consistently show that Medicare Advantage beneficiaries overwhelmingly like their healthcare plan. In fact, a recent survey shows that 95% of Medicare Advantage beneficiaries report being satisfied with the quality of their healthcare.¹

Through Medicare Advantage, Humana provides our members with access to high-quality, affordable healthcare that delivers better outcomes.

• Medicare Advantage is the popular choice for more than 34.4 million seniors with its focus on affordability, accessibility, and better health outcomes.²
• On average, MA beneficiaries spend $2,541 less on out-of-pocket healthcare costs per year than traditional Medicare beneficiaries.¹
• Because of Humana’s emphasis on prevention and care coordination, Humana’s Medicare Advantage beneficiaries experienced 33% fewer emergency department visits and 23% fewer inpatient stays than those in fee-for-service Medicare.³

A recent groundbreaking study from Harvard University and Humana Healthcare Research published in Health Affairs reveals that Medicare Advantage patients who receive care at senior-focused primary care clinics get better access to primary care, better outcomes, and reduced racial and socio-economic disparities compared to other types of primary care organizations, like the traditional fee-for-service Medicare model.⁴

• Better access to healthcare: Medicare Advantage patients of value-based, senior-focused primary care organizations receive 17% more primary care visits.⁵
• Reduced health disparities: Senior-focused primary care organizations narrowed racial and socioeconomic disparities, as Black and low-income Medicare Advantage beneficiaries had 39% and 21% more primary care visits, respectively.⁵
• Better health outcomes: Medicare Advantage patients of senior-focused primary care organizations are more likely to receive recommended cancer screenings, benefit from controlled blood pressure, improve medication adherence and better control diabetes. The study finds early evidence that patients of senior-focused primary care organizations have 11% fewer emergency department visits, 6% fewer hospitalizations, and are 10% less likely to be readmitted to the hospital within 30 days.⁶

Some health systems prefer to accept only patients in the fee-for-service Medicare program because it incentivizes ordering more procedures to maximize their revenue, regardless of their value to patients.

But the facts are clear: Medicare Advantage’s investment in preventive, comprehensive care leads to better health outcomes than fee-for-service beneficiaries.

• Medicare Advantage beneficiaries have over 70% fewer hospital readmissions and 25% fewer preventable inpatient admissions compared to fee-for-service beneficiaries.⁵
• Medicare Advantage beneficiaries have higher rates of preventive screening measures, like vaccinations and cancer screenings, compared to fee-for-service beneficiaries.⁵
• Medicare Advantage beneficiaries have lower rates of inappropriate medication use compared to fee-for-service beneficiaries.⁵
• Medicare Advantage beneficiaries with certain chronic conditions, including diabetes, hyperlipidemia, and hypertension, have lower rates of inpatient utilizations and emergency room visits compared to fee-for-service beneficiaries.¹
• Medicare Advantage beneficiaries with prediabetes who develop type 2 diabetes are diagnosed nearly 5 months earlier on average than similar fee-for-service beneficiaries.¹

Humana’s coordinated and connected network of providers and physicians deliver the highest quality of care and better health outcomes for our members.⁷

• We partner with providers that deliver high quality, efficient care, which is essential to ensuring seniors stay healthy and to keeping their out-of-pocket costs low.
• Our work with value-based care providers has resulted in members having more primary care visits while experiencing fewer hospitalizations and fewer emergency department visits.

Our coordinated, connected networks are essential in helping our vulnerable members facing social risk factors to get reliable access to the benefits and care they need.