Banking & Finance and Health Care

Health system partners with insurer on HMO plan

December 10, 2014
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Metro Health facade
Metro Health Hospital's rooftop garden is the second-largest green roof in Michigan. Courtesy Metro Health

A national insurer is rolling out an HMO plan to the local market as part of a partnership with a health care system.

Metro Health in Wyoming and Humana in Louisville, Ky. said yesterday that they’ve agreed that Humana will offer a new health maintenance organization plan built around Metro Health to "people in Grand Rapids purchasing insurance through the Michigan Health Insurance Marketplace."

The plan provides in-network access to Metro Health Hospital, its 12 neighborhood physician offices and the affiliated physician network throughout West Michigan.

The plan is designed for members to seek medical care from the hospital and providers listed within the plan, unless there's an emergency or physician referral.

Joe Braun, director of Michigan Market Point at Humana, said Metro Health is a “perfect partner” to offer accessible health care to Grand Rapids residents.

Mike Faas, president and CEO at Metro Health, said the organization is “happy to partner with Humana.”

“Having access to primary care and a relationship with a primary care physician is the cornerstone to managing health,” Faas said.

Plan resources

The health plan includes Humana’s resources for members to manage chronic illness, create healthy lifestyle decisions and navigate health care reform, including several tools: a Personal Nurse program, which allows members with chronic illnesses to work with a nurse to communicate needs to physicians and manage their health; RxMentor program, connecting people to pharmacists for personal consultations regarding medications; and EasyPrice calculator, which helps people estimate their financial assistance and find plan options in their markets.

Eligibility

Humana is also partnering with CVS/pharmacy, YMCA and other community-based organizations during the open enrollment period, which ends next Feb. 15.

Humana said the collaborative effort is meant to provide educational information to people interested in determining their eligibility for financial assistance and understanding their plan options.

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