In-Network Relationships

by Debbie Simon, UnityPoint Health

Insurance network participation helps to ensure high-quality, cost-effective healthcare access.

It’s an exciting time to be a leader in healthcare. Medical technologies and other innovations are improving care so more and more people can get back to living the busy lives they love. Certainly there are industry challenges, but at the end of the day, we are focused on achieving our goal of providing the people of central Illinois with the best care possible. And it begins with creating better access to quality care. 

That’s why UnityPoint Health is focused on building a high-quality, cost-effective regional care network. It’s important to us that as many patients as possible can access our physicians, hospitals and other services. Expanding our network allows us to better coordinate care among our hospitals, physician clinics and home care services. It also provides an additional choice to the people we serve, which we believe will help drive down the cost of quality healthcare.  

Health systems are not automatically in health insurance networks. We strive to partner effectively with insurance companies to provide affordable care—and make sure those relationships provide good service to the people we serve. Historically, some of our hospitals and physicians were in major networks, while others were not. We’re very pleased that now all our hospitals and physicians are in-network for the major commercial health insurance plans, including Blue Cross/Blue Shield, Aetna/Coventry, United and Humana. We are also in all the Medicare Advantage and Medicare Supplement plans for all carriers. We have a comprehensive network of services that can work directly with employers to provide additional options for their health plan needs.

Medicaid plans have become an additional part of this picture as well. Historically, we received payments directly from Illinois Medicaid, but the state now contracts with managed care companies to manage these plans. This has required us to contract with these companies as well, just as we do on the commercial side. In 2019, we have been able to successfully enter into agreements with all four statewide Medicaid managed care organizations, including the newly-added Molina Healthcare, which will help ensure patients have access to our pool of quality hospitals and physicians.

Having all of our hospitals and physicians in network helps us partner more effectively to provide the most comprehensive level of services, and to make sure patients can be seen at the best location to meet their needs. We seek relationships with insurance carriers where we can partner to ensure we are bringing the most value through our quality patient experience and cost. 

Our insurance network participation and relationships are an important part of how we strive to bring healthcare access, high quality and great value to the community. iBi

Debbie Simon is regional CEO of UnityPoint Health.

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