WALNUT CREEK, Calif.--(BUSINESS WIRE)--Health Net of California, Inc., a subsidiary of Health Net, Inc., and John Muir Health have formed an Accountable Care Organization (ACO) serving Health Net members utilizing John Muir Health’s medical centers and its physician network in Contra Costa, Solano and Alameda counties.
“Our goal is to help improve the ability of patients to find the right care at the right time and in the most appropriate setting,” said Chris Ellertson, regional health plan officer for Health Net. “Through the arrangement, Health Net and John Muir Health will work collaboratively to build new efficiencies aimed at reducing the cost of care while maintaining access to quality care and decreasing the upward pressure on insurance premiums.”
According to Lee Huskins, president and chief administrative officer of John Muir Health’s physician network, the ACO will focus on promoting patient engagement and improving the patient experience through a combination of care management and wellness and prevention programs, utilizing approaches like:
- Promoting quality, cost-effective medical outcomes through a patient-centered medical home that utilizes an interdisciplinary provider team.
- Enhancing care by coaching and providing specific tools to patients with complex care needs and their family members and caregivers to continue their healing during the transition from the hospital to home.
“This partnership is well-aligned with our efforts to lower costs, enhance quality and service, and increase access to John Muir Health,” said Huskins. “We’re committed to engaging patients as partners in their care to help them maintain and improve their health. We look forward to working collaboratively with our patients and Health Net on this effort.”
An ACO is a group of doctors, hospitals, other health care providers and health plans that closely align and collaborate on providing coordinated, quality care to patients and help avoid unnecessary duplication of services and medical errors.
About John Muir Health
John Muir Health is a nationally recognized, not-for-profit health care organization east of San Francisco serving patients in Contra Costa, eastern Alameda and southern Solano Counties. It includes a network of 950 primary care and specialty physicians, more than 5,500 employees, medical centers in Concord and Walnut Creek, including Contra Costa County’s only trauma center, and a Behavioral Health Center. The health system also offers a full-range of medical services, including primary care, outpatient and imaging services, and is widely recognized as a leader in many specialties – neurosciences, orthopedic, cancer, cardiovascular, trauma, emergency, pediatrics and high-risk obstetrics care. For more information, visit www.johnmuirhealth.com.
About Health Net
Health Net, Inc. (NYSE: HNT) is a publicly traded managed care organization that delivers managed health care services through health plans and government-sponsored managed care plans. Its mission is to help people be healthy, secure and comfortable. Health Net provides and administers health benefits to approximately 5.9 million individuals across the country through group, individual, Medicare (including the Medicare prescription drug benefit commonly referred to as “Part D”), Medicaid, U.S. Department of Defense, including TRICARE, and Veterans Affairs programs. Health Net also offers behavioral health, substance abuse and employee assistance programs, managed health care products related to prescription drugs, managed health care product coordination for multi-region employers, and administrative services for medical groups and self-funded benefits programs.
For more information on Health Net, Inc., please visit Health Net’s website at www.healthnet.com.
Cautionary Statements
The company and its representatives may from time to time make written and oral forward-looking statements within the meaning of the Private Securities Litigation Reform Act (“PSLRA”) of 1995, including statements in this and other press releases, in presentations, filings with the Securities and Exchange Commission (“SEC”), reports to stockholders and in meetings with investors and analysts. All statements in this press release, other than statements of historical information provided herein, may be deemed to be forward-looking statements and as such are intended to be covered by the safe harbor for “forward-looking statements” provided by PSLRA. These statements are based on management’s analysis, judgment, belief and expectation only as of the date hereof, and are subject to changes in circumstances and a number of risks and uncertainties. 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Actual results could differ materially from those expressed in, or implied or projected by the forward-looking information and statements due to, among other things, health care reform and other increased government participation in and taxation or regulation of health benefits and managed care operations, including but not limited to the implementation of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively, the "ACA") and related fees, assessments and taxes; the company’s ability to successfully participate in California’s Coordinated Care Initiative, which is subject to a number of risks inherent in untested health care initiatives and requires the company to adequately predict the costs of providing benefits to individuals that are generally among the most chronically ill within each of Medicare and Medi-Cal and implement delivery systems for benefits with which the company has limited operating experience; the company’s ability to successfully participate in the federal and state health insurance exchanges under the ACA, which in the past have experienced technical challenges in implementation and which involve uncertainties related to the mix and volume of business that could negatively impact the adequacy of the company’s premium rates and may not be sufficiently offset by the risk apportionment provisions of the ACA; increasing health care costs, including but not limited to costs associated with the introduction of new treatments or therapies; the company’s ability to reduce administrative expenses while maintaining targeted levels of service and operating performance, including through the company’s master services agreement with Cognizant; whether the company receives required regulatory approvals for Cognizant’s provision of services to the company and any conditions imposed in order to obtain such regulatory approvals; the company’s ability to recognize the intended cost savings and other intended benefits of the Cognizant transaction; and the risk that Cognizant may not perform contracted functions and services in a timely, satisfactory and compliant manner; negative prior period claims reserve developments; rate cuts and other risks and uncertainties affecting the company’s Medicare or Medicaid businesses; trends in medical care ratios; membership declines or negative changes in the company’s health care product mix; unexpected utilization patterns or unexpectedly severe or widespread illnesses; the timing of collections on amounts receivable from state and federal governments and agencies, including collections of amounts owed under the T-3 contract; litigation costs; regulatory issues with federal and state agencies including, but not limited to, the California Department of Managed Health Care and Department of Health Care Services, the Centers for Medicare & Medicaid Services, the Office of Civil Rights of the U.S. Department of Health and Human Services and state departments of insurance; operational issues; changes in economic or market conditions; failure to effectively oversee the company’s third-party vendors; noncompliance by the company or the company’s business associates with any privacy laws or any security breach involving the misappropriation, loss or other unauthorized use or disclosure of confidential information; impairment of the company’s goodwill or other intangible assets; investment portfolio impairment charges; volatility in the financial markets; and general business and market conditions. Additional factors that could cause actual results to differ materially from those reflected in the forward-looking statements include, but are not limited to, the risks discussed in the “Risk Factors” section included within the company’s most recent Annual Report on Form 10-K and subsequent Quarterly Reports on Form 10-Q filed with the SEC and the other risks discussed in the company’s filings with the SEC. Readers are cautioned not to place undue reliance on these forward-looking statements. Except as may be required by law, the company undertakes no obligation to address or publicly update any forward-looking statements to reflect events or circumstances that arise after the date of this release.
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