6 Area Health Systems Invest in Johns Hopkins Medicine's Medicare Advantage Plans

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BALTIMORE, MD (September 30, 2016) — Johns Hopkins Medicine today announced that six of the region’s largest and most prominent health systems are investing in its Medicare managed care health plans, which offer comprehensive health care coverage to Medicare-eligible beneficiaries in 11 counties in Maryland.

Under the agreement, the six systems will become equity partners in Hopkins Health Advantage, a licensed insurance company offering the Johns Hopkins Advantage MD and Advantage MD Plus health plans, the fastest growing Medicare Advantage (Medicare Part C) plans available in Maryland.

The six health systems, which together provide health care to more than half of the population in the region, will join Johns Hopkins HealthCare, the population health and managed care arm of Johns Hopkins Medicine, as investors in the Johns Hopkins Medicare Advantage plan. Johns Hopkins HealthCare provides managed care health plan administration services to nearly 400,000 individuals in the mid-Atlantic through its four health plans, including the Advantage MD products. The new partners include:  

  • A health system collaborative consisting of:

    • Adventist HealthCare, including Shady Grove Medical Center and Washington Adventist Hospital
    • Frederick Regional Health System
    • LifeBridge Health, including Carroll Hospital, Northwest Hospital and Sinai Hospital
    • Peninsula Regional Health System
  • Anne Arundel Medical Center
  • Mercy Medical Center

This collaboration does not impact the individual ownership of the parties involved, which will remain independent of the Johns Hopkins Medicine delivery system that includes The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center, The Johns Hopkins University, Johns Hopkins Community Physicians, Sibley Memorial Hospital, Howard County General Hospital, and Suburban Hospital.

Including the facilities and providers associated with these new investors, Johns Hopkins HealthCare’s provider network includes more than 9,000 additional providers and facilities offering one of the more comprehensive Medicare Advantage products available in Maryland.

Johns Hopkins HealthCare President Patricia M.C. Brown welcomed the opportunity to collaborate financially with key health care systems that already participate in Johns Hopkins HealthCare’s preferred provider network to provide members in Johns Hopkins Advantage MD plans with the highest-quality health care available.

“These agreements promote a highly collaborative, provider-led approach to providing health plan benefit services to individuals eligible for Medicare coverage in Maryland.” Ms. Brown said.  She characterized the unusual joint venture with health systems that are not part of the traditional Johns Hopkins family as an example of thinking outside the box to facilitate health system transformation. 

She added, “This advances Johns Hopkins HealthCare’s quest to be a dedicated advocate for our clients/employers, patients/members, health care providers and the broader communities we serve. As financial stakeholders, these six health systems have an even greater stake in ensuring that members in our Advantage MD health plans receive the most effective, efficient care possible, producing optimal health outcomes.” With these plans, patients will still be able to see their doctor and continue to use their preferred hospital.

The agreement comes just prior to the next Annual Election Period during which Medicare-eligible beneficiaries can select their health coverage for the next year – opting either for Original Medicare (Parts A and B) coverage or for a Medicare Advantage (Part C) plan. By contrast, Medicare Advantage plans provide more comprehensive coverage and cap how much a member must pay out of pocket, making it easier to budget for health care expenses. Some plans also offer beneficiaries additional benefits not otherwise available through traditional Medicare.

Original Medicare generally covers about 80 percent of beneficiaries’ health care costs, leaving them responsible for paying the remaining 20 percent out of pocket with no annual limit. Many Medicare beneficiaries pay extra to purchase Medicare Supplement insurance and prescription drug coverage offered through private insurers.

Over the past five years, enrollment in Medicare Advantage — an alternative to Original Medicare — has grown nearly 50 percent nationally. This surge has been fueled by Medicare Advantage’s more predictable costs, additional benefits and care coordination.

About Johns Hopkins HealthCare

Johns Hopkins HealthCare LLC (www.hopkinsmedicine.org/johns_hopkins_healthcare/) is the managed care arm of Johns Hopkins Medicine. Established in 1995 as a partnership between The Johns Hopkins Health System Corporation and the Johns Hopkins University School of Medicine, Johns Hopkins HealthCare provides a full range of traditional insurance services, including customer service, enrollment and claims processing, in addition to innovative managed care programs designed to target overall population health strategies. JHHC currently provides health care coverage to nearly 400,000 members in four health plans: Priority Partners Managed Care Organization (Medicaid), Johns Hopkins Employer Health Programs, Advantage MD (Medicare Advantage) and the Johns Hopkins US Family Health Plan.

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