Healthcare Provider is Shifting Focus to Other Insurers
ThedaCare is ending its participation in Network Health Plan as of July 31, 2016. It is estimated the move will affect Network Health Plan members across the 14-county region ThedaCare serves who are currently enrolled in commercial and Medicare Advantage products that provide access to ThedaCare physicians, hospitals, clinics, labs and other services.
ThedaCare is in discussions with Network Health Plan to extend its participation through Dec. 31, 2016, allowing time for employers and individual plan members to enroll in new plans. Additionally, continuity of care guidelines may apply, allowing Network Health Plan members to retain their ThedaCare primary care physician for up to a year, and to access their specialist physician(s) and hospital care for an additional 90 days.
“This was a carefully considered decision. Changes in market dynamics and business relationships spurred this course of action,” said Bill Mann, senior vice president of Payer and Employer Strategies for ThedaCare. “While we understand this action will prompt change for some Network Health Plan members, we have high service expectations and fully believe our customers will be well served by the insurance companies with which we have partnered, such as Anthem, UnitedHealthcare, WPS or Humana. Our quality of care, superior expertise in managing complex conditions, top-notch physicians, community-orientation and overall value remain available in other health plans.”
Health insurance agents, employers and providers have been notified of the change. ThedaCare is providing support as payers transition to new plans.
Plan members who are affected by this change are encouraged to talk with their insurance agent or human resources department to learn about options for other health plans that include ThedaCare.
For more than 100 years, ThedaCare™ has been committed to finding a better way to deliver serious and complex healthcare to patients throughout Northeast Wisconsin. The organization serves over 200,000 patients annually and employs more than 6,800 healthcare professionals throughout the region. ThedaCare has seven hospitals located in Appleton, Neenah, Berlin, Waupaca, Shawano, New London and Wild Rose as well as 35 clinics in 14 counties. ThedaCare is the first in Wisconsin to be a Mayo Clinic Care Network Member, giving our specialists the ability to consult with Mayo Clinic experts on a patient’s care. ThedaCare is a non-profit healthcare organization with a level II trauma center, comprehensive cancer treatment, stroke and cardiac programs as well as a foundation dedicated to community service. Construction of ThedaCare Regional Cancer Center in Appleton is underway. For more information, visit www.thedacare.org or follow ThedaCare on Facebook and Twitter.