IHS, Humana team in Medicare HMO deal They will offer services in Integrated's Fla. nursing homes

December 05, 1996|By M. William Salganik | M. William Salganik,SUN STAFF

Putting a new twist on its managed-care strategy, Integrated Health Services of Owings Mills announced a contract with Humana, a large national managed-care company, yesterday to jointly offer Medicare HMO services to residents of Integrated's nursing homes in Florida.

Integrated has based a growth strategy on acquisitions -- recent purchases make it the country's largest provider of services to people who have been discharged from a hospital -- and on developing contracts with managed-care insurers in which Integrated assumes insurance risk.

Although Integrated has two other risk contracts with managed-care companies, the Humana deal "is a brand new model," said Marc B. Levin, executive vice president of Integrated.

"We're not disclosing revenue [projection] numbers because revenues would be modest, since this is a first step," Levin said. "What's important is the opportunity to gain experience and to expand this to other HMOs and other regions."

He said Integrated was already discussing similar deals, "and we expect another announcement by the end of the year."

For Humana, "this is helping us facilitate a way to provide Medicare HMO benefits to people who have not been able to take advantage of them before," said W. A. Weronka, a spokesman for the company, which is based in Louisville, Ky. Weronka said Humana had surveyed the industry and "we know of no one else who is doing this."

Humana is the largest Medicare HMO insurer in Florida, with 220,000 seniors enrolled.

Medicare HMOs, which are growing rapidly, are generally profitable for HMO companies. They offer seniors a chance to avoid a great deal of paperwork as well as the deductibles and co-payments they pay under normal Medicare coverage. However, the seniors receive care only from doctors and hospitals who contract with the HMO they select. In many markets, including Baltimore-Washington, they pay no monthly premiums, avoiding "Medigap" policies that can cost $100 a month.

So far, the products have been aimed at younger, healthier seniors. By reaching out to seniors already in nursing homes, Humana opens a new market. The contract does not cover nursing home care itself, for which Medicare offers only limited benefits.

Humana will pay Integrated a monthly fee for each nursing home resident who is enrolled as a Humana member. Integrated will provide all needed care, including hospitalization. To the extent it can manage care efficiently, it will profit. Integrated is in a position to save on hospitalization costs because it offers a range of services such as home health, intravenous drug therapy and rehabilitation facilities.

Integrated shares gained 50 cents yesterday to close at $23.125.

Pub Date: 12/05/96

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