The three-year agreement, effective January 1,
2015, aims to reduce health care costs for members in parts of
Contra Costa, Solano and Alameda counties
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. Without limiting the foregoing, statements
including the words “believes,” “anticipates,” “plans,” “expects,”
“may,” “should,” “could,” “estimate,” “intend,” “feels,” “will,”
“projects” and other similar expressions are intended to identify
forward-looking statements. 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.
This release contains references and links to other websites
that may contain content that is not owned or controlled by Health
Net. Please be aware that references and links to other websites
are provided for the user’s convenience and that Health Net is not
responsible for any such content that is not owned or controlled by
Health Net. Health Net does not express an opinion on any such
content and disclaims any liability in connection therewith.
Health Net Investor Contact:The Abernathy MacGregor
GroupDavid Olson, (818) 917-1469dwo@abmac.comorHealth Net Media
Contact:Brad Kieffer, (818)
676-6833brad.kieffer@healthnet.comwww.twitter.com/hn_bradkiefferorJohn
Muir Health Media Contact:Ben Drew, (925)
947-5387ben.drew@johnmuirhealth.com
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