Tidewater Physicians Multispecialty Group reached a resolution with Humana to accept the insurer's Medicare Advantage plans next year.
After months of confusion from patients and negotiations between parties, TPMG notified patients of the resolution in a Dec. 13 letter shared with the Daily Press and The Virginian-Pilot. Humana spokesperson Lisa Dimond confirmed TPMG signed an agreement to continue its in-network participation with the health insurance company.
That means Humana plan members, including retirees from the city of Newport News, can continue seeing their doctors and providers at TPMG on an in-network basis. TPMG, which offers primary care and more than 30 specialties, serves more than 150,000 patients across more than 85 locations in the Hampton Roads area, according to its website.
Sue Wills, a Newport News government retiree in York County, said she was pleased when she received a message from TPMG in her online patient portal on Dec. 12 to let her know they'd reached a resolution and would continue taking her insurance next year.
"I think it's going to be an ongoing thing," Wills said. "I think it kind of reflects the climate in the entire country right now with health care ... that the patients are kind of the last ones in the equation."
TPMG had sent an Oct. 3 letter to patients that said the health care provider would no longer be able to accept Humana Medicare Advantage plans in 2025 and advised patients who wished to continue care there to consider switching to another insurance plan.
"We sent this letter to give patients plenty of notice to consider our Humana status when selecting their insurance plan for 2025 and to give them the option to select another plan that TPMG accepts," TPMG CEO David Warren said in an email to The Pilot.
Wills had shared her concerns with the Daily Press about being able to continue seeing her doctors as the Oct. 3 letter said, "If you want to join Humana Medicare Advantage in 2025, you will need to change your primary care and specialist doctors to physicians in another medical group."
In response to the Dec. 3 Daily Press story based on that letter, Warren said in an email that no patients would have been dropped and they would have been able to continue care with TPMG.
Newport News had notified TPMG of its city-sponsored retiree health plan administered by Humana where eligible retirees receive a premium contribution of roughly $280 per month that would be lost if the retiree changed to an individual market plan, city spokesperson Kimberly Bracy said in an email. The city's plan also enables retirees to see out-of-network providers with no change in cost share.
As negotiations with Humana continued, TPMG committed to seeing Newport News retirees on an out-of-network basis, Bracy said, and the city promptly shared that commitment with retirees in a Dec. 6 letter.
TPMG did not respond to questions sent via email requesting further details about the contract agreement with Humana. Marketing director Terri Reedy said in an email those details are proprietary and confidential.
"TPMG is dedicated to delivering high-quality, affordable care to the Hampton Roads community, and we have worked hard to reach an agreement that benefits our patients," Reedy said.