Envision Healthcare signs deal to keep its radiologists in-network with key insurer
Envision Healthcare has inked a deal to keep its radiologists and other physicians in-network with a key insurer, the private equity-backed multispecialty group announced Thursday.
The agreement with AvMed, one of Florida’s leading health plans, spans multiple years and covers the entire Sunshine State. Envision said the pact will allow both commercial and Medicare Beneficiaries continued access to its radiologists, anesthesiologists, emergency medicine specialists, hospitalists, neonatologists and trauma care providers.
“We are pleased to work with AvMed to provide thousands of AvMed members in-network care when and where they need it most,” Envision CEO Jim Rechtin said in a May 25 announcement. “As we strengthen our relationship, we will continue making care more accessible and affordable for patients and enhancing the health of the communities we serve.”
The Nashville-based physician services firm currently employs more than 500 radiologists, many of whom practice in Florida, according to a spokesperson. It also plans to soon begin providing teleradiology care to patients at a large academic center in the state. Envision reached a similar agreement with CVS Health-owned commercial insurer Aetna in April.
The pact comes as radiology practices fight to remain in-network with health plans of choice in their service areas. Since the roll out of the No Surprises Act, commercial insurers have started terminating in-network contracts that involve higher-than-average reimbursement rates, according to S&P Global Ratings. UnitedHealthcare, the nation’s largest commercial insurer, knocked Envision out of its network at the end of 2020, citing “egregiously high rates.”
Backed by New York-based private equity firm KKR, the physician services firm filed for chapter 11 on May 15, hoping to cancel $5.6 billion in debt. At the time, Envision cited private payers’ refusal to provide adequate reimbursement as one of the factors fueling its need to seek bankruptcy. The company scored a victory earlier this year when arbitrators awarded Envision a $91 million judgment from UnitedHealthcare for “unilaterally reducing reimbursement rates.”
Doral, Florida-based AvMed was recently acquired by 12-hospital, integrated delivery system Sentara Healthcare, which at the time had its own 1.2 million-beneficiary health plan. The nonprofit insurer, meanwhile, had about 200,000 members in Florida at the time of the merger announcement in January.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.