Western Health Advantage
In a letter to health insurance agents who represent Western Health Advantage (WHA) individual and small group plans, it was announced that UC Davis Health will drop out of the WHA provider network for 2018. WHA is a HMO health plan. UC Davis Health System was one of the original founding sponsors of WHA in 1996.
Western Health Advantage Alerts UC Davis Dropping From Network
It is important that we communicate news regarding UC Davis Health changes and how your clients and their employees will be impacted. WHA recently received notification that UC Davis Health intends to exit the WHA provider network effective January 1, 2018. This decision will impact individual, small and large group plans.
Members with a UC Davis Medical Group Primary Care Physician (PCP) will be required to select a new PCP within the next six months. Members currently receiving treatment may request continuity of care allowing them to temporarily remain with their existing UC specialty provider during their treatment plan. Additionally, WHA is working with UC Davis Health to revise their provider agreement to allow access to UC Davis Medical Group specialty services and to the UC Davis Medical Center with a direct referral.
Your clients will want to know why this has happened. UC Davis Health made this unilateral decision due to today’s challenging and uncertain healthcare climate. They determined the high cost structure of their academic medical center is no longer compatible with a regional HMO like WHA, whose business strategy is to be a market leader in affordability.
In our opinion, and in the opinion of our other provider partners, WHA’s collaborative model is the future of healthcare. WHA will continue to grow (as demonstrated by last week’s announcement of our 2018 reentry into CalPERS), will continue to expand its service area, and will continue to prosper.
We understand this change will cause distress and inconvenience. WHA is committed to doing everything we can to support you, your clients and their employees to ensure the smoothest possible transition and provide continuing access to convenient, affordable and quality healthcare.
WHA’s provider network remains strong and accessible, with more than 80% of physicians in our network in the Sacramento region welcoming new patients. Members can choose from approximately 275 PCPs via Hill Physician Medical Group, Mercy Medical Group, Woodland Clinic Medical Group and NorthBay Healthcare.
We are here to support you during this process. As more information becomes available, we will provide you with additional details regarding our member service support, employer and member communications plans, and our community engagement strategy. In the meantime, please feel free to reach out directly to me or your WHA service team representative if you have questions.
Thank you for your dedication and service on behalf of Western Health Advantage.
Sincerely,
William Figenshu
Chief Sales Officer