Lovelace: 94% of Members Stayed after ABQHP Split

Lovelace Health Plan said Thursday that nearly 94 percent of its 58,000 members who were affected by the end of the firm’s contract with ABQ Health Partners have stayed with Lovelace.

Lovelace also said it has received word from the U.S. Centers for Medicare and Medicaid Services that the agency will not extend the open enrollment period in New Mexico for Medicare members past the Dec. 7 deadline.

ABQ Health Partners had asked CMS to extend the deadline, saying that too many people had to make decisions about their health plans in a short period of time.

“We have been notified by our contract manager at CMS that they were not gong to extend the open enrollment period,” said Lovelace spokeswoman Laurie Volkin.

A CMS spokesman confirmed that the agency will not extend the open enrollment period.

Lovelace Health System President and CEO Ron Stern said he decided to release the number of those who had been affected by the end of the contract because ABQ Health Partners had said that more than 100,000 people had been affected.

“While we consider this information to be proprietary, we want to release the real number and ensure its accuracy,” Stern said in a news release. “Their (ABQHP) inflated numbers account for all patient encounters, not individuals who regularly see a physician, typically two or three times a year. They also included inpatient, ER and urgent care visits, and patients who may have health insurance other than Lovelace.

“But what is most important is that we have assisted the vast majority of members with transitioning to new physicians.”

Lovelace Health Plan has 210,000 members and a network of 9,000 providers in New Mexico. ABQ Health Partners’ 184 doctors “represents only 2 percent of LHP’s entire network,” the release said.

The contract between Lovelace and ABQ Health Partners ended Nov. 8. Since then, the health plan and the physician’s group have been working to find patients new doctors or new health plans.

Its contract to care for Lovelace patients represented nearly half of ABQ Health Partners’ business. Since 2007, the doctor’s group has had $270 million in revenue from its Lovelace contract.

New Mexico Business Weekly

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