VANDY DROPS MEDICARE PATIENTS, WANTS 20% FEE INCREASE

“This debacle is yet another reminder that unfortunately everything comes down to the almighty dollar,” Councilmember Courtney Johnston told us Thursday morning. “I hope these two can come to an agreement to continue to serve this vulnerable population who are the true and only casualties in this fight.” Johnston, who sits on the Metro Council’s Health and Safety Committee, was referring to a failed negotiation between Vanderbilt University Medical Center and the Medicare Advantage insurance plan provider Humana, which resulted in the termination of healthcare coverage at VUMC for Metro pension holders.

During the first week of January, Vanderbilt sent out letters to Medicare patients covered by Humana and Wellcare notifying them that their coverage would no longer apply on April 1st, 2023. The reason? According to Humana’s spokesperson, Jim Turner, Vanderbilt wants a 20% fee increase for all treatments.

PLAYING WITH PEOPLE’S LIVES

Metro’s director of legislative affairs, Mike Jameson, described the impact this termination of care will have during the Metro Council meeting on Tuesday: “There is a pensioner, a former firefighter, who is receiving sustained care at Vanderbilt and if he does not continue to receive that care for the next two critical months, he will lose his eyesight."

As shown by the investigation into VUMC ordered by the governor after Daily Wire personality Matt Walsh exposed the “money-making” motive behind its gender clinic’s surgeries, Vanderbilt’s greed seems to have gotten under the skin of some of the councilmembers. “It feels weird to be doing the bidding of a healthcare corporation like Humana,” said Councilmember Young, “but at the same time I think it’s worth publicly putting pressure on an entity like Vanderbilt University Medical Center, who does a lot of contracting, does a lot of business, and gets a lot of benefits from the Metropolitan Government. All while paying zero dollars in property taxes to us.”

As of January 1st, 2023, thanks to BL2021-781, all Metro pension holders were moved over to Humana. Though this money-saving transition to one medical care provider received mixed reviews from Metro employees as it made its way through council in 2021, many Davidson County taxpayers had reached the end of their rope during discussions as they watched the city put more than $86 million in tax dollars toward pensions while remaining perpetually in the red.

Metro HR wants their pension holders to know that the transition to Humana and the termination of coverage at VUMC are unrelated. In an exchange with The Pamphleteer, CM Johnston reflected on the council’s decision regarding BL2021-781 while empathizing with pensioners distressed over the recent developments: "Putting all our eggs in one basket has proven time and again to be unwise." Metro Human Resource Director Shannon Hall also shared the department’s exasperation during Tuesday’s Heath and Safety committee meeting: “This is something that caught us all off guard.”

It is worth noting that this coverage termination between Humana and Vanderbilt doesn’t only impact Metro retirees. According to Hall, the majority of Davidson County residents who are 65 and older have a Humana Medicare advantage plan– meaning they, too, will be dropped by Vanderbilt. Though Humana has expressed they are willing to go back to the table and negotiate, there is still no word as to whether Vanderbilt will be rescinding their decision.