SMH-Physician Hospital Organization Update
Frequently Asked Questions (FAQ)
Updated Dec. 8, 2025
This FAQ is intended to provide general guidance to members of the Sarasota Memorial Physician-Hospital Organization regarding the organization’s planned dissolution at the end of the 2026 calendar year.
We recognize that this change is a significant one, and the PHO team is committed to communicating clearly and supporting members through the transition process. We will update this webpage regularly as more information and next steps become available.
The PHO team also will send email updates and information about a series of virtual meetings it will host starting in January through our regular PHO web portal at smhpho.com. We encourage you to check the portal and this FAQ webpage frequently for updates. You also may reach out through the PHO portal for additional information.
Q: Why is the PHO dissolving?
A: The Board would like to emphasize that the decision to dissolve the PHO is in no way a reflection of the quality of service provided by the PHO. The organization has served the community well for more than 30 years.
After extensive discussion at the Nov. 20, 2025 board meeting, PHO leaders agreed to move forward with plans to dissolve the organization at the end of 2026. The difficult decision was triggered by changing market conditions and official notification by Sarasota Memorial in December that it will withdraw from the Physician-Hospital Organization effective Sept. 30, 2026.
In its decision to leave the PHO, Sarasota Memorial cited a pressing need to expand its health plan coverage, services and provider network offered to its employees in our growing region and beyond. The issue has become critical as construction begins on SMH's new hospital in North Port, and as an increasing number of SMH employees and family members are located outside the Sarasota-Manatee region and area served by the PHO's Gulf Coast Provider Networks.
Q: When will the dissolution be effective?
A: The board intends to cease operations and terminate the corporation on Dec. 31, 2026. It will take some time to prepare a detailed dissolution plan and file the required documentation with regulatory bodies. Among other details, the Board’s plan will outline how debts will be settled and how remaining assets will be distributed. It also will address ongoing contracts, accounts receivable collection, and the responsible handling of confidential materials. Once all steps are complete, the state will issue a certificate of dissolution, legally terminating the PHO's corporation.
Q: Why am I being asked to pay dues and remain in a PHO that is dissolving at the end of 2026?
A: The PHO will continue to manage all of its existing contracts, delegated credentialing, payer relations and other responsibilities, and provide ongoing support to physician members through the end of the 2026 calendar year. The annual dues, which help cover those costs, will be reduced to $75 for 2026, down from $375. Assets remaining at the end of the year, after all financial matters are settled, will be distributed to PHO members according to the corporate dissolution rules.
Q: How will this impact the care I provide to SMH employees and their families?
A: SMH employees and their dependents will remain covered under the existing SMH Care plan with access to the PHO’s Gulfcoast Provider Networks until Sept. 30, 2026, at which time SMH plans to transition employees to a broader medical network offered by Aetna. To continue caring for SMH employees and their dependents after that date, you will need to directly contract with and become part of Aetna’s “broad medical network” before the new SMH Care plan takes effect on Oct. 1, 2026. Aetna has given SMH verbal assurances that it will develop a dedicated pathway and account representative to support PHO members through this transition. We will share more details and updated Aetna contact information in January, or as soon as the information is available.
Q: What changes can we expect in SMH’s expanded employee network?
A: SMH’s intent is to develop a network that delivers wider access to high-quality providers across the health system’s service area. While we do not yet have full details of the new network composition, SMH leaders said they plan to build in significant overlap between the current PHO/Gulfcoast Provider Networks and the expanded Aetna network, which will continue to be administered by Meritain. In expanding its network access, SMH priorities include preserving existing physician-patient relationships, minimizing network disruption and maximizing access throughout the service area. More details about the expanded employee network will be available in late spring or early summer 2026.
Q: How will the PHO handle all other managed care contracts while it is dissolving?
A: With the exception of the SMH Care/Gulfcoast Provider Select Networks that will terminate on Sept. 30, 2026, all other third-party payer agreements (Aetna, Humana, HealthSmart, for example) will remain in effect until the transition is complete. All PHO agreements will terminate by Dec. 31, 2026.
We encourage you to contact each payer in early 2026 to negotiate individual participation agreements. The PHO contracts currently in effect cannot be transferred to your individual practice when the PHO dissolves on Dec. 31, 2026, so it is critical to start this process now, as executing direct contracts can take several months.
A list of payers contracted with the PHO, and their contact information, is listed below.
Q: If I execute a new agreement with a payer, can I cancel my participation through the SMH PHO?
A: Our PHO has always maintained a cafeteria approach to participation in our plans. To continue caring for SMH employees and dependents, you must remain in the Gulf Coast Provider Networks until Sept. 30, 2026. With that exception, you can transition your practice to your new, non-Gulf Coast Provider Network agreements at any point within the next year.
A list of payers contracted with the PHO, and their contact information, is listed below.
Q: What do I need to tell my patients if I choose not to execute independent agreements with payers?
A: If you will no longer be participating with a payer, you are ethically and legally obligated to notify your patients in writing 90 days in advance of potential changes to their insurance network status and ensure continuity of care for those patients as they transition out of your practice. That means you will be required to notify your patients by mail and post a notice in your practice of the termination by Sept. 30, 2026 (for a Dec. 31, 2026 termination date).
Q: What if a patient has an appointment scheduled after the termination date?
A: If you enter into new contracts with the payers you participate in with the SMH PHO, you do not need to do anything. However, if you will no longer be participating with a payer on the date of that appointment, you will need to notify your patient in advance.
Q: How will outstanding account receivables be handled?
A: The PHO does not pay claims. Individual claims will be handled by the payers, and all appeals and grievances should be managed per guidance in each payer’s provider manual. The SMH PHO team is able to advocate on your behalf until Dec. 31. 2026.
Q: Who can help me navigate setting up new contracts? For instance, do I need to set up a new contract for every physician in a practice, or can the agreement cover all of the physicians in a practice/corporation?
A: Please contact each payer for advice, as insurance providers can have different requirements. Even if a contract is under the practice's name, individual physicians must often be separately credentialed with the insurance company. A healthcare attorney also can help you navigate individual payer contracts and ensure you comply with all regulatory requirements to avoid personal liability.
Q: What if I need to add a new physician to my practice during this transition?
A: While we cannot accept new corporations or their physicians into the PHO due to the pending dissolution, new physicians are permitted to join an existing PHO member corporation for 2026. For new PHO members of existing corporate members, the credentialing fee of $700 will be waived, and the annual fees will be prorated over the 2026 calendar year.
Q: If I do nothing, what happens?
A: If you do not establish independent, direct contracts with the payers by the PHO termination date, you will be considered an out-of-network provider for those plans. This will likely result in higher costs for your patients and significantly lower—or no—reimbursement for your services.
For those who want to continue seeing SMH employees and their dependent family members, you must directly contract with Aetna's broad network before Oct. 1, 2026. We will provide a dedicated contact for Aetna and additional details as soon as they become available.
CONTACT INFORMATION – PHO Contracted Providers
Aetna and First Health/Coventry (subsidiary of Aetna)
Karin Julien
Lead Director, Aetna Network Management
Phone: 813-775-0585
Email: julienk@aetna.com
Website: https://providerlocator.firsthealth.com/3001
As noted above, SMH will be transitioning its employees from the Gulf Coast Provider Network to Aetna's "broad medical network" on Oct. 1, 2026. Aetna is working on a dedicated pathway to help PHO physician members directly contract with Aetna to ensure uninterrupted care for SMH employees. We will share more details about the new network and contact information for a dedicated Aetna account representative in January, or as soon as the information becomes available.
Health Smart
Lee Kinard
Manager, Network Development
Email: lee.kinard@healthsmart.com
Website: www.healthsmart.com
Humana
Name: Matt McMahon
Email: mmcmahon@humana.com
MultiPlan and Integrated Health Plan
Karen Maershbecker
Senior Network Development Executive
Phone: 813-498-1943
Email: Karen.mawershbecker@multiplan.com
Website: https://www.multiplan.com/providernominations/provider
Three Rivers
Fernando de le Paz
Phone: 725-241-0251
Email: fdelapaz@trpndirecpay.com
Contracting email: enrollment@trpndirectpay.com
Website: www.trpndirectpay.com