Agreement Avoids Expected Termination, Maintains Access to Care
Vermont Business Magazine The University of Vermont Health Network has reached a multi-year agreement with UnitedHealthcare to maintain coverage for patients with UnitedHealthcare commercial insurance plans. The agreement runs through March 31, 2026, and secures access to UVM Health Network facilities and physicians for patients who are covered through one of the nation’s largest insurance carriers.
This new agreement comes at the end of a two-month extension to the previous contract, which the UVM Health Network sought in order to allow patients and employers more time to make alternative plans.
It also comes at the end of a contentious two years, in which UnitedHealth announced in February 2023 that it was pulling out of the UVMHN because of reimbursement costs they considered too high. UH covers more than 2,600 commercial members in Vermont and northern New York. Those members would be considered "out of network" (with certain exceptions) if the new deal was not reached and would have absorbed higher costs to be treated within the UVMHN. Most of the effected members are in New York.
UnitedHealthcare’s decision last year reflected a nationwide trend
of negotiating tighter rates as hospitals struggled with increased costs.
“We are glad to have averted a loss of coverage for our patients who receive their insurance through UnitedHealthcare commercial plans,” said Sunny Eappen, MD, MBA, President and Chief Executive Officer of the UVM Health Network. “However, we are very sorry for the stress and confusion this has caused. I’m certain our patients, families and caregivers who are impacted by this are frustrated – justifiably so. This is not how we want to engage with payer partners and hope we don’t end up in a situation like this in the future.”
Not-for-profit safety net hospitals and health systems like the UVM Health Network must ensure they remain financially sustainable in order to meet their mission of caring for all who seek care by negotiating contracts with commercial payers that cover the total costs of providing care, including government underpayments.
The following plans were not impacted by the renewal negotiations at any point, and patients will continue to receive uninterrupted coverage:
· Non-Commercial UnitedHealthcare plans managed by the state or federal government – such as Medicare Advantage, Managed Medicaid, VA Community Care Network
· United Medicare Supplement plans
· United Behavioral Health plans
· The Empire Plan for New York State Employees
Additional Information
As a safety net provider, the UVM Health Network will always provide emergency care to anyone who comes through the door, regardless of what insurance they have or whether they have insurance at all.
For information specific to insurance coverage, affected patients should contact UnitedHealthcare directly. Additional UVM Health Network-specific information may be found at UVMHealth.org/UnitedHealthcare.
As a nonprofit safety net organization, the UVM Health Network does not distribute funds to shareholders, and any operating margin earned goes directly back into paying staff, purchasing up-to-date equipment, and investing in top-tier facilities that patients deserve.
About the University of Vermont Health Network
The University of Vermont Health Network is an integrated system serving the residents of Vermont and northern New York with a shared mission: working together, we improve people’s lives. The partners are:
The University of Vermont Medical Center
The University of Vermont Health Network Medical Group
The University of Vermont Health Network – Alice Hyde Medical Center
The University of Vermont Health Network – Central Vermont Medical Center
The University of Vermont Health Network – Champlain Valley Physicians Hospital
The University of Vermont Health Network – Elizabethtown Community Hospital
The University of Vermont Health Network – Porter Medical Center
The University of Vermont Health Network – Home Health & Hospice
Source: 2.21.2024. BURLINGTON, Vt. – The University of Vermont Health Network
