Renewal Includes Commitment from United to Cover Reasonable Cost Increases and Address Policies That Make it Harder for Patients to Access Care in Vermont and Northern New York
Vermont Business Magazine The University of Vermont Health Network has agreed in principle to commercial contract terms with UnitedHealthcare (UHC) for the coming contract year. The agreement would run through March 31, 2023, if finalized, and affects about 2,900 subscribers (about 2,000 in Vermont) and their families in Vermont and Northern New York who have UHC coverage through their employers. UHC has been leaning on hospital groups across the East to lower their costs. UVMHN called the new deal a "partial victory" against a much larger entity.
While the deal is being finalized, the current contract has been extended through April 30 to avoid any service interruptions.
UnitedHealthcare wrote to its patients in early March to inform them that University of Vermont Health Network providers and facilities in Vermont and upstate New York, including the University of Vermont Medical Center, Central Vermont Medical Center, Porter Medical Center, Alice Hyde Medical Center, Champlain Valley Physicians Hospital, and Elizabethtown Community Hospital, would no longer participate in its commercial insurance provider network as of April 1, 2022.
In a statement at the time, UVMHN said, "For a number of years, our ability to provide timely and appropriate care to our patients covered by United Commercial plans has been affected by significant administrative and operational issues. Despite our best efforts to resolve these issues, patients continue to experience unnecessary delays in approvals for common tests, including imaging, treatments and medications among many other challenges."
Without this last-minute deal, people with United insurance would have to pay out-of-pocket for services at the UVMHN hospitals.
John R Brumsted, MD, President and Chief Executive Officer of the University of Vermont Health Network, said today: "We are happy to close this chapter and make sure we are meeting patient needs, regardless of their insurance carrier.
"This is a partial victory for local, not-for-profit health care providers. We are doing our best, every day, to provide the health care services our patients need. We are not concerned with return-on-investment for stockholders – we’re focused on the health of our patients. But we need to cover the cost of providing care to remain sustainable. We were up against one of the biggest for-profit companies in the country, which nets $24 billion in profit annually.
"The UVM Health Network is deeply rooted in the communities we serve, and our friends and neighbors are also our patients. We regret the disruption and stress caused by this protracted Commercial negotiation."
UnitedHealthcare issued this statement: “We have agreed in principle to a new contract with UVM. As we work to finalize the deal, both organizations have agreed to extend our existing contract through April 30, ensuring our members uninterrupted access to UVM’s facilities and its physicians. We hope to be ready to announce the final agreement soon.”
About the process: When the UVM Health Network enters into negotiations with a health insurer, the three main goals are:
- Obtain reasonable coverage of cost inflation;
- Get relief from insurance company rules and procedures that are contrary to excellent care and provider accountability;
- Move toward value-based payments and away from fee-for-service.
Sources: UVMHN, UHC 3.29.2022
