UnitedHealthcare, N.Y. hospital system settle contract dispute

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UnitedHealthcare and Continuum Health Partners have reached a multi-year agreement to keep the health system’s four hospitals within the insurer’s network.

In January, Continuum said that its contract with Minnesota-based UnitedHealthcare was to expire on Jan. 1 for some services and March 1 for other at its four hospitals: Beth Israel Medical Center, St. Luke’s and Roosevelt Hospitals, Long Island College Hospital and New York Eye & Ear Infirmary. The end of the contract, the hospital system said, could affect hundreds of thousands of New Yorkers and thousands of physicians affiliated with its system through the Oxford Health Plan.

Continuum officials said that the main obstacle in negotiations to renew the contract was UnitedHealthcare’s “demand for unreasonable contract terms that result in reductions in reimbursement for services.” Those demands, Continuum said in a statement, came despite the insurer receiving “record earnings” in the past year and increasing premiums on average of 15% with some businesses seeing more than 25% increases in their monthly payments to UnitedHealchcare for insurance.

At that time, Ruth Levin, Continuum’s senior vice president for managed care, said the hospital system was open to further negotiations, but the hospital and its physicians “cannot accept United’s requirements to comply with unfair business practices” in reducing reimbursements and preventing payments for “medically necessary services.”

While neither the hospital system nor UnitedHealthcare would share specific details with IFAwebnews.com, the two sides did acknowledge that a compromise has been reached.

In a statement, UnitedHealthcare said the new agreement applies to all the commercial health insurance plans of UnitedHealthcare and Oxford Health Plans, plus the insurer’s Medicare and Medicaid health plans.

“We are pleased to have reached this agreement with Continuum which enables us to once again offer Continuum’s medical services to our members while working to reduce overall health care costs,” UnitedHealthcare said.

In a letter to its physicians obtained by IFAwebnews.com, Levin said she was “happy to inform” them of the new contract effective March 1.

“We are pleased with the result,” Levin wrote. “We will get the word out to the community – our patients and employers – as will United, to ensure everyone knows that our hospitals are contracted, participating providers.”

Continuum spokesman Jim Mandler said that the company cannot discuss the details of the contract agreements.

If the two sides did not reach an accord, patients insured under UnitedHealthcare that wished to continue to see Continuum physicians would have been forced to pay out-of-pockets costs not covered by the insurer. Employer groups and small businesses would also have seen larger costs for care, Continuum noted in January.

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