Conway, Arkansas – Beginning on July 1, Conway Regional Health System and United Healthcare Insurance cut ties.
According to the company’s CEO, Matt Troup, more than 10,000 patients will now be required to pay out-of-pocket expenses as a result of this decision.
Troup claims that they have a contract with a group known as Physician Hospital Organization, which stands in for the 280 providers.
He claimed that this was the first contract they had to break with a health payor in 25 years.
In an emergency or if they require emergency care, Troup said that people with United Healthcare can go to Conway Regional, but the hospital fee might be more.
Troup also said that a patient whose continued treatment is contingent upon permission from United Healthcare will be covered.
“They’re maybe some out-of-pocket costs that are a little higher, that varies by plan, by employer but I can’t really comment on what all impact that has,” Troup said. “Clearly, it’s going to potentially cost more if the patient insists on going to Conway Regional for elective surgeries and procedures.”
According to Troup, they had been negotiating a deal with United Healthcare for six months. On June 30 at 1:40 pm, he claimed they received a 103-page proposal contract.
Troup stated that the contract’s expiration date was June 30 at midnight, which did not leave them with enough time to complete the necessary paperwork.
“It’s completely unrealistic to except us to turn around that kind of analysis in that period of time. I guess in some sense it’s encouraging, but we still have a lot of questions,” he said.
Troup claims that United offers two different plans, one of which is commercial and is provided by employers, and the other is Medicare Advantage. He said that both measures would have an effect on 15,000 patients, excluding the 280 physicians whose contracts with United Healthcare were also canceled.
Troup advised patients to get in touch with United Healthcare to find out which medical professionals and facilities are covered by their current insurance plan.
“I take it personal when I go to a restaurant and the wait staff that’s covered by United is concerned about access to their physician, that grieves me,” he said.
Wife Jennifer Morehead will deliver her second child by cesarean section on August 1. She said it’s worrying if they have to pay out-of-network while considering hospital charges.
“When you’ve planned to have a hospital bill of around this amount, and then suddenly you realize it’s going to be 80 percent more than what you have planned for, it’s pretty significant and it’s shocking,” Morehead said.
She is fortunately covered by her husband’s United Healthcare plan, which Morehead claims pays some out-of-network expenses. She said that until late May, she was unaware of the contract status.
On July 1, Morehead submitted a request for ongoing care. United Healthcare, according to her, has 30 days to review and approve her claim.
“It really is you’re checking your email, you’re logging into the patient portal for the healthcare company, and you’re just hoping for news,” she said.
According to Troup, the practicality of keeping the hospital open at the rates United Healthcare is recommending is ultimately what’s at risk. He claimed that it had been almost ten years since United Healthcare changed their rates.
“If I’m going to pay market rates for staff, I have to pay market rates for the payor community,” he said. “There’s clear evidence that United is so far below the other payors that it’s not sustainable.”
Troup claims that in a few days they will answer to United Healthcare on their contract proposal.
Cole Manbeck, United Healthcare’s director of corporate communications, issued the following comment on the record:
“Conway Regional Health System is demanding to double the cost of care at its hospitals over the next 24 months, including an egregious 65% price hike in just the first year of our contract. We made numerous attempts to compromise, including providing Conway Regional a signature-ready, multi-year contract on June 30 that included significant rate increases that were more than fair and appropriate. Rather than sign the contract or provide a counterproposal, Conway Regional chose to allow our agreement to expire. While we remain open to continued negotiation should the health system deliver a realistic proposal that’s affordable, our focus now is on ensuring the people we serve have access to the care they need through either continuity of care or a smooth transition to a new provider.”