OHSU and UnitedHealthcare Reach Agreement
Key Insights
OHSU and UnitedHealthcare have reached a good-faith agreement, working to finalize a new contract.
The previous contract was due to expire on March 31, potentially impacting 74,000 patients.
OHSU had cited issues with UnitedHealthcare, including claim denials (56% vs. industry standard 5-10%) and lengthy resolution times (average 307 days).
UnitedHealthcare contended with "unreasonable price hikes" in OHSU's proposed contract.
This matters because contract disputes between healthcare providers and insurers can significantly impact patients' access to care and increase costs.
In-Depth Analysis
The agreement between OHSU and UnitedHealthcare comes after concerns about patients losing in-network access to OHSU doctors. If the contract had expired without a new agreement, UnitedHealthcare patients would have faced higher out-of-pocket costs for OHSU services. OHSU claimed operational and financial issues with United were disrupting care and that United denied a high number of claims. United, while not responding to OHSU's numbers, stated it was contending with OHSU's proposed price hikes, saying the hikes would have significantly increased the cost of procedures like C-sections, outpatient surgeries, and ER visits. The Hospital Association of Oregon noted increased friction between insurers and providers post-pandemic, stating hospitals aren't being paid enough to cover patient care costs. OHSU has said that it will ensure the stability of patients until March 31. Past that date, patients might be asked to look for care elsewhere. The new, good-faith agreement signals that the deal will be finalized before the deadline.
FAQs
Q: What happens if OHSU and UnitedHealthcare did not reach an agreement? - A: OHSU would have become out-of-network for UnitedHealthcare members, leading to higher costs and potentially limited access to care.
Q: What were the main points of contention? - A: OHSU cited high claim denial rates and slow payment processing by UnitedHealthcare, while UnitedHealthcare cited unreasonable price increases proposed by OHSU.
Key Takeaways
OHSU and UnitedHealthcare are working to finalize a new contract.
If you are a UnitedHealthcare member with OHSU as your provider, monitor updates closely.
The resolution of this negotiation highlights the ongoing challenges in healthcare regarding reimbursement rates and contract negotiations between providers and insurers.
Discussion
Do you think these types of negotiations will become more common? Let us know! Share this article with others who need to stay ahead of this trend!
Sources & References
Source 1: KGW Article
Source 2: KPTV Article
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