Oct 13, 2023 - News

UNC Health signs new contract with UnitedHealthcare after insurance dispute

Animated illustration of a health plus made up from two bandaids, rotating between a plus shape and an "x" shape.

Illustration: Aïda Amer/Axios

Update: Four days before its contract was set to expire, UNC Health has signed a new contract with UnitedHealthcare — avoiding a potential disruption to the coverage of thousands of patients in North Carolina.

UNC Health is notifying nearly 200,000 of its patients that their coverage could be affected by a dispute with UnitedHealthcare, one of the largest health insurance companies in the U.S.

Driving the news: UNC Health is in the middle of a contract negotiation with UnitedHealthcare, and the hospital network said in a letter it is sending to patients that the two parties are far apart over reimbursement policies and rate increases.

  • UNC Health is also displeased with how often United Healthcare denies patient claims, according to the letter obtained by Axios.

State of play: The contract between UNC Health and UnitedHealthcare is set to expire April 1, 2024.

  • The dispute would not affect Medicaid patients or patients of UNC Health Appalachian, UNC Health Blue Ridge, UNC Health Southeastern, or Prime Surgical Suites.

Why it matters: If the contract expires, hundreds of thousands of patients across the state would be considered out of network at UNC Health, which could lead to many patients having to find a new doctor.

  • Around 10,000 UNC Health employees and their dependents are also covered by UnitedHealthcare, though UNC Health is moving them to a new insurer in January.

The other side: UnitedHealthcare said in a statement it believes UNC Health is attempting to create "unnecessary fear and stress" among its patients as a negotiation tactic.

  • The insurer is committed to reaching a long-term agreement over the next six months, said Cole Manbeck, a spokesperson for the company.

Flashback: The dispute is similar to one that UnitedHealthcare had with WakeMed last year that caused thousands of patients to be considered out-of-network for months.

What they're saying: UNC Health, in a letter to employees, said the hospital system is struggling with inflation and staffing shortages coming out of the pandemic, and that United Healthcare is not reimbursing the hospital at a high enough level.

  • "We must hold payors, including UnitedHealthcare, accountable for adequate reimbursement and voice our concerns when administrative burdens like improper denials and preauthorization barriers get in the way of care," Matthew Ewend, UNC Health's chief clinical officer, wrote to employees.
  • "UNC Health is urging UnitedHealthcare to mirror our own commitment, prioritizing patient welfare."
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