With less than three weeks before their contract expires, WellSpan Health and UnitedHealthcare remain embroiled in a war of words.
UnitedHealthcare has been focused on what WellSpan charges for health care.
For the York-based health system, the issue is the administrative hassles posed by working with the insurer.
What’s the latest: In an online notice, UnitedHealthcare claimed WellSpan declined to extend the current contract and give negotiations more time.
In a statement, WellSpan countered that the regional health system initiated the discussions nine months ago.
“We believe there has been ample time to address concerns from both sides,” WellSpan said.
The contract, set to expire Oct. 31, primarily governs UnitedHealthcare’s reimbursement to WellSpan for providing care to the insurer’s members.
What’s next: Both sides said they are continuing to negotiate.
UHC, though, claimed that WellSpan rejected its offer to extend the deadline “presumably in an effort to use our members and their patients to pressure us to agree to the price hikes the health system continues to seek.”
WellSpan pointed out that UHC’s approach to WellSpan is similar to the insurer’s approach to negotiations with other health systems.
Some have forged last-minute deals. Others, such as Huntsville Hospital Health System in Alabama, have parted ways with UHC.
“The growing number of organizations that are refusing to cave to United’s hardline negotiating tactics is expanding and we are proud to stand up for affordability in healthcare by making sure United does their fair share in offsetting inflationary costs impacting the industry,” the health system said.
What’s at stake: WellSpan cares for about 36,000 people insured by UHC, according to previous figures from the health system.
They include people with coverage from their employers, as well people with Medicaid and Medicare Advantage plans.
If the contractb is not renewed, those patients would no longer be covered in-network for care at WellSpan facilities, forcing them either to switch providers or pay more to stay with WellSpan.
Most WellSpan facilities are not in-network for the insurer’s Medicare Advantage plans.
The details: UnitedHealthcare, or UHC, argues that WellSpan is charging too much.
In its online update, for example, UHC claimed that outpatient surgery costs 60% more at WellSpan York Hospital than the average for other hospitals in UHC’s network in southcentral and eastern Pennsylvania.
“We are asking WellSpan to understand its role in the skyrocketing cost of healthcare and to work with us to ensure quality healthcare is available at an affordable cost,” UHC said in its online statement.
WellSpan contended that UHC selected “outlying data points” to make its case.
WellSpan York Hospital, a regional trauma center that handles the most complex injuries, for example, “cannot be appropriately compared” to other local hospitals with less acute-care services, according to the health system..
In an online update of its own, WellSpan said it is seeking a “middle single-digit” rate increase overall despite a double-digit spike in costs for staffing, medication and other supplies.
WellSpan has also criticized the insurer’s administrative practices, arguing that UHC throws up frequent hurdles, such as denials of coverage denials and delays in payment.
According to figures provided by WellSpan, the insurer denies initial claims at a rate that is 72% higher than the average for other commercial insurers.
And UHC’s outstanding receivables are roughly 100% higher than the average for other commercial insurers, WellSpan added.
The background: WellSpan employs about 23,000 people across more than 250 locations in Central Pennsylvania and northern Maryland, including acute-care hospitals in Adams, Franklin, Lancaster, Lebanon, Union and York counties.
A subsidiary of Minnesota-based UnitedHealth Group, UHC is one of the largest health insurers in the U.S. and covers about 27.3 million people.
UnitedHealth Group had revenue last year of $371.6 billion and net income of $23.1 billion, according to securities filings.
