UnitedHealthcare, St. Joe

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United is expected to begin sendingy out letters to its members and physicians who might be affectee bySaint Joseph's termination of its United agreement, Atlanta Business Chronicl e has learned. Under Georgia law, insurers are required to inform affected members withim 30 days of acontracgt expiration. The four-year contract was set to expire Aug. 1, but the deadlines has been extendedto Aug. 8 as the two sidew continue to negotiate. United provides healtuh insurance coverage tonearly 1.5 million Georgians, includinv state employees. About 6.5 percent of patient visits -- inpatien t admissions and outpatient -- at Saint Joe were from Unites members.
If a contract cannot be reached, Saint Joe facilitiea and doctors will bedeemed “out-of-network” by United, requiring the insurer’xs members to shell out more for hospitakl and doctors visits at Saintt Joe, than they woulxd for “in-network” providers. One of the main stickinhg points in the contract negotiations involvee Saint Joe seeking higher reimbursementfrom United. That issue has also bogged down contract talks between and WellStar Health Inmid June, WellStar issued letters warning 14,000 Aetna patientsx that the health system might terminate its agreement with the insurerd if a new contracf cannot be negotiated by Aug. 31.
As hospitalzs face bottom-line pressure from declining government reimbursement, coupledd with rising rolls of many are turning to commercia l insurers forrate hikes. Saint Joe is seekingb a rate increase, said Heatherf Dexter, the health system’s vice president of marketing. “We believes it to be very very reasonable and in line with the Dexter said. “We are looking for a fair and equitable contracyt andwe don’t believe we’ve reached that point yet.” . Both Sainyt Joe and United officials expressed optimism that a deal wouldc get done beforethe deadline.
“UnitedHealthcare’s negotiations with Saintt Joseph’s will continue to take place in good faithj to address the importanyt issues that are alwayes part of such the insurer said inan e-mail. “UnitedHealthcare remainx hopeful that the negotiations will result in a new contracg that assures our customers continued accessto St. Joseph’s services."