All Children's, UnitedHealthcare terminate contract over requested 35% reimbursement increase

St. Petersburg, Fla.-based Johns Hopkins All Children's Hospital is no longer in UnitedHealthcare's network following the hospital's request for a 35 percent reimbursement hike, according to a Tampa Bay Times report.

A contract between the hospital and the payer terminated May 11. As a result, All Children's said more than 10,000 pediatric patients will have to pay out-of-network rates for hospital services.

This is the first contract renegotiation in five years between the organizations. All Children's originally requested a 60 percent increase in reimbursement from the payer, citing rising healthcare expenses. The hospital later lowered that request to 35 percent, but Minnetonka, Minn.-based UnitedHealthcare only agreed to a 20 percent hike, the report states.

Jonathan Ellen, MD, president and vice dean of All Children's, told Tampa Bay Times, "United has lagged way behind the market in terms of the amount they reimburse us for taking care of their children."

In a statement to the publication, UnitedHealthcare said it pays All Children's "competitive rates that are in line with other specialty hospitals in the St. Petersburg area." The payer added the hospital continues "to turn down our offers, insist on a 35 percent raise, and are deferring to an out-of-state consultant to manage the negotiation rather than working directly with our local team to reach a quick resolution." 

More articles on payer issues: 
30% of health plans are pursuing outcomes-based contract negotiations, Avalere study finds 
Carroll County Memorial, Anthem expand in-network agreement 
Tenet, Humana reach contract resolution after 7 months

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