Tucson, Ariz.-based Northwest Healthcare and UnitedHealthcare in Minnetonka, Minn., reached a contract impasse that could affect thousands of patients' in-network access to Northwest's services by May 1, according to tucson.com.
Northwest Healthcare, a subsidiary of Franklin, Tenn.-based Community Health Systems, notified patients via letter March 2 about UnitedHealthcare's intention to end the parties' contract. The dispute could affect Northwest Healthcare's two affiliated hospitals, physicians and clinics.
UnitedHealthcare partially attributed the disagreement to Northwest Healthcare's alleged refusal to join the payer's value-based care initiatives. In addition, the insurer said Northwest Healthcare is requesting rate increases exceeding 25 percent over three years "without any commitment to improving the health of our members," UnitedHealthcare officials said in an emailed statement to tucson.com.
Northwest Healthcare countered UnitedHealthcare's argument by stating the payer is requesting "an immediate" 25 percent cut in reimbursement rates to the provider's two Tucson hospitals — Northwest Medical Center and Oro Valley Hospital, hospital spokesperson Kimberly Chimene told the publication. Ms. Chimene also said UnitedHealthcare has refused to sign contracts based on quality and cost efficiencies with the hospital.
Officials with Northwest Healthcare did not specify how many patients would be affected by the termination, which would involve UnitedHealthcare's Medicaid, Medicare Advantage and commercial beneficiaries. However, UnitedHealthcare projects roughly 27,500 of its members obtained services at a Northwest Healthcare facility in the past 18 months, the report states.
Officials from both parties said negotiations are ongoing.