Premier Health no longer in-network with UnitedHealthcare

Dayton, Ohio-based Premier Health is out of network with Minnetonka, Minn.-based UnitedHealthcare following the parties' inability to reach a contract resolution before their May 14 deadline, Dayton Daily News reports.

Premier and UnitedHealthcare have been unable to resolve a dispute regarding how UnitedHealthcare ranks hospitals and providers. To promote price transparency, the payer ranks hospitals and providers in tiers, based on various cost and quality metrics.

In a statement to Dayton Daily News, UnitedHealthcare said: "Despite repeated efforts to reach a compromise, all of Premier Health Network's proposals maintained their position as one of the most expensive health systems in southwest Ohio and demanded local businesses be restricted from offering competitive benefits that put consumer choice first and allow workers to be rewarded for choosing quality, cost efficient care providers."

Premier Communications Director Ben Sutherly said in an emailed statement to Becker's Hospital Review, "Premier Health remains committed to resolving our differences with UnitedHealthcare as soon as possible while protecting patient choice. We continue to keep the lines of communication open out of great concern for our patients. The upheaval that UnitedHealthcare is creating for its members in the middle of a benefit year is disappointing, and we greatly appreciate that local employers are taking steps to ensure that their employees continue to have a choice of providers for their healthcare needs."

All Premier hospitals and physicians are now out-of-network with UnitedHealthcare's employer-based, individual and Medicaid plans. The contract dissolution does not affect UnitedHealthcare's Medicare Advantage policyholders. Premier said it will offer affected policyholders primary care physician office visits for a maximum out-of-pocket price of $25 through Dec. 31, according to the statement.

Editor's note: This article was updated May 16 at 4:05 p.m. CT to include a statement from Premier. 

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