Premier, UnitedHealthcare reach Medicare Advantage agreement, but lack consensus on other plans

Dayton, Ohio-based Premier Health and Minnetonka, Minn.-based UnitedHealthcare settled an in-network contract for Medicare Advantage policyholders through the end of 2017, but the parties have yet to negotiate terms for individual and employer-based health plans, Dayton Daily News reports.

Here are three things to know.

1. 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.

2. Thousands of UnitedHealthcare members have lost in-network access to Premier facilities following the termination of Premier's hospital contract with the payer's employer-sponsored and Medicare policyholders April 29. If the contract dispute continues, UnitedHealthcare members with individual, employer-based and Medicaid coverage will also be out-of-network with Premier physician groups by May 13.

3. In statement to Dayton Daily News, Premier said: "we want to reach a reasonable contract with UnitedHealthcare as soon as possible to minimize disruptions for our patients. However, we don't want that resolution to come at the expense of patient choice." 

More articles on payer issues:
Iowa ACA marketplace hangs by thread as last major insurer threatens exit
Failed Aetna merger boosts Humana's Q1 profit
Florida Blue billing glitch causes overcharges for 9,500 members

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