Two Duke LifePoint hospitals are no longer in UnitedHealthcare's network and three other hospitals owned by the Brentwood, Tenn.-based health system are at risk of being out of the insurer's network Jan. 1, according to North Carolina Health News.
Here are four things to know:
1. At least five Duke LifePoint hospitals are in contract negotiations with UnitedHealthcare. Two of the hospitals — Maria Parham Medical Center in Henderson, N.C., and Person Memorial Hospital in Roxboro, N.C. — are already out of network with UnitedHealthcare after their contracts expired earlier this month.
2. The hospitals say UnitedHealthcare's reimbursements are too low. "Our current contract is not sustainable," a spokesperson for Frye Regional Medical Center in Hickory, N.C., one of the hospitals included in the negotiations, told North Carolina Health News. "UnitedHealthcare pays Frye Regional below market average for hospital and physician services."
3. UnitedHealthcare says meeting the hospitals' demands would increase costs by $11.3 million over three years for employer-sponsored and individual plans. That amount doesn't include additional costs associated with UnitedHealthcare Medicare Advantage plans, according to the report.
4. The hospitals have notified patients that they could be out of network for UnitedHealthcare Jan. 1.
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