Across the country, nearly 50 million people rely on UnitedHealthcare to access affordable, high-quality health care. Our provider network, one of America’s largest, ensures that every person we serve can access care — whenever and wherever it’s needed. Part of maintaining that network is negotiating provider contracts — about 2,000 each year. The vast majority of these agreements are negotiated in good faith with no disruption to patient care. We maintain good relationships with more than 120 hospitals, approximately 12,000 primary care physicians, and more than 27,000 specialists throughout Virginia, Maryland, and Washington, D.C. That includes health systems such as MedStar, the University of Maryland Medical System, Inova Health, and Privia Health, just to name a few.
Unfortunately, we do have some hospital systems and provider practices that choose to negotiate their positions through the media and put the people they care for at the center of the dispute. Two examples of this cynical strategy, which are playing out in the Washington, D.C.-metro area, mark the first major disruptions to our network in the market in several years. This has left tens of thousands of people scrambling to find alternatives for their care. The path through these disputes must be one that ensures affordable, equitable access to care for everyone.
Let’s start with Johns Hopkins, one of the most venerable institutions in medicine, which demanded unacceptable stipulations asserted by no other health system in the country. We appreciate the cost pressures health systems face, and we admire the trust people place in the care Johns Hopkins provides, which is why we went into negotiations eager to reach a fair and equitable agreement.
Yet, this dispute isn’t about money. We agreed to rate increases they sought. The issue is access — specifically, protecting equal access to care for the people we serve.
Johns Hopkins sought provisions that would allow it to refuse treatment for any employer it does not want to do business with. In other words, as an in-network provider, it wants the right to turn away UnitedHealthcare members at its discretion. Imagine showing up at the hospital or clinic and being told that you can’t see your doctor because Johns Hopkins doesn’t want to do business with your employer.
Our members rely on our network for consistent access to the care they need. We have a responsibility to uphold that, and we expect all providers in our network to honor their commitments to treat everyone. A provider that selectively and unilaterally turns patients away — regardless of medical need or coverage — disrupts equitable access to care. That not only undermines the foundation of what it means to be a network provider, it also erodes trust in the U.S. health care system.
In our negotiation with Capital Women’s Care (CWC), a large mid-Atlantic obstetrics and gynecology (OB/GYN) practice, the issue is about money — specifically higher costs for consumers and employers.
CWC sought double-digit payment increases for services under commercial, Medicaid, and Medicare Advantage plans, which would have made CWC more than 30% more expensive than the average of other OB/GYN providers in UnitedHealthcare’s Maryland and Virginia commercial network. In real dollars, CWC’s bill for a standard delivery would be more than $2,600 higher than the average cost of OB/GYN providers in our commercial network in Maryland; the cost of a C-section from a CWC provider would be more than double the average cost of providers in our Maryland commercial network. The majority of these cost increases would fall on patients and families.
New parents, who are already feeling squeezed in this economy, shouldn’t also have to contend with massively inflated costs before their babies even come home. Such rampant price increases make health care more expensive for all our members, and it’s happening across the country. This year, the cost of health care is set to increase more than three times the rate of inflation. At a certain point, out of control costs themselves limit access. UnitedHealthcare alone can’t stop that, but we have a responsibility to work for reasonable prices that pay doctors fairly and preserve access to care for everyone.
We know this is deeply personal. We aspire for everyone to have access to the best care possible. But what does it mean to have a top health system in our network if they can turn you away just because they want to? What good is high quality health care if no one can afford it?
We are doing everything we can to reach agreements. Recently, Johns Hopkins informed us it is walking away from discussions because we will not agree to a contract that allows it to turn patients away from an in-network provider. However, we will remain at the negotiating table as long as it takes. We hope Johns Hopkins and CWC will join us there and work toward reasonable solutions that protect patient access for all.
Joseph Ochipinti is UnitedHealthcare’s CEO for the Mid-Atlantic region.
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