Premier, UnitedHealthcare stalemate continues in negotiations

Dayton-based Premier Health and UnitedHealthcare are still at odds in their ongoing negotiations to restore in-network access to Premier hospitals for thousands of patients covered by UHC health plans and also maintain Premier physicians as part of UHC’s network.

Both sides have agreed to extend hospital and physician coverage for seniors with Minnesota-based UHC’s Medicare Advantage plans until the end of this year, but the stalemate continues over coverage for those with individual or employer-sponsored coverage.

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Physicians employed by Premier — southwest Ohio’s largest hospital network with more than $2 billion in annual revenue — will be considered out-of-network at midnight Saturday for UHC members with employer-sponsored and individual health plans and those with Medicaid plans managed by UHC.

Premier acknowledged the urgency to reach a deal before the final deadline passes.

“At Premier Health, 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,” Premier said in a statement.

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Failed contract negotiations have already left thousands of UHC policyholders in the Dayton-area scrambling to find new in-network facilities after their hospital contract expired April 29, a situation UHC said it hopes to avert before the deadline for physicians’ contract passes.

“We remain in discussions with Premier,” the giant health insurer said in a brief statement.

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All toll, about 70,000 residents in the Dayton-area enrolled in UHC health plans this year.

The sticking point in the contract negotiations revolves mainly around Premier’s decision not to participate in UHC’s health plan design, which ranks hospitals and providers in tiers based on cost and quality.

Premier argues it would be inherently disadvantaged by the tiered system, which, Premier says, would also limit consumer choice. UHC argues the plan design encourages consumers to choose the most cost-efficient care providers, helping to drive down health costs for consumers in the long run.

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