United Healthcare Patients Could Lose Coverage At WNC Duke LifePoint Hospitals

Nov 20, 2018


 As Duke Lifepoint hospitals wait to see what comes of the merger between Lifepoint and RCCH Healthcare, citizens of Swain, Jackson and Haywood county now have another healthcare issue: their insurance.

UnitedHealthcare announced that they are negotiating their contract with Duke LifePoint in late October. The company owns Haywood Regional Hospital, Swain Community Hospital and Harris Regional Hospital. Patients at all three hospitals received letters explaining that their contracts with United Healthcare will end on January 1st unless they can renegotiate the terms.

Sara Crawford, who is part of the public relations team at Harris Regional and Swain Community Hospital, explained in an email that the hospitals are negotiating with UnitedHealthCare because they are currently paying physicians “below market average rates.”

“Our goal in working with UnitedHealthcare is to secure a rate for our employed physicians’ services that allows continued reinvestment in patient care, enhanced services and facilities, recruitment of new physicians and caregivers and planning for our community’s healthcare future,” says Crawford on behalf of the hospitals.

The contact applies to all the physicians employed by Duke LifePoint hospitals but not the hospital itself. That means patients will still be covered for emergency room care. United Healthcare alleges that Duke LifePoint has been holding up negotiations, says spokesperson Cole Manbeck.

Manbeck explains that United Healthcare presented Duke LifePoint with a proposal in August and did not receive a response until November 1st.

For many in Western North Carolina, this may feel like a nasty flashback to a similar negotiation between Mission Healthcare System and insurance provider Blue Cross and Blue Shield of North Carolina last year. Their contract ended in July as well leading to back and forth negotiations that went on until December 2017.

In a role reversal, Harris Regional Hospital, which is now a part of negotiations with United Healthcare, saw  20 percent more patients during the time that Blue Cross Blue Shield patients were out of network at Mission Healthcare system hospitals. Blue Cross Blue Shield is the only healthcare provider on the Affordable Care Act marketplace for Western North Carolina so this affected a large percentage of people insured in the area.

 

Harris Regional Hospital is also one of the few hospitals in the region with a labor and delivery unit. They have seen a 70 percent increase in births since labor and delivery closed at Angel Medical Center in Franklin, NC last year.

 

The main point of negotiation between the two companies seems to be rates for physicians.

 

UnitedHealthcare says that Duke LifePoint is asking for rate increases of nearly 70 percent over three years for employer-sponsored and individual plans. The statement continues saying, “Rising medical costs are one of the most urgent issues facing North Carolina families, and while many health systems across the state are helping slow these unsustainable cost increases, DLP would rather put United Healthcare patients in the middle of this negotiation and continue with its egregious demands.”

The deadline for negotiations to be finalized between the two companies without any loss of coverage for patients is January 1st, 2019.