The Peru Gazette

I’m writing to let you know about a developing situation affecting some of our patients in Vermont and Northern New York: In spite of our best efforts to reach a new agreement, UnitedHealthcare has decided to terminate its commercial insurance contract with the UVM Health Network when that contract expires on April 1. UnitedHealthcare’s decision does not impact other contracts with them, such as Medicare Advantage.

As of April 1, our hospitals, providers and skilled nursing facilities will no longer be able to provide in-network coverage to 2,660 UnitedHealthcare subscribers and their families. Extensions will apply for some patients: For example, any patients currently undergoing a course of treatment, such as cancer treatment or pregnancy care, likely will be entitled to continued coverage at the in-network level for a transition period. Patients should contact UnitedHealthcare for specifics. Additionally, as nonprofit health care providers, we will always care for patients in need of emergency care regardless of their insurance coverage.

UnitedHealthcare is expected to begin contacting patients who are affected by this situation as soon as this week. Our Network is undertaking outreach efforts: We have made information available to UnitedHealthcare policyholders on our website (UVMHealth.org/UnitedHealthcare), and we’re providing information for patients to our clinics and call centers. Patients should work with their current UVM Health Network provider to ensure a smooth transition to a new provider if they choose. A list of in-network providers can be found through UnitedHealthcare’s website or by contacting them directly.

The UVM Health Network’s mission is to provide high-quality health care to everyone we serve, and we are deeply concerned when decisions like this impact our patients. We apologize for the disruptions this situation may cause in your community, and across our region. It’s important to note that, for years, our ability to provide timely and appropriate care to patients covered by UnitedHealthcare’s commercial insurance plans has been affected by significant administrative and operational issues. Additionally, despite their financial strength, UnitedHealthcare has made every attempt to undercut their reimbursement rates to our nonprofit health system, which negatively impacts our budget and our ability to invest in patient services, our workforce and our facilities.

Last year, we were able to reach a last-minute agreement with UnitedHealthcare to keep their commercial customers in-network. Unfortunately, UnitedHealthcare has made the decision to end negotiations for renewal of the current contract. We proposed a plan that would have allowed current patients to continue accessing our care with their UnitedHealthcare coverage through the end of 2023, under financial terms that would have had a negative impact on our health system. But UnitedHealthcare declined.

There’s a dynamic happening nationwide that is harmful both to patients and to health care providers: As hospitals and health systems, including ours, struggle under the increased expenses of providing care, many insurers are posting high profits. We’re seeing that same dynamic in the current situation with UnitedHealthcare. As a health system, we need to be able to negotiate reasonable, responsible insurer contracts that allow us to meet our patients’ needs while allowing our providers to do their jobs, so we can be here for everyone we serve for the long run.

If you are impacted by UnitedHealthcare’s actions or know someone who is, please take the following steps regarding coverage or continuity of care:

• Go to our online resource for UnitedHealthcare members for information on how to navigate this transition. It can be found at UVMHealth.org/UnitedHealthcare.
• For questions specific to a UnitedHealthcare plan, patients should contact United directly.
• Patients who are receiving health insurance through their employer should speak with them about their available options.
• Patients enrolled in health insurance through non-employer plans may wish to change insurers during the next open enrollment period in order to ensure care at the UVM Health Network remains in-network.

Thank you for your continued leadership and partnership, and I’ll keep you updated on this situation and other news regarding the UVM Health Network and our communities.

Sincerely,

Sunny

Sunil Eappen, MD, MBA
President and CEO, The University of Vermont Health Network