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UnitedHealthcare Agrees to Extend In-Network Coverage to UVM Health Network Patients For Remainder of 2023

Extension Allows Commercial Insurance Plan Members Additional Time To Determine Alternative Care Or Medical Coverage Options

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Frequently Asked Questions - UnitedHealthcare Commercial Contract Extension

Burlington, Vt. – The University of Vermont Health Network will remain in-network for UnitedHealthcare Commercial insurance plans through the end of the 2023 calendar year as part of a recent agreement between the non-profit health system and one of the nation’s largest insurance carriers.

This extension agreement will allow affected patients additional time to identify alternative medical insurance coverage or health care options starting with their 2024 plan year. 

Who does this impact?

Only Commercial UnitedHealthcare plans, such as those provided by employers or purchased directly, are affected by this extension agreement through December 31, 2023 and expected subsequent termination. 

The following plans have NOT been impacted by these renewal negotiations:

  • Non-Commercial UnitedHealthcare plans managed by the state or federal government – such as Medicare Advantage, Managed Medicaid, VA Community Care Network  
  • United Medicare Supplement plans 
  • United Behavioral Health plans  
  • The Empire Plan for New York State Employees 

“We’re glad that United has agreed to extend this coverage for the remainder of 2023 to help give our patients the time they need,” said Sunny Eappen, MD, MBA, President and Chief Executive Officer of the UVM Health Network. “This situation has caused much stress and anxiety for our patients and we hope this extension helps to ease some pressure in the face of a frustrating situation. We would like to thank everyone who has been supportive of our patients and our health system throughout this process, especially our community members and state and federal government leaders.”

What does this mean for those who are UnitedHealthcare Commercial Plan members?

As part of this extension agreement, UVM Health Network will remain in-network for all patients covered by United Commercial Insurance plans through December 31, 2023. Based on conversations with United to date it is not likely we will continue to be in-network in the 2024 plan year, despite our best efforts to come to a fair agreement.

Patients or employers who are affected may use this additional time to identify insurance options that keep UVM Health Network in-network post December 31, 2023, or work with their health care provider to transition to an alternative in-network option. 

As a safety net provider, the UVM Health Network will always provide emergency care to anyone who walks through the door, regardless of what insurance they have or whether they have insurance at all. 
For information specific to insurance coverage, affected patients should contact UnitedHealthcare directly. Additional UVM Health Network-specific information may be found at UVMHealth.org/UnitedHealthcare

Additional Information

  • The extension agreement with United does not include any increases and maintains the same rates from the 2022 fiscal year contract, which will have a negative impact on the Network’s finances. 
  • Nationally, hospitals continue to struggle under increased expenses of providing care, while many of the nation’s largest insurers continue to post profits in the billions.  
  • As a nonprofit organization, the UVM Health Network does not distribute funds to shareholders, and any operating margin earned goes directly back into paying staff, purchasing up-to-date equipment, and investing in top-tier facilities that patients deserve.

Despite the financial impact, UVM Health Network leaders said the extension is meant to support patients as part of the Network’s non-profit mission. “Our health system is a trusted part of our communities throughout Vermont and northern New York,” Eappen said. “While we have to do everything we can to stay financially solvent, our priority has been to do our part to minimize disruption for those seeking care.”
 

 

 

Originally published February 21, 2023

Burlington, Vt. – Since last year, The University of Vermont Health Network has worked to reach a new agreement on behalf of patients who receive commercial insurance through UnitedHealthcare. Despite many attempts to preserve patient access to care, United, one of the nation’s largest for-profit insurers, has decided to allow that contract to expire as of April 1, 2023, in line with state requirements that may lead to some coverage in New York being extended through June 1.

Only Commercial UnitedHealthcare plans, such as those provided by employers or purchased directly, are affected by this non-renewal. 

Plans NOT Impacted: 

  • Non-Commercial UnitedHealthcare plans managed by the state or federal government – such as
    • Medicare Advantage  
    • Managed Medicaid 
    • VA Community Care Network  
  • United Medicare Supplement plans 
  • United Behavioral Health plans  
  • The Empire Plan for New York State Employees 

“This will have a serious impact on our patients who subscribe to UnitedHealthcare’s commercial insurance, and we are disappointed they have made this decision rather than attempt to come closer to payment rates approved by the Green Mountain Care Board that more accurately reflect the cost of providing health care in 2023 and align with rate increases negotiated with other Vermont payers,” said Sunny Eappen, MD, MBA, President and Chief Executive Officer of The UVM Health Network. “Our obligation is to our patients, families, staff and communities, not to UnitedHealthcare shareholders, and we will continue working hard to provide high-quality patient care while remaining one of the lowest cost health systems in the country, and doing our best to support patients who will be impacted by this decision.”

UVM Health Network proposed a plan that would have allowed current patients to continue accessing care with their United coverage through the end of 2023, under financial terms that would have had a negative impact on the health system. This would have allowed patients time to seek new insurance and treatment plans. However, that request was denied by United, and their more than 2,600 commercial members in Vermont and northern New York will be out of network (with certain exceptions). 

Resources for Patients

This page will be kept up to date with FAQs and resources for UnitedHealthcare members to help navigate this transition.

UVM Health Network team members will provide as much support to patients as possible from the provider perspective, but for questions specific to a UnitedHealthcare plan, patients should contact United directly. 

  • Many patients currently undergoing a course of treatment, such as cancer treatment or pregnancy care, will likely be entitled to continued coverage at the in-network level for a transition period. Patients should contact UnitedHealthcare for specifics.
  • As a safety net provider, the UVM Health Network will always provide emergency care to anyone who walks through the door, regardless of what insurance they have or whether they have insurance at all. 
  • 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.
  • 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 contacting them directly.

Decision Reflects Nationwide Trends for Hospitals, Insurance Companies 

UnitedHealthcare’s decision reflects a nationwide trend, as hospitals struggle under increased expenses of providing care, while many of the nation’s largest insurers – including UnitedHealthcare – continue to post profits often in the billions. 

In 2022, UnitedHealth Group, UnitedHealthcare’s parent company, distributed approximately $13 billion to shareholders. The UVM Health Network, like all of Vermont’s hospitals, is a nonprofit organization. Any operating margin is not paid to shareholders, but instead goes directly back into patient care such as through paying staff, purchasing up-to-date equipment and investing in top-tier facilities that patients deserve.

Facing significant financial, operational and workforce challenges, the Network reported a $90 million loss for fiscal year 2022. “We’re working hard to overcome those challenges, so we can be here for our patients and communities in the long run,” Dr. Eappen said, pointing to the organization’s Path Forward financial stabilization work, as well as investments in housing for employees and plans for a new Outpatient Surgical Center that will both improve patient access and support the organization’s financial stability in the future.

In contrast, UnitedHealthCare reported revenue growth of nearly 12% year over year, to $249.7 billion in 2022. UnitedHealthCare’s operating earnings alone (one way of describing profits) were $14 billion in 2022, dwarfing the $3.1 billion total required annually to operate the entire UVM Health Network in Vermont and northern New York.

Vermont remains the lowest cost state in the country for Medicare per capita expenditures, led by the health service areas where Network affiliates Central Vermont Medical Center, Porter Medical Center and UVM Medical Center are located. The UVM Medical Center has also recently been ranked first among academic medical centers in the country for value.

To remain solvent and continue providing patient care, the UVM Health Network and all other hospitals and health systems must negotiate reasonable, responsible insurer contracts to cover the expenses of caring for patients covered by each insurance company.