Here’s a trend we saw in 2020 and will likely continue to see in 2021: UnitedHealthcare forcing providers to choose between accepting dramatic pay cuts or being cut out of United’s network. Given the current financial climate, most providers are not in a position to choose the former, and the result is that we’re seeing more and more providers pushed out of the insurance giant’s network. This happened to CaroMont Health in Gaston County, NC recently, and scarcely a month later, it’s happening again. Montefiore Health System in the Bronx, NY, is now officially out of network with United after United stalled negotiations and ultimately refused Montefiore’s attempts to strike a deal in the final hours of the contract on December 31, 2020. This dispute is a particularly big blow because of the role the health system plays in the community. Besides the 60,000 United members impacted by the situation, Montefiore provides safety net services to many underserved and vulnerable NYC patients—the same population that continues to be hit the hardest by the COVID-19 pandemic. And while it takes a village to care for a community, United doesn’t seem willing to do their fair share and contribute at the same financial level that most other payors do, according to news accounts. United may see itself as exceptional because of its ability to reduce healthcare costs by cutting provider payments, but the only truly exceptional thing here is United’s refusal to support critical health infrastructure during a global pandemic.
United kicks off 2021 by cutting a critical NYC safety-net health system from its network as COVID-19 cases reach record highs
On December 22, lohud predicted UnitedHealthcare’s dispute with one of New York City’s most critical providers could create an access crisis for the city’s most vulnerable patients. On January 1, that prediction came true.
