We rang in 2021 with yet another big move by UnitedHealthcare: its decision to cut Envision Healthcare from its network after the two companies were unable to come to an agreement regarding physician reimbursement rates. As a result, some 25,000 Envision doctors in 44 states and the District of Columbia—primarily anesthesiologists and emergency physicians—are out-of-network for United members as of January 1, 2021.
Sound familiar? That’s because we’ve heard this story before. In 2018, United threatened to push Envision out-of-network over a rate disagreement, but the two sides ultimately came to a deal — only after Envision agreed to accept 22% rate cuts. Furthermore, United’s recent behavior toward Envision shows continuation of a trend highlighted by Healthcare Dive back in March of 2020: United pressuring private-equity-backed physician staffing groups (like Mednax, US Anesthesia Partners, and TeamHealth) to accept lower rates, and displaying a bullish willingness to cut them from their network entirely if the groups don’t agree to United’s terms.
As we continue to monitor the long-term implications of United wielding its power and influence across the industry (see: Optum’s acquisition of Change Healthcare, in the near-term, we’re most worried about how Envision’s out-of-network status could impact COVID-19 patients. After all, there is no end in sight to this pandemic. And to date, every 1 out of 10 patients hospitalized with COVID-19 has been cared for by an Envision physician. That means that United’s cost-sharing for out-of-network inpatient COVID-19 care could leave many patients with a gap in coverage. Although we’ve ushered in a new year, we already see more of the same from United: the ruthless pursuit of profit.
