24/06/2024

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Baptist Health and United Healthcare at odds over reimbursement

Baptist Health and United Healthcare at odds over reimbursement

A disagreement of medical insurance coverage could impact thousands of Arkansas families as it could lead to many being out of network at Baptist Health locations.

LITTLE ROCK, Ark — Arkansas’s largest healthcare provider could soon be out of network for a major insurance payor if an agreement over reimbursement rates isn’t reached. 

Baptist Health and United Healthcare have been in talks to reach an agreement but are currently still discussing.

If a deal isn’t reached by the end of the year, those with that insurance will be out of network, and that includes those who are seeking treatment at all Baptist locations and providers.

We reached out to both Baptist Health and United Healthcare for more information and they responded with the following:

Cara Wade, spokesperson for Baptist Health, said: “Arkansans have experienced inflation at a pace not seen in years. Arkansas hospitals have also been impacted by an unprecedented rise in costs such as wages, supplies, and pharmaceuticals. Adding to the challenge, Arkansas hospitals have been identified as having the lowest reimbursement rates in the nation, according to both government and private studies including RAND Hospital Price Transparency Round 4. 

While Baptist Health continues to improve operational efficiencies and cost management, it is not enough to overcome the growing external cost pressures.
Over the past several years, Baptist Health has worked with our insurance payors to develop a path towards addressing the nationally low reimbursement rates.  While we have found mutually beneficial ways to move forward with most payors, we have not yet been able to reach an agreement with all payors for 2024. There is a possibility that some agreements will not be reached by the end of the year. If an agreement is not reached with a particular payor by the end of the year, patients with that insurance will be without in-network coverage for all Baptist Health locations and providers beginning Jan. 1, 2024.  Information regarding contracted payors is posted on the Baptist Health website.

Fortunately, federal and state laws exist to protect continued care access in situations like this.  Many patients with employer-covered health insurance that have eligible medical conditions (e.g. pregnancy) can formally elect to continue receiving care with Baptist Health for up to 90 days. We recommend patients contact their insurance plan to determine eligibility and complete any applicable forms. All patients will continue to have access to Baptist Health hospitals for emergency services. Regardless of network status, state retirees should continue to have access to Baptist Health under the various plans available, but again, we recommend contacting your insurance plan for details. 
For more than 100 years, Baptist Health has delivered all our best in health care through Christian compassion and innovative services. We consider it a privilege to serve those who have entrusted us with their care, and greatly appreciate your patience and understanding during this challenging time.”

United Healthcare’s statement: “Our goal is to renew our long-standing relationship with Baptist Health to ensure the members we serve have continued, uninterrupted access to Baptist’s hospitals and physicians. Unfortunately, Baptist continues to request double-digit price hikes that are neither affordable nor sustainable. We are proposing meaningful, market-competitive rate increases that ensure Baptist is reimbursed fairly. We are asking Baptist to work with us to reach an agreement that families and employers across Arkansas can afford.”

As for when we could expect to see this resolved, that remains unclear, but we do have some context from other hospitals. 

Earlier this year, Conway Regional went through something similar, and it was resolved in a little over a month.