Mayo, UnitedHealthcare ink contract for Medicare Advantage members

Beginning Jan. 1, UnitedHealthcare's Medicare Advantage members will be in network at Mayo Clinic facilities in the Midwest under a new contract agreement between the two organizations, the Star Tribune reported June 23.

The move comes after the Rochester, Minn.-based health system began limiting appointments in late 2021 because of capacity concerns, which turned into a policy that blocked out-of-network patients from making appointments.

At that time, UnitedHealthcare did not have a network contract with the clinic for its Medicare plans, and servicing out-of-network Medicare Advantage patients often resulted in the clinic receiving reimbursements lower than those covered by contracted plans.

In February, Mayo told the Star Tribune that between 2019 and 2021, the number of its in-state patients with coverage from non-contract Medicare Advantage payers almost doubled to more than 3,200 people. Out-of-state patients in the same situation rose to 7,000 during the same period, Mayo told the publication.

Under the new contract, UnitedHealthcare's commercial plans for employers and individuals will remain in network with the clinic. The Medicare Advantage agreement does not include Mayo facilities in Arizona and Florida, a clinic spokesperson told Becker's.

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