Mobile, Ala.-based Infirmary Health is out of network with UnitedHealthcare as of June 4.
The health system and insurer were unable to reach a new contract agreement, according to a June 5 news release from Infirmary. The split affects commercial members and individual plan members but does not affect UnitedHealth's Medicare Advantage plans.
Infirmary Health's three acute care hospitals, a long-term care hospital, freestanding emergency departments, imaging centers and other hospital-owned facilities are now out of network with UnitedHealthcare. Infirmary Medical Clinics are still in network with the insurer. The system is the largest private health system in Alabama.
Infirmary Health said in the release it is "experiencing an unprecedented rise in expenses, including supplies, labor, and pharmaceuticals along with payer denials of payment for services already rendered."
"While Infirmary Health continues to improve operational efficiencies to manage expenses, it is necessary that for-profit insurers, like UHC, provide fair reimbursement, and ultimately, prioritize the healthcare needs of their insured patients."
In a statement shared with Becker's, a UnitedHealthcare spokesperson said the insurer is "fully committed" to restoring network access to Infirmary Health hospitals.
"We're negotiating in good faith and have proposed rate increases that ensure Infirmary Health continues to be reimbursed fairly. We hope Infirmary Health shares our commitment to reach an agreement that’s affordable for the people and employers we collectively serve," the spokesperson said. "As we continue our discussions with Infirmary Health, our focus at this time is on ensuring Alabama and Mississippi families have access to the care they need through either continuity of care or a smooth transition to another hospital, as appropriate."
The number of contract disputes between payers and providers reported in the media has risen in recent years, according to research from FTI Consulting. The number of publicized disputes rose 69% from 2022 to 2023.
In the first quarter of 2024, at least 20 disputes between providers and payers were covered in the media, according to FTI Consulting. Of those, 50% failed to reach a timely resolution, a significant increase over the first quarter of 2023.