The insurer and health system reached a multiyear agreement covering UnitedHealthcare commercial and Medicare Advantage plan members, according to a July 19 news release from Prisma Health.
The agreement is retroactive to June 1, according to the release. UnitedHealthcare and the 18-hospital system split Jan. 1 after failing to agree on terms for a new contract.
The new arrangement covers all of Prisma Health’s hospitals, facilities and physicians, according to a statement on UnitedHealth’s website.
“We thank our members and customers for their support and patience throughout this process. We are honored to continue supporting all of the people throughout South Carolina who depend on us for access to quality and affordable healthcare,” the insurer said.
Prisma Health CEO Mark O’Halla said the agreement reflects “the increased costs we incur for the provision of medical care to our patients.”
“These terms will allow us to prioritize patients’ needs and provide our physicians and hospitals with the resources required to deliver high-quality health care to United health plan members,” Mr. O’Halla said.
The agreement comes after a contentious public fight that wound up in court. In January, a Prisma Health spokesperson told Becker’s that UnitedHealthcare refused “to enter a reasonable agreement that reimburses us for the cost increases we have and continue to absorb for their health plan members.”
A UnitedHealthcare spokesperson said Prisma Health had “maintained demands for outlandish price hikes.”
In August 2023, Prisma Health filed a request for a restraining order against UnitedHealthcare alleging the insurer broke its confidentiality agreement by disclosing details of contract negotiations to the media without Prisma’s knowledge.
The case was dismissed July 22, according to Greenville County, S.C., court records.
