The University of Vermont Health Network will be out of network with UnitedHealthcare's commercial plans April 1 without a new contract.
More than 2,600 employer-sponsored and individual commercial members in Vermont and northern New York will lose coverage for the Burlington-based health system’s hospitals, facilities and physicians. Some fully insured members in New York will see an extension that ends June 1, according to a Feb. 21 news release from UVMHN.
UVMHN said UnitedHealthcare is terminating the contract, while the payer told Becker's the health system is asking for a 15 percent increase in reimbursement rates on top of previous increases.
"We are disappointed they have made this decision rather than attempt to come closer to payment rates approved by the Green Mountain Care Board that more accurately reflect the cost of providing health care in 2023 and align with rate increases negotiated with other Vermont payers," Sunny Eappen, MD, President and CEO of the UVMHN, said.
"Despite receiving a nearly combined 20 percent increase in reimbursement rates over the last three years, UVMHN is now proposing a more than 15 percent price hike in one year," a UnitedHealthcare spokesperson said. "However, in anticipation of the health system leaving our commercial network on April 1, we are committed to collaborating with UVMHN to ensure the people we serve have access to the care they need through either continuity of care or a smooth transition to a new provider."
UnitedHealthcare said it is still open to negotiations. The impasse does not impact Medicare Advantage plans or the Veteran Affairs Community Care Network. UVMHN also participates in UnitedHealth's New York Medicaid plan.