Envision, UnitedHealthcare extend contract: 5 things to know

UnitedHealthcare and Nashville, Tenn.-based Envision Healthcare, one of the country's largest providers of emergency room services, agreed to extend their contract, effective Jan. 1.

Here are five things to know:

1. Under the agreement, UnitedHealthcare members will have in-network access to hospital-based services offered by Envision physicians.

2. Christopher A. Holden, president and CEO of Envision, said in a prepared statement, "We believe this is an opportunity for clinicians and payers to work together to make progress toward a more effective healthcare system."

3. On Sept. 21, UnitedHealthcare sent letters to more than 250 hospitals warning them it may drop Envision from its network starting in 2019. More than 1 million UnitedHealthcare members would have been affected by the contract termination.

4. UnitedHealthcare was ready to terminate its contract with Envision in April. At the time, UnitedHealthcare argued Envision wrongfully sued the payer and by doing so broke an arbitration clause in their agreement. The insurer also called Envision's emergency room billing practices "egregious." In March, Envision sued UnitedHealthcare for allegedly lowering contracted payments to Envision physicians and not allowing new Envision medical practices to join its network.

5. Surprise medical bills continue to be a controversial issue between payers and providers. On Dec. 10, nine organizations representing consumers, businesses and health insurance providers revealed they are banding together to protect patients from unexpected medical bills. But Federation of American Hospitals President and CEO Chip Kahn and American Hospital Association President and CEO Rick Pollack said the alliance is mischaracterizing the root of the issue, and inadequate health plan provider networks are a root cause of surprise bills.

More articles on payers:
CMS' final rule on risk adjustment payments: 3 things to know
BCBS of Wyoming customers overcharged due to banking error
ACA plan enrollment falls 11%: 3 things to know

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Top 40 articles from the past 6 months