UnitedHealth says St. Francis 2.5 times pricier than St. Louis market; hospital cites 25% price drop

Saint Francis Healthcare System in Cape Girardeau, Mo., will no longer be in UnitedHealthcare's provider network beginning March 5 after negotiations between the two organizations derailed, according to CBS affiliate KFVS 12 News.

The insurance company and hospital are in a gridlock over reimbursement rates, with UnitedHealthcare arguing Saint Francis outprices other providers in nearby St. Louis, while Saint Francis says the insurer is seeking payment cuts.

Dr. Maryann Reese, RN, president and CEO of Saint Francis, told the news station Jan. 27 that UnitedHealthcare sent a termination notice to the hospital Nov. 6, 2019. Dr. Reese expressed disappointment in the decision, saying Saint Francis has lowered prices by 25 percent since 2018, and can't accept UnitedHealthcare's proposed payment cuts. She said UnitedHealthcare customers reflect about 5 percent of Saint Francis' business.

On Jan. 27, UnitedHealthcare, the insurance unit of UnitedHealth Group, told KFVS 12 News that "the cost of care at Saint Francis Medical Center is nearly two and a half times more expensive than the average cost of the hospitals in our network in the St. Louis metropolitan area, where more competition among hospitals has driven costs down." The health insurer said it initiated contract negotiations with Saint Francis in the summer of 2019, but the hospital didn't respond to the communications for nearly three months.

To read more about the dispute, click here.

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