Premier Health asks UnitedHealthcare policy holders to switch plans

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Premier Health asks UnitedHealthcare policy holders to switch plans

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Premier Health sent a letter this week to its patients saying “we strongly advise” those with UnitedHealthcare policies to consider switching plans, as both sides remain far from a deal that would let policy holders again get coverage at Premier doctors offices and hospitals.

The contract between UnitedHealthcare and Premier, the region’s largest health system, expired May 13 after negotiations fell apart. The two parties both said they are not close to a deal that would again bring Miami Valley Hospital, Atrium Medical Center and the rest of Premier Health’s affiliates back in network.

The dispute centers around the giant insurer’s plan to rank hospitals and doctors in tiers based on cost and quality, with the goal of incentivizing lower health care costs. Premier opposes the ranking system, which it says is already steering patients away from its hospitals and providers.

There are 70,000 UnitedHealthcare members who have used Premier facilities or physicians in the last year prior to May’s contract expiration and 200,000 patients with UnitedHealthcare in the Dayton region.

A Premier spokesman said the letter speaks for itself and the health system didn’t have additional comment.

In an Oct. 16 letter signed by Premier CEO Mary Boosalis, she states Premier has contracts with other plans like with Anthe Blue Cross/Blue Shield, Medical Mutual, Aetna, Human and Cigna.

“If your employer hasn’t offered another plan option other than UHC, consider asking your human resources department to either switch health plans or to provide a plan option that includes Premier Health as “in-network.”

Some local hospitals that remain in UHC’s network include Dayton Children’s, Grandview, Greene Memorial, Kettering Medical Center, Medical Center at Elizabeth Place, Soin Medical Center, Southview, Springfield Regional, and Sycamore.

Premier has a large network of primary care doctors under its umbrella, along with Miami Valley Hospital with an additional site at Miami Valley Hospital South, Good Samaritan Hospital, Atrium Medical Center and Upper Valley Medical Center.

Premier said the last offer it put on a table was for no rate increase in 2017, a 3 percent increase in 2018, a 3 percent increase in 2019 and no increase in 2020. UnitedHealthcare’s last offer is a 10 percent rate decrease in 2017, a 5 percent decrease in 2018, and a 5 percent decrease in 2019.

UnitedHealthcare has maintained none of Premier’s offers address the high cost of care that gets passed onto its customers. It said it is still open to conversation with Premier.

“Local employers are asking everyone to play a role in helping address the high cost of health care in Dayton, and we want to work with Premier on this goal, but to this point we have been unable to find a resolution that creates sustainable improvements.”

The insurer said it still has a broad network of physicians that its policy holders can see.

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