Premier Health and UnitedHealthcare have not reached an agreement in negotiations that would have preserved health plans for thousands of residents in the region, Premier officials said.
Dayton-based Premier Health, the largest health system in Southwest Ohio, and UHC, the nation’s largest health insurer, did agree Friday to extend Medicare Advantage coverage until the end of this year for UHC members who use Premier hospitals and providers.
However, the two sides remain at odds over a key issue for a portion of their contract that expires at midnight Saturday. Not reaching an agreement will displace tens of thousands of local residents with individual and employer-sponsored health plans.
Those policy holders will no longer have access to Premier hospitals as part of the insurance company’s network.
Premier physicians will be considered out-of-network on May 14 for employer-sponsored, individual and Medicaid plan members, according to UHC. And Premier hospitals and physicians will be out-of-network for Medicaid plans starting May 14.
In a statement, Premier Health said, “We are deeply disappointed that UnitedHealthcare has rejected our proposal to extend our contract until the end of the year. Our offer was put forth in good faith, and an agreement would have provided patients and area employers the opportunity to make choices about where and from whom to access care, during the normal open enrollment period for 2018.”
All toll, about 70,000 residents will be impacted in the area, according to UHC, which said Premier’s decision not to participate in the insurer’s plan design, which ranks hospitals and providers in tiers based on cost and quality, was the sticking point in the ongoing negotiations.
“We are committed to continuing discussions with Premier and working on an acceptable solution that ensures local employers can design competitive benefits that reward their workers for choosing quality, cost efficient care providers and restores network access to its hospitals,” said UnitedHealthcare in a statement.
Premier objects to the “tiering” system because, company officials said, it would intentionally steer patients away from Premier providers.