A contract dispute that threatened to leave more than a million UnitedHealthcare beneficiaries on the hook for surprise medical bills was settled last week after months of conflict.
The healthcare insurance giant had been battling physician staffing company Envision Healthcare, with UnitedHealthcare asserting that Envision demanded excessive prices for its services and contributed to the high cost of emergency department visits, saying data "indicates that Envision physicians charge on average 975% of Medicare for their services."
Envision, which staffs hospital emergency, radiology, anesthesiology and other departments, said there were never any problems until UnitedHealth demanded massive cuts to allow it to stay in-network, according to Healthcare Finance. UnitedHealthcare said it offered Envision competitive rates for all of their hospital-based services, similar to what other ER and hospital-based physicians are paid in other markets.
Complicating the feud was the fact that Envision is also a competitor to UnitedHealthcare's sister company Optum, which now owns surgery centers and doctors.
In May, a court ordered arbitration between the insurer and network provider after dismissing a lawsuit brought by Envision claiming UnitedHealthcare changed its payment rate agreement, and on Sept. 21, UnitedHealthcare sent letters to hospitals warning them it may drop Envision from its network starting in 2019.
Had the two companies not extended their contract, UnitedHealthcare members would have been facing surprise bills for out-of-network charges when seeing an Envision physician, even if the physician worked at an in-network hospital.
"We are pleased to continue our long-term relationship with UnitedHealthcare by successfully extending our agreement to ensure patients have in-network access to Envision Healthcare hospital-based clinicians," Envision President and CEO Christopher Holden said in a statement. "We believe this is an opportunity for clinicians and payors to work together to make progress toward a more effective healthcare system."