CHI St. Vincent, one of the largest health care providers in Arkansas, could be out of UnitedHealthcare’s insurance network starting April 1 if an agreement over reimbursement rates isn’t resolved.
CHI St. Vincent is the latest Arkansas provider to battle the insurance company based in Minnetonka, Minnesota, over reimbursement rates.
“Our goal is to stay in network with United,” said Chad Aduddell, market president at CHI St. Vincent, which has four hospitals in Arkansas. “I think we’re getting closer. But in order for us to be in network, we’re going to have to reach a proposal that’s financially sustainable for St. Vincent.”
CHI St. Vincent covers about 70,000 UnitedHealthcare patients, about 15,000 through its commercially insured product, and about 55,000 through Medicare Advantage, Aduddell said.
He said CHI is asking “for a very modest increase” from UnitedHealthcare.
“Were were making requests that keep us competitive with other health care providers in the market, but we’re not even keeping up with the cost of inflation on salaries, wages and benefits, and certainly not keeping up with inflation and supplies and pharmacy,” Aduddell said.
But UnitedHealthcare has a different view of the negotiations.
“CHI St. Vincent is seeking a nearly 25% price hike for our commercial plans over the next three years, along with a rate increase for our Medicare Advantage plans that would make them the most expensive in our Arkansas network,” UnitedHealthcare said in a statement to Arkansas Business. “Our top priority is to reach an agreement that remains affordable and ensures continued access to the health system. We hope CHI St. Vincent shares our commitment and collaborates on solutions that Arkansas families and employers can afford.”
Aduddell said he doesn’t agree with UnitedHealthcare’s assessment of the negotiations.
CHI St. Vincent’s request for an increase “doesn’t even keep pace with what we’re seeing in inflation, from any of the categories, wages to supplies to pharmacy. It just, it just doesn’t.”
Aduddell said CHI St. Vincent, like other hospital systems, have struggled in recent years with rises in costs such as wages, supplies and pharmaceuticals. In addition, Arkansas hospitals have some of the lowest reimbursement rates in the country.
Aduddell said CHI St. Vincent is estimating an $80 million to $85 million loss this fiscal year which ends June 30.
“We have reduced some services and cut some expenses,” he said.
If UnitedHealthcare is unable to reach an agreement with CHI St. Vincent, CHI providers and its hospitals will be out of network for UnitedHealthcare policyholders.
Last year, Baptist Health of Little Rock, was out of the UnitedHealthcare network for more than a month when both sides couldn’t agree on a contract.
Aduddell said as the multi-year contract with UnitedHealthcare comes to an end, “the two sides need to come together and get this done so that patients aren’t impacted.”
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