Baptist Health Out of Insurer’s Network

Baptist Health Medical Center in Little Rock

Baptist Health of Little Rock, the largest health care provider in Arkansas, has been out of UnitedHealthcare’s insurance network since Monday, as both sides couldn’t reach an agreement in negotiations over reimbursement rates.

UnitedHealthcare said in a Jan. 2 statement on its website that Baptist Health sought “double-digit price hikes that are neither affordable nor sustainable for families and employers across Arkansas.”

Other Arkansas hospitals also have had a dispute with UnitedHealthcare’s reimbursement rate in recent months.

Baptist Health said in a statement to Arkansas Business that Arkansas hospitals have seen costs rise for wages, supplies and pharmaceuticals at the same time Arkansas hospitals receive the lowest overall reimbursement rates in the nation by “a significant margin.”

As a result, Baptist Health said it could no longer accept the “nationally-low reimbursement rates” to continue to deliver health care to the communities it serves.

While Baptist Health’s offer to UnitedHealthcare “includes reimbursement rates that meet immediate needs,” the offer is “still well below the national average, and are below what UnitedHealthcare already pays to other hospitals in surrounding cities,” such as Texarkana, Texas, Springfield, Missouri, Shreveport, Louisiana, Tulsa and Memphis, health system spokeswoman Cara Wade said in a statement to Arkansas Business.

And while Baptist Health said it improved operational efficiencies and controlled costs, it hasn’t been enough to overcome rising expenses. Baptist Health reported an operating loss of $12.93 million in 2022, as the financial stresses of COVID-19 continued to course through health care systems.

Baptist Health said it reached agreements for 2024 with all large payers except UnitedHealthcare. “Unfortunately, UnitedHealthcare has taken a different approach and is posting what Baptist Health believes is misleading and negative information that does little to address the undisputed reimbursement challenge that has developed over many years,” Wade said. 

A UnitedHealthcare spokesman said in an email that Baptist Health is about 20% higher in cost compared with other peer hospitals throughout Arkansas. “Yet the health system proposed a one-year, 15% price hike and recently communicated to us it would also be seeking a double-digit rate increase in the second year of our contract,” the spokesman said. “We have proposed a multi-year contract that includes meaningful rate increases that ensure Baptist is reimbursed at more than fair and reasonable rates. 

“We ask that the health system either finalize the terms of our proposal or provide a reasonable proposal Arkansans and local employers can afford,” the spokesman said via email. 

As a result of not being able to reach a deal, Baptist providers and hospitals are out of network for UnitedHealthcare policyholders in employer-sponsored and individual commercial plans, Medicare Advantage and Group Retiree plans, as well as Dual Special Needs Plans, according to a statement on UnitedHealthcare’s website. 

Baptist Health has 12 hospitals in Arkansas and more than 100 primary and specialty care clinics in the state.

“While this is not the outcome we have been hoping for, we believe it’s necessary if we are to achieve our goal of ensuring families and employers in Arkansas have access to affordable care,” Baptist Health said. 

Conway Regional Health System initially left UnitedHealthcare’s network on July 1 after tough negotiations over reimbursement rates failed to produce an agreement. In August, Conway Regional announced it had a new deal with UnitedHealthcare.