TO THE EDITOR:
In December 2022, Conway Regional Health System and its associated physicians notified UnitedHealthcare of its intent to terminate its agreement effective July 1. In a communication to employers and brokers across the state, United made inaccurate claims about Conway Regional, and these warrant a fair and measured response.
United has made claims that we demand rates that are “not affordable or sustainable.” At one point, United stated publicly that our proposal would make us “the most expensive hospital in the state.” Understandably, employers and patients suffering from rising inflation and various economic pressures do not want to have their rates increase.
United’s claims are simply untrue and unsubstantiated.
To refute United’s claims, let me first establish some basic premises. United is an insurance company that negotiates rates with hospitals and physicians for the services they provide. Those rates vary by health system and physician. We are not all paid the same rate for the same service we provide. Prior to 2021, hospitals (including Conway Regional) had no idea what other hospitals were paid.
Now, based upon publicly available data, we know that United inpatient rates with Conway Regional are approximately 50% less than other area hospitals. Based upon our review and in consultation with a third party, we have found United outpatient rates are about half of other insurance companies.
Same services, dramatically lower rates.
In our negotiations with United, Conway Regional has consistently and unwaveringly sought near parity rates. We have repeatedly made clear to United that we do not seek to be the high-cost, high-rate provider in the market, only near parity rates. To get to market will require a significant increase, but not the increase United reports.
Given the current health care landscape where costs have risen so dramatically, we cannot tolerate this kind of inequity in rates and expect other payers such as Blue Cross, Cigna and Aetna to pick up the slack. If United gives favorable pricing to one hospital and pays half that rate to another, why is it unreasonable for the underpaid hospital to request to be reimbursed at a market rate? Why should other payers and employers pay more to make up the difference?
But what would happen if Conway Regional were not in the United network? Every employer I speak to emphatically states that cost would increase dramatically because United’s rates with those other in-network providers are higher. So, who created the dilemma we are presently in?
We must assume United must pay those higher rates to other health systems to maintain network integrity and be “at market.” Perhaps United doesn’t consider Conway Regional as essential to selling their product. Why is it OK for United to leverage the market to lower costs but wrong for Conway Regional to pursue a reasonable and fair rate for its services?
The men and women who serve in health care are some of the best and brightest people in our community. My role as their CEO is to honor their sacrifice in a way that is economically viable so that we are here for the next 100 years of service. To accept payment at a rate that’s dramatically below market and other insurance companies is to do a disservice to them and our community.
What’s at stake here isn’t merely a business relationship between hospitals and insurers. It’s about the viability of essential services in our communities and staying true to the mission of serving the people who rely upon us.
United needs to do what’s right.
Sign up for Daily E-news
