Baptist Health and United Healthcare dispute the payment

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Baptist Health and United Healthcare dispute the payment

LITTLE ROCK, Ark. – Arkansas’ largest healthcare provider could soon lose network for a major insurance payer if an agreement on reimbursement rates cannot be reached.

Baptist Health and United Healthcare have been in talks to reach an agreement but are currently in negotiations.

If an agreement is not reached by the end of the year, those with out-of-network insurance, and that includes those seeking treatment at all Baptist locations and providers.

We contacted Baptist Health and United Healthcare for more information and they responded as follows:

Cara Wade, spokeswoman for Baptist Health, said: “Arkansans are experiencing inflation at a rate not seen in years. Arkansas hospitals are also being affected by an unprecedented increase in costs such as wages, supplies, and drugs . reimbursement rates in the country, according to government and private studies including RAND Hospital Price Transparency Round 4.

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While Baptist Health continues to improve operational efficiencies and cost management, it is not enough to overcome the growing external cost pressures.
Over the past several years, Baptist Health has partnered with our insurance payers to pave the way toward addressing the nation’s low reimbursement rates. While we have found mutually beneficial ways to maintain the majority of payers, we have not yet reached an agreement with all payers for 2024. There is a possibility that some agreements will not be reached at the end of year. If an agreement cannot be reached with a particular payer by the end of the year, patients with insurance will be out of network coverage for all Baptist Health locations and providers starting Jan. 1, 2024. Baptist Health Website.

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Fortunately, there are federal and state laws to protect continued access to care in situations like this. Many patients with employer-sponsored health insurance who have a qualifying medical condition (eg pregnancy) can formally elect to continue Baptist Health care for up to 90 days. We recommend patients contact their insurance plan to determine eligibility and complete any applicable forms. All patients will continue to have access to Baptist Health hospitals for emergency services. Regardless of network status, state retirees should continue to have access to Baptist Health under the various plans available, but again, we recommend contacting your insurance plan for details.
For more than 100 years, Baptist Health has provided all of our best in health care through Christian compassion and innovative services. We consider it a privilege to serve those who entrust us with their care, and greatly appreciate your patience and understanding during this challenging time.”

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United Healthcare’s statement: “Our goal is to renew our longstanding relationship with Baptist Health to ensure that the members we serve have continued, uninterrupted access to Baptist hospitals and physicians. Unfortunately, Baptist continues to request a double-digit rate increase that is neither affordable nor sustainable. We are proposing a meaningful, market-competitive rate increase that ensures Baptist is paid fairly. We are asking Baptist to work with us to achieve a agreements available to families and employers across Arkansas.

As for when we can expect to see this resolved, that remains unclear, but we do have some context from other hospitals.

Earlier this year, Conway Regional went through something similar, and it took over a month to resolve.