IU Health announces contract reached with UnitedHealthcare

Feb. 07--Area residents were elated Thursday morning upon learning that IU Health and UnitedHealthcare had signed a new two-year contract agreement. The agreement, which will be retroactive to Jan. 1, 2014, will restore official in-network coverage to the 664,000 Indiana patients insured by UnitedHealthcare who receive care at IU Health facilities and by IU Health providers -- such as IU Health Bloomington Hospital and IU Health Southern Indiana Physicians.

IU Health and UnitedHealthcare had been involved in ongoing negotiations since last year, but had been unable to agree on a new contract before the existing contract expired on Dec. 31, 2013. IU Health had been granting temporary in-network status to UnitedHealthcare-insured patients since the old contract expired, but some of those patients were complaining about higher deductibles and out-of-pocket maximums.

"Oh my God!", said Colleen Bailey, who's been receiving chemotherapy treatments at IU Health Bloomington Hospital since November for breast cancer, and had initially feared the impasse would cause her out-of-pocket expenses to double from $6,000 to $12,000. "This is fantastic news."

Bailey said UnitedHealthcare last month gave her a "gap exception" for her chemotherapy treatments along with any associated costs, meaning she could apply them all to her in-network deductible.

"But it's been a huge hassle," she said. "I've been on the phone with them every day concerning the bills I've been getting -- for things like blood work done in my doctor's office. The doctor is supposedly still in-network, but the lab in his office is with IU Health, so they were applying that bill to my out-of-network deductible."

Bailey said she's also had to fill out numerous "continuation of care" forms, and still has not received forms UnitedHealthcare had promised to fax her several days ago.

"This resolution will result in a lot fewer headaches for me," she said. "It was bad enough lying awake at night thinking about cancer. It made things harder lying awake at night thinking about how I was going to pay for it."

Marjorie Blewett, an 86-year-old Bloomington resident who's covered by Medicare but has a secondary AARP policy through UnitedHealthcare, seemed downright giddy about the resolution of the months-long impasse.

"Thank goodness!" she said. "I feel relieved that I get to keep my doctor and my hospital. That whole conflict was really confusing for me at a stage in life when I didn't want to be confused."

Bloomington retiree Jim White, 76, was also delighted that IU Health and UnitedHealthcare were able to settle their differences. White has a Medicare supplemental health insurance policy through Zerox, the company he used to work for. UnitedHealthcare is the policy's administrator.

"This comes as a great relief, not only to me but to our three grown children," White said. "This was putting a real pinch on them too."

Both parties compromised

IU Health spokeswoman Whitney Ertel said the main sticking point between IU Health and UnitedHealthcare was the issue of "tiering."

"If they (UnitedHealthcare) were wanting to direct care to our facilities only in times of severity, that expertise naturally comes at a higher price than if patients were free to really utilize IU Health as truly in-network," Ertel said. "Volume and pricing go hand in hand. IU Health believes that all patients need choice and access to high quality, affordable care."

Ertel said both parties made concessions to reach the resolution.

"While we are pleased to have concluded negotiations, we would have readily agreed to these final terms in December," she said. "We continue to make decisions in the best interest of our patients and sincerely regret any unnecessary stress or inconvenience the extended discussions may have caused patients, physicians and employers."

Mark Moore, president and CEO of IU Health Bloomington, said, "I'm pleased that we have concluded negotiations with United Healthcare so that our patients can continue to easily receive care from IU Health Bloomington and IU Health Southern Indiana Physicians. The best interest of our patients will always be our top priority in these types of negotiations and arrangements."

Dr. John Kohne, chief medical officer of IU Health, said in a statement that he wanted to thank the health system's patients for their loyalty and patience.

"While we are pleased to have reached an agreement with UnitedHealthcare, it's unfortunate that our patients experienced any unnecessary stress or inconvenience," he said. "We remain committed to offering Hoosiers the nationally recognized, affordable healthcare they deserve."

Jessica Kostner, spokeswoman for UnitedHealthcare, said the two parties are now putting the finishing touches on the new contract.

"Over the next several days, UnitedHealthcare will be finalizing the details of our formal agreement with IU Health so that our members continue to have uninterrupted access to care, and we are able to maintain our relationship with this valued hospital and physician group."

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